Методические рекомендации для студентов ii курса по теме Медицинское обcлуживание в Великобритании
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Regulation and Policies Quality of care one of the key focuses of the NHS. Indeed, one of their stated goals is to enhance the quality and safety standards of health and social care services. Quality issues are addressed in a variety of methods. There are a number of regulatory bodies in place which monitor and assess the quality of health services provided by public and private providers. This involves regular, periodic assessment of all providers, investigation of all individual issues that have been drawn to the attention of the regulatory body, and careful consideration in order to recommend the best methods of practice. The three bodies previously responsible for healthcare insurance regulation in England (the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission) were merged into Care Quality Commission in 2008. Quality of care delivered is not monitored by the regulatory bodies mentioned above alone; it is also monitored on a regular basis either by the Department of Health or its regional organizations, which consists of ten Strategic Health Authorities. In 1998, the Department of Health developed a set of National Service Frameworks intended to improve particular areas of care, such as coronary, cancer, mental health, diabetes, etc. This set national standards and identified changes that needed to be made for certain defined services or care groups, such as coronary, cancer, mental health, and diabetes. They were one of a range of measures used to raise quality and decrease variations in service. Finally, the UK has a Quality and Outcome Framework, which measures the quality of care delivered by General Practitioners. It was introduced in 2004, and has been in operation since 2005. This framework provides incentives for improving quality: practices are awarded points related for how well the practice is organized, how patients view their surgical experiences, whether extra services (such as children’s health and maternity) are offered, and how well common chronic diseases such as asthma and diabetes are managed. GP’s are then paid fees based on their earned points. Participation is voluntary, but most GP’s opt in due to the opportunity for increased income. Disadvantages and Shortcomings of the Current System There as certain disadvantageous side effects to the government’s participation in the healthcare system. Their active role in healthcare weakens the functionality of market mechanisms. In addition, the tight control undertaken in regards to medical expenses has resulted in a lack of medical resources, such as equipment, doctors and nurses in public hospitals. Finally, with free medical services provided to all citizens, the public tend to make extensive and even excessive use of these medical services. As such, it is common to encounter long lines in public hospitals. UK Healthcare vs. US Healthcare In a study that compares 7 industrialized countries, UK was ranked 2nd, while the US consistently underperformed in most areas of health care relative to other countries. The US healthcare system is the most costly in the world. Of the countries studied, it was the only one that did not have a universal health insurance system. The US is last in terms of access, patient safety, coordination, efficiency, and equity. The US has the highest healthcare spending in the world. Of the 15% of GDP the US spends on healthcare annually (that’s about $2.2 trillion dollars), around 50% is spent by the government (around $1.1 trillion). By contrast, the UK spends only around 8% of its GDP on healthcare. The UK National Health Service cares for 58 million people (100% of the population of England), where the US’s public healthcare currently covers about 83 million (around 28% of the US population). Also, US healthcare sets age and income requirements (Medicaid orMedicare) on public healthcare coverage, whereas UK made public health care accessible to all UK permanent residents by making it free at the point of need. The US does hold certain advantages over UK when it comes to the private healthcare sector. For instance, the UK rates 40% higher than the UK in percentage of men and women who survived a cancer five years after diagnosis. The US also ranks higher in percentage of patients diagnosed with diabetes who received treatment within six months. The number of US patients who received timely treatment for diabetes was more than 6 times that of the UK, and twice that of Canada. Similarly, the percentage of US seniors who received hip replacements within 6 months of diagnosis of need is more than 6 times that of UK and twice that of Canada. Finally, the percentage of seniors (Age 65+) with low-income who say they are in “excellent health” in US was far and away greater than that of any other nation. Roles of Actuaries in UK Healthcare System “In the UK, where there are about 9,000 fully qualified actuaries, typical post-university starting salaries range between GBP £25,300 and £35,000 and successful more experienced actuaries can earn well in excess of £100,000 a year”(Lomas 2009). The governing bodies for actuaries in the UK are the Institute and Faculty of Actuaries and the Association of Consulting Actuaries. Reinsurance in UK In 2007, UK finalized the implementation of the Reinsurance Directive into UK law. Its key provisions include authorization and financial supervision by a reinsurer's "home" state regulator, mutual recognition of such authorization between member states, the abolition of collateral requirements (funds pledged to cover a reinsurer's liability) and the harmonization of minimum standards across the European market. The major reinsurers in the UK include Towers Watson, Swiss Re and R&Q Reinsurance Company (UK) Limited. They provide Property & Casualty and Life & Health clients and brokers all over the world with reinsurance products, insurance-based capital market instruments and risk management services; they also offer solutions in the areas of employee benefits, talent management, rewards and risk and capital management. There are other reinsurers (who account for a relatively small portion of all reinsurers) that cover Non-Life and Health reinsurance in the UK. ADDITIONAL ACTIVITIES: TEXT Overworked and underpaid Britain’s National Service (the NHS) is funded by the government, and is the biggest employer in Europe, with 1.2 million employees. But nursing recruitment in the UK is at its worst level for 25 years, and 40% of new nurses come from overseas, often from South East Asia. In 2001, the Royal College of Nursing published the results of a survey of its members. These are some of the key results. Most nurses work both day and night shifts. Three fifths of NHS nurses an average 6.5 hours overtime per week. One third do this for no extra pay. 90% think that they are poorly paid. A quarter have a second job to supplement their salary. The biggest age group is 35-44. Only 1 in 8 nurses is under 30. 31% would leave nursing if they could. Findwordsthatmean: Someone who gives someone a job. (employer) People who do a job for someone else. (employees) Bringing new people into a profession. (recruitment) Blocks of time that you work. (shifts) Extra work outside of your normal hours. (overtime) The money that you earn from your job. (salary) Find the right statistics from the text: How many people work for Britain’s NHS? (1.2 million employees). What percentage of new nurses are from outside the UK? (40%). What is the average length of nurses’ overtime per week? (6.5 hours). What percentage of nurses think that they are poorely-paid? (90%). What percentage of nurses have another job? (15%). What age are 7/8 of nurses? (35-44). TEXT Listen to Jenny, a seniour nurse, talking about her typical working day in hospital and answer the questions: a) First, match the words with their definitions:
Students read the questions before listening: What type of ward does she work on? How is the shift system organized? How many beds do they have? What time do the doctors see the patients on the ward? What does she do in the afternoons? What is the last thing she does before going home? Tapescript: Well, my name’s Jenny Write, I’m a registered nurse and I work at the princess Margaret Hospital in Swindon. I manage one of the children’s wards there. I’m responsible for the other seven nurses and for organizing their shifts. The nurses do shifts on a rotational basis. That means that they work five weeks of day shifts and then one week of night shifts. There are a couple of hours each day where the shifts change over. Every morning I go round the ward to check the new admissions and talk to the staff and patients. We have 22 ordinary beds and 10 intensive care beds. I try to check all the patients’ records before the consultants come round, which is usually at about 10 o’clock. In the afternoons, I do paperwork and have meeting with nurses or doctors. The last thing I do before I go home is to check that there are beds free for any emergency admissions in the night. Roleplay. In pairs students roleplay the following conversation: Student A: You are a nurse in the UK. Try to persuade your friend, a nurse in Russia, to come and work with you. Student B: You are a nurse in Russia. Tell you friend in UK how you feel about your job, and listen to him/her talking about working condition in UK. (Students speak about any experience they have of hospitals in your country, whether as patients or as visitors. Did the hospital(s) seem well-organised and well-funded?). Read the facts and opinions about health care. Which of these opinions characterize the health care system positively and which negatively? In Britain, medical insuarance is organized by the Government and is compulsory, while in some other countries it is not. The country doesn’t spend a lot of money per person on health care, whereas in some other western countries health care systems are much more expensive. Despite the shortage of money, the system of medical care works well. The British spend a small proportion of their wealth on health service, because of its simple administration. In spite of poor, you can get good medical care in Britain. Although Britain has public health care, it has a private sector too. The exceptions to free medical care are teeth and eyes, though even this care is available to large numbers of people who do not have to pay. f ) Try a dialogue. Consider the following situation: NHS in GtearBritain has both advantages and disadvantages. Exchange your opinions on the matter.
VIDEO: Полезныессылкинавидеопотеме “Health Service in Great Britain”: http://www.youtube.com/watch?v=DIc4Q-7mgkE http://www.youtube.com/watch?v=0sm-fRvgFhU http://www.youtube.com/watch?v=QcC2VjOKN10 http://www.youtube.com/watch?v=NTTb6qks-qw http://www.youtube.com/watch?v=y6WJrlJXmtY (Cм. также в электронном приложениии) QUESTIONS TO THE CREDIT ON THE TOPIC “Health Service in Great Britain”: When was the National Health Service Act brought into operation? Is medical treatment free in Great Britain? Is emergency medical treatment free for visitors from abroad? Are there private patients in Great Britain? Why do many people who have enough money prefer to be private patients? What is the role of a family doctor in the National Health Service system? What is the role of health centers in the health service system in Great Britain? Can a patient change his family doctor? Are there consultant services in health centers? |