Topic 3: Inequalities in the provision of, and access to, health care in contemporary society

Question 1

NHS founded what year and by who?

Answer 1

1948
Bevan

Question 2

Increase of NHS waiting times End of 2019- Sept 2024

Answer 2

4.57 million end of 2019
7.77 million Sept 2024

Question 3

How much NHS spent in private hospitals 2023?

Answer 3

£2.1bn

Question 4

How many planned operations are carried out by private hospitals? (outsourced by NHS)

Answer 4

1 in 10

Question 5

What is a ‘two-tier’ system?

Answer 5

-A system where those who can afford to pay for care can access it faster than those who are forced to wait for treatment on the NHS.
-People argue this is happening now
-Goes against founding principles on NHS; access to healthcare is determined by need not ability to pay.

Question 6

How many patients a year have to be transferred from private to an NHS hospital when there are complications?

Answer 6

6,000

Question 7

Calnan

Answer 7

2010
Healthcare choices leads to greater inequality:
Lack of knowledge and expertise
Most patients lack the scientific and medical knowledge needed to make informed decisions, Dixon et Al
Unequal opportunity
Richer and more educated patients are better placed to access and make sense of the information needed to choose. Opportunity to pay for private healthcare. AO3- even wealthiest of patients consult doctors
Uncertainty and unpredictablity
Not always a clear cut choice in health matters. Outcomes of treatments are never 100%

Question 8

Latif in relation to ethnicity and access to healthcare.

Answer 8

2010
Reasons for why there is a poorer access to health care amongst ethnic minorities:
-Lack of interpreters (especially in rural areas), health information in multiple languages, counselling. This can lead to a lack of awareness of services available.
-Ethnic groups may interpret symptoms differently meaning it can be hard for them to communicate their illness- sinking heart syndrome.
-NHS staff lack cultural competence and are ethnocentric, leading to stereotyping, bias and unconscious discrimination.

Question 9

Dixon et al

Answer 9

2010
7/10 patients still opted for their local hospital and relied on the advice of their GP

Question 10

Criticisms of Marketisation of the NHS

Answer 10

-Led to more services being provided by private companies therefore profits that could be going to the NHS and diverted into private companies.
-Competition of NHS and private
-Private sector chooses the easiest and quickest cases (probably because most of them lack ICUs), leaving NHS with the most expensive cases.
-2010 evidence of NHS operating like a private business and encouraging paying to jump the queue
-Services move away from poorer, less profitable areas.

Question 11

Neoliberalists on the Marketisation of the NHS

Answer 11

-Competition creates improvement in healthcare as they consequently have to compete for customers using better services.

Question 12

The Glasgow effect

Answer 12

Age expectancy is 54 years in Glasgow.

Question 13

Inverse Care Law

Answer 13

Tudor Hart
Funding is inversely allocated in the UK- most funding goes to the affluent areas that are not in need of it, whereas deprived areas lack funding.

Question 14

Postcode lottery

Answer 14

Buchan (2011)
Depending on where you live your options are either closed off or opened in healthcare

Question 15

AO3 to inverse care law

Answer 15

Labour government has introduced direct funding to areas in poverty in the UK

Question 19

Guillidford et al

Answer 19

2014
Men are 30% less likely to visit their GP than women

Question 20

Smith et al

Answer 20

2005
Men had greater fears of consulting doctors in relation to cancer
Men considered asking for health emasculating

Question 21

Why do men have better access to private care?

Answer 21

Greater economic power
Men are more likely to benefit from being in a higher social class than women

Question 22

What are women at a greater risk for?

Answer 22

Clinical Iatrogenisis
Side effects of oral contraception, link to drugs for women not being tested on women.

Question 25

Travellers and Access to healthcare

Answer 25

-No established home therefore cannot register with a General Practitioner surgery -Low level of literacy, can’t read information health guidance -Difficulty in maintaining cleanliness as they do not have toilets or access to clean water

Question 26

Sheffield uni on traveller health

Answer 26

2-5x worse than settled populations

Question 27

Macpherson report on Ethnicity

Answer 27

-Notes of institutional racism as the ‘collective failure of an organisation to provide people the correct treatment because of their colour, culture or ethnic origin’

Question 28

Equality act

Answer 28

2010 It is against the law to discriminate against someone due to a protected characteristic

Question 29

2 examples of private healthcare companies

Answer 29

BUPA and Imperial

Question 30

Disadvantages of Private Healthcare

Answer 30

No intensive care facilities Not equipped for high risk or unexpected healthcare issues Only set up for particular treatments Neglected some fields of healthcare as they are so specialised in other areas Take easiest cases as those are the ones they are most prepared for and therefore leave the most risky ones to the NHS.

Question 31

Spire Healthcare scandal

Answer 31

Ian Paterson, a doctor at a Spire Healthcare Private Hospital, told patients they had cancer when they did not. Hi lights that private healthcare has flaws also.

Question 32

Neoliberal

Question 33

Dixon et al

Answer 33

2007 Poorer educated, unemployed or low income households visited teh GP less, relative to their needs,

Question 34

Lambkin

Answer 34

WC mothers in Sunderland failed to take up ante-natal services due to resentment and suspicion of MC professionals.

Question 35

Blaxter

Answer 35

Working class do not have availability to go to the doctors as they have shift work rather than being fatalistic.

Question 36

Alford

Answer 36

1975 Structuralist approach The **dominant interests** of hospital managers and CEO’s, attempting to make profit and reduce costs, override the **challenging interests** of GPs attempting to get the best for patients I.e therapeutic services.