This article was written by Plonkee, who lives in England and writes for the personal finance blog, Plonkee Money, at plonkee. In the UK healthcare is mainly funded and provided by the National Health Service NHS which was founded in the late s after the landslide electoral victory of the Labour party in the first post war election. The principles of the NHS are that healthcare should be provided based on medical need, not ability to pay and broadly speaking, healthcare in the UK remains free at the point of use. The budget is allocated by central government and is managed by local healthcare trusts.
How to Write a Summary of an Article? National Health Service Reorganization Any UK government is faced with a long list of health issues, this list would include macro questions such as the relationship of the National Health Service NHS to broader policies which might affect the health of the population and how to finance and staff health services.
The NHS has gone through many stages of development in the last century, however the act introduced the most radical accounting control system since the birth of the NHS. Much accounting research has been developed on this topic and this paper will bring together some of their findings.
These crises were particularly evident in the hospital services and were caused by a combination of scarcity of compatible resources and an infinite demand for health care. The main focus of the impact was the concept of the internal market. This essentially involved the National health service essay of two of the main functions of the NHS, purchasing and providing.
Purchasing is defined as the buying of health services to satisfy local needs and providing, is defined as the day to day business of delivering that care. The purchasing agencies are provided with a budget which reflects their defined population, from which they must identify health needs, plan ways to satisfy them while ensuring the quality of the service.
When the purchaser identifies their requirements, they produce a contract with the providers, who in turn invoice the purchaser for the materials and services provided.
Flynn described the internal markets in the NHS as a mechanism to match supply with demand, and allow hospitals to compete on price and quality National health service essay attract patients.
This new ideology of governance of the NHS has changed dramatically, especially through the Thatcher administration. Harrison describes how there are three ways of co-ordinating the activities of a multiplicity organisation, through markets, clans and hierarchies.
Clans and hierarchies are based on using the process of co-operation to produce an ordered system of outcomes. The new NHS is now reflected as having a market orientated organisation.
The reformed NHS was established on 1st April In this market it should be expected that managers respond with price, quality and branding as weapons of competitive behaviour Flynn Her research that looked at two factors, which forced reform in the NHS, demographic trends and technological advancement.
The first factor focused on the growing problem facing nation states in the developed world is that of an ageing population and hence a greater dependence on the NHS in future years.
Between and the percentage of the UK population over sixty five increased by one third and the numbers aged eighty five and over, more than doubled Population Trends The second factor looked at the advancing technology of medical care across the developed world, which offered a new range of medical services and techniques.
These advances however caused a problematic escalation in the supply and demand for medical treatment, and therefore total cost of that treatment to the purchaser. The basic rationale of her paper, was how the introduction of a market into health care causes an anticipated stimulus to competition and hence constant improvement in resource allocation and cost management.
Hood identified two aims of the government in office as regard to the public sector, first the desire to lessen or eliminate differences between modes of private and public sector organisation.
Secondly, the intention of exerting more control over the actions of public sector professionals. However, to discuss the first aim it is important to realise that there is a fundamental difference between developing a customer orientation in the private sector and a user orientation system in the public services Flynn Private sector problems tend to be in efforts to market their products or services to the consumer, usually in competition with other firms.
Whereas, public sector problems tend to be trying to deter too many people using their services, as opposed to attracting them. Therefore, this produces a fundamental problem in the trying to eliminate these aspects. Several issues caused the government desire not only to control, but also to make resource usage more efficient.
Firstly the deepening public sector problems had to be addressed, and the adoption of more accountable systems seemed a perfect solution. There was also the desire not only to be able to control but also reduce public expenditure.
Finally, political promises were made to reduce the share of public expenditure in National Income, to curtail the range of functions being performed by government, whilst also seeking to improve, nurture and stimulate the business attitudes and practices necessary to re-launch Britain as a successful capitalist economy, this was a conservative attitude.
The government therefore promoted the view that accountable management reforms are needed for the public sector to be more accountable to those who receive, pay for or monitor public services; to provide services in a more effective, efficient and publicly responsible fashion Humphrey The emergence of an internal market for health services inevitably resulted in the emergence of various accounting techniques, their purpose was to act as a stimulus to ensure efficient allocation of resources and to minimise costs.
The increasing competition derived from this market created a need for management control systems. Hood categorised international accountable management as having up to seven dimensions, for government implementation of a system in the public sector.
First, that it sought a greater disaggregation of public sector organisations, secondly, it would be searching for a stronger competitive use of private sector management techniques.
Thirdly, a heavier emphasis on efficiency of resource usage, fourthly, reforms in accountability management. The four are geared towards the second aim of control. Arguably the views on the adoption of management control systems in the public sector depends on our position in society.
As our society is more focused on markets, competitiveness and efficiency, it is likely that accounting techniques will play an important role, however, the importance of keeping the welfare of our society should be first and foremost. After all the goals of public sector organisations should differ from those in the private sector e.
The objective of the NHS as an organisation remains unchanged since the reforms, in terms of securing an improvement in the state of the health of the population.National Pike Health Center: The Oldest Outpatient Substance Abuse Treatment Agency, Individualized Treatment!
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