The equity implications of health system change in the UK (original) (raw)
Related papers
Health inequity in the UK: exploring health inequality and inequity
Practice Nursing, 2022
In this article, the first of two, Vanessa Heaslip et al examine the factors that lead to certain groups having poorer health outcomes in the UK Practice nurses are ideally placed within local communities to have a significant impact on addressing health inequities. However, to achieve this they need to understand the many factors that lead to certain groups having poorer health outcomes. Advances in longevity do not automatically match advances in health and wellbeing across all social groups. In the UK, someone living in a deprived area of England is more likely to die eight and a half years younger than someone living in a more affluent area. The COVID-19 pandemic has highlighted health inequities faced by ethnic minority groups in particular. This article, the first of two, will define the terminology used, explore access to health services in the UK and present the evidence driving healthcare policy.
Health Services Research, 2003
Goal. Assess the progress and pitfalls of current United Kingdom (U.K.) policies to reduce health inequalities.Objectives. (1) Describe the context enabling health inequalities to get onto the policy agenda in the United Kingdom. (2) Categorize and assess selected current U.K. policies that may affect health inequalities. (3) Apply the “policy windows” model to understand the issues faced in formulating and implementing such policies. (4) Examine the emerging policy challenges in the U.K. and elsewhere.Data Sources. Official documents, secondary analyses, and interviews with policymakers.Study Design. Qualitative, policy analysis.Data Collection. 2001–2002. The methods were divided into two stages. The first identified policies which were connected with individual inquiry recommendations. The second involved case-studies of three policies areas which were thought to be crucial in tackling health inequalities. Both stages involved interviews with policy-makers and documentary analysis.Principal Findings. (1) The current U.K. government stated a commitment to reducing health inequalities. (2) The government has begun to implement policies that address the wider determinants. (3) Some progress is evident but many indicators remain stubborn. (4) Difficulties remain in terms of coordinating policies across government and measuring progress. (5) The “policy windows” model explains the limited extent of progress and highlights current and possible future pitfalls. (6) The U.K.'s experience has lessons for other governments involved in tackling health inequalities.Conclusions. Health inequalities are on the agenda of U.K. government policy and steps have been made to address them. There are some signs of progress but much remains to be done including overcoming some of the perverse incentives at the national level, improving joint working, ensuring appropriate measures of performance/progress, and improving monitoring arrangements. A conceptual policy model aids understanding and points to ways of sustaining and extending the recent progress and overcoming pitfalls.
Socio-Economic Inequalities in Health Care in England
Fiscal Studies, 2016
This paper reviews what is known about socioeconomic inequalities in health care in England, with particular attention to inequalities relative to need that may be considered unfair ('inequities'). We call inequalities of 5 per cent or less between the most and least deprived socioeconomic quintile groups 'slight', inequalities of 5-15 per cent 'moderate' and inequalities of more than 15 per cent 'substantial'. Overall public health care expenditure is substantially concentrated on poorer people. At any given age, poorer people are more
9 Years on: What Progress Has Been Made on Achieving UK Health-Care Equity?
The Lancet, 2006
The aspiration to equity in health care is common to most member states of the Organization for Economic Cooperation and Development (OECD). Though precise definitions may vary, health care equity is generally understood to refer to the provision of health care on the basis of clinical need alone, undistorted by social or economic factors such as geographical location or ability to pay. In the UK, the Labour government first elected in 1997 reaffirmed its commitment to health care equity as one of the founding principles of the National Health Service (NHS). It was also a founding member of the International Forum on Common Access to Health Care Services, established to encourage the maintenance and development of universal and equitable access to good quality health care.
Guest Editorial: Tackling health inequalities: Balancing universal and targeted approaches
New South Wales Public Health Bulletin, 2002
Many tens of thousands of people work in the health system and in the course of 12 months most people will have had contact with the health system. Health is big business. The challenge we face within the health system when tackling health inequalities is to find ways of harnessing this huge investment of human and economic capital in ways that ensure that our efforts are efficient and effective and not marginalised, with insufficient 'firepower' to make a difference. 2 33 Guest Editorial: Tackling health inequalities: Balancing universal and targeted approaches 35 How can primary care increase equity in health? 38 Can the Families First initiative contribute to reducing health inequalities? 42 The NSW Health Resource Distribution Formula and health inequalities 45 How can evidence-based practice contribute to reducing health inequalities in NSW? 47 Reducing socioeconomic health inequalities: Issues of relevance for policy
Equal Access to Health Care and the British National Health Service
Policy Studies, 2003
Equal access to health care is a central objective of many health care systems, and is often seen as the founding principle of the British National Health Service. However, this paper argues that it can be seen as a piece of grand or flamboyant rhetoric of symbolic politics, representing a misreading, or at least an oversimplification, of history. It examines stated equity objectives in the NHS by placing them in the cells of an equity matrix. It is discovered that few NHS policies have aimed to achieve 'equal access to health care' in any meaningful sense. Policies in the 'old NHS' were largely concerned with equality of provision, with some later moves towards equal expenditure for equal need. The 'new NHS' of the New Labour government stress both fair access and a more ambitious aim of reducing the health gap. Moreover, this rhetorical emphasis has obscured wider issues, in that little attention has been paid to issues such as which variations are unacceptable, how much variation should be tolerated, and the potential trade-offs between concepts such as equity and efficiency.
Health, equity and the north of England: a case study on a new approach
British medical bulletin, 2015
In 2013, responsibility for public health returned to local government from the National Health Service (NHS) in England. This article describes, as a case study, a new fresh approach to tackling health inequalities, which built on a desire by local councils in the north of England to rethink approaches and collaborate on new ideas to improving health and reducing health inequalities. The collaboration was supported by an independently commissioned inquiry that assessed the evidence and proposed new policy options. This article describes the context to the collaboration, called Health Equity North, findings from the independent inquiry and emerging impact. Four areas for action were recommended: linking poverty with economic prosperity, devolution and public sector reform, investment in early years and renewed impetus for the health sector. That health service action alone had been limited without addressing the wider determinants of health such as employment, education and housing....