UK NHS: Accountability, Legal and Ethical Issues in Healthcare Sector

This report provides a detailed analysis of accountability as a crucial element in healthcare and social practices, focusing on legal and ethical issues within the context of social security and healthcare protection in the UK. It examines the evolving accountability structures within the British National H...Read More

Legal And Ethical
Issues

INTRODUCTION
Nurturing developments in the British National Health services (NHS) have instituted
new entanglements in the arrangements of accountability for services of health and care. This
explanation of accountability set out that how the latest structures of the organisations have call
into question the traditional customary accountability structure, by generating more efficient
scattering system of liabilities within the governance of health care and social services in regard
to UNITED KINGDOM. The key changes in the enactment of UK NHS is he increasing
complication of accountability, way more delegated and defused system of health care, the main
aim of authorities is bringing about enhancement in local autonomy and higher domination by
general practitioners (GP) the marked specification in the system is the deep-rooted
centralization which is fervent with escalating directives and political system which is drawn
together. The national health services of Britain are generally characterised “control and
command” structure which prescribed the conditions for liabilities within the NHS,
corresponding the policies of strategies and budgets. The revolutionary field of medical practices
has undergone various progress which made it feasible to diagnose different copious illness or
sickness more precisely (Gray, Phillips and Normand, 2016). This report will provide detailed
expression of Accountability being a essential element of health care and social practices with
the understanding of legal and ethical issues under the purview of social safe keeping and heath
care protection.

MAIN BODY
Accountability implies the course of action and advancement by which one stakeholder
justifies and take hold of his responsibility for its action, it means being at conduct for any failure
or success, profit or loss and other enduring consequences. Within the year of 2012-13 there
were 3 apex goal by the commission of public health services and public health of England and
local Government, which were; To restore a self-strengthening set of incentives that promote
reforms of organisations in a continuing process which can be manage by clinicians, Authorising
greater autonomy but on a discriminative manner and which is dependent on fundamental
assessment of performance in contrary to the main criteria which is already in possession, To
create a universal model of provisions which are described locally by department of health.
The derived changes in the considerable sphere which involves running out responsibilities
between the NHS from the health department and handing it over to a whole new structural body
namely NHS England (NHSE) which is in control for the engaging of at least 40% of England
health service I.e. dental services, services of specialization, genral medic al practices and areas
of public health programmes by Government aid (Harkensee and Andrew, 2021). Occurring of
contractual legal obligations between the department of health and the national health services of
England lays down mandates of Governments requirements which are prescribed in the
formation of five cardinal areas which facilitate in the position of NHS aftermath framework as
well as it includes supplementary regulations which are summarized as ; (a) counter block people
from dying prematurely, England being best in Europe ar preventing ill health, diseases and
providing betterment in faster diagnosis and treatment of various health conditions such as heart
disease, cancer, HIV, tuberculosis with the purpose of that citizens may enjoy higher life
expectations, (b) Strengthen the quality of life for people having major health conditions, NHSE
working in best way possible to support people with their ongoing intensify physical and mental
health conditions such as depression, anxiety, type-1 diabetes for the improvement in quality of
life so, the word care can actually ,mean much more, the treatment of people with the use of
latest technology and better integration of different services for advancement in diagnosis, ( c ) A
location of help for people to recover from episodes of chronic health issues and subsequent
wounds or injuries, services across the country which have improved analysis and calling
attention to the differences in quality and the results of the practices used which shall ensure
eminent equality between mental and physical health services and upgrading crystal clear

transparency through data publications and involving local people or authorities in the decision
making process about the services, (d) Treating with people with care by putting them into safe
environment and protecting them from forceable harm or injuries, the board of health care has
been asked to reduces the number of incident to avoid injury and make progress towards the
development for safeguarding of patients, (e) Freedom of innovation to NHS for expecting
greater outcomes for well-being of patients the autonomy at local level must be reenforced,
upgrading research, inventions and innovations, controlling the incentives, leading a way to
saving efficiency while maintaining the quality. The organisations of NHS protect the patients
and support the participation of board which bring out improvement in research and contribution
of economic growth while ensuring the furtherance of patients (Jones, 2021).
Everyone needs the emotional and physical support in their life regardless of their
disabilities, it is the right of the people to live with care and with the healthy life to maintain their
mental healthcare. Health and social care workers have a duty to support the people who are in
need in any place whether they are in their homes or in their residential place. There is teamwork
between the health care and the social care workers, they work together to assist the people who
are in need. As, in the social sector there are 1.48 million employees in the UK. They have
various of work to perform and to admire them as well; (a) in a need provide care for the
families, (b) to assist the people in their relationships, (c) help the people in their old age, (d)
people who were challenging with their mental disabilities and stress as well, (e) people who
become addicted of intoxication like drugs and alcohol, (f) who were financially stressed.
There are some rights of the social care workers like they can mediate in the private life
of the people to give them a better life, to encourage them. They have a responsibility on their
shoulders to give a better environment to the society while working in the different areas, they
can operate as a friend, as a doctor, as an advocate. As a health care support the social care
workers in England are responsible for their answers and the work they omit, they have to boost
the confidence, take care of the dignity of the people who use their services, the communication
must be clear to uphold the health of the people, to respect the secret of the people, have a
mindset to being continue in a service (Papachristou and Bosanquet, 2020).
According to the BRITISH CIVIL LAW the vicarious liability is very strict as the
institution is responsible for what is done or what ought to be done by their employees. As an
employer it becomes the duty to protect their employees.

Vicarious liability is a principle where the employer is responsible for the actions of the
employees, whether the employee has done the work which was not assigned by the employer,
and for that wrong work also which was not done by the employer himself. There is a case of”
“Bellman vs Northampton” in which it was held by the appellate court which is against the
decision of the High court in which the MD of the Company was held liable for the assault
commit against the employee which is done by the staff and even not in the premises of the
company and the appellate court gives the clarification regarding the liability occur on the
employer that there is a connection between the employer and the incident occurred between the
employee and the staff members by saying that the employee was engaged himself under the MD
of the company and also the incident was happened was related to the company issue. So, it held
that the MD was liable for the vicarious liability of the staff members (Sandy, 2019).
However there is difference between the legal and the ethical issues as all the legal
standard was governed by the Government where as the in the ethical it snot necessary that there
are some legal boundaries. Basically the ethics is based upon the natural law depend upon the
people that what they feel about the right and the wrong thing and on the other hand the legal
standards bounds the people and it is not depend upon the person character if something is wrong
in the eye of the law than its wrong for the whole society and according to the rules the person
can punish according to the wrong done. The main difference between the legal and the ethics is
that the legal issues are applicable on the every citizen of the State, where as the ethics is differ
person to person. There are some legal and ethical issues in health care also which relates to
medical negligence, consent issues, confidentiality etc. (Tackmann and Dettmer, 2019) There are
some legal issues which impact the health care system;(1) Anti trust issues and ACO s – its a
group of doctors and other social workers who were together provide the best quality care to the
patients. The main aim of the ACO s is to reduced the cost and provide the high quality care to
the patients.
whistle blower suits – The NHS has a duty to expose the fraud done by the people who were
dishonest, this case proof that the health care found many ways to fraud the Government.
Like there are some legal issues in the healthcare there are some ethical issue also;
(1) Patient confidentiality – it is mandatory to have intimate relationship between the
health care worker and the patient. It builds trust between them. (2) Informed consent – it means

to have knowledge about the risk while doing the treatment and it should be disclose to the
patient also (Wilson and Khansa, 2018).
CONCLUSION
In the day to day life health care experienced professionals facing the legal and the
ethical issues relating to the treatments, management and the others issues. When the person got
engaged himself or herself in some kind of duties and accountability and they know about the
responsibilities then it becomes their duties to fulfil their obligations and to get honest towards
their duties, and also to guard the rights of their employees or the other staff members.
Accountability is not only applied in the health care department it is the duty of each and every
employer in every sector to watch the record keeping and to delegate the duties to the responsible
employees who perform their side of the duties with care.

REFERENCES
Books and Journals
Gray, A.M., Phillips, V.L. and Normand, C., 2016. The costs of nursing turnover: evidence from
the British National Health Service. Health policy, 38(2), pp.117-128.
Harkensee, C. and Andrew, R., 2021. Health needs of accompanied refugee and asylum‐seeking
children in a UK specialist clinic. Acta Paediatrica, 110(8), pp.2396-2404.
Jones, E., 2021. COVID-19 and the Blitz compared: mental health outcomes in the UK. The
Lancet Psychiatry, 8(8), pp.708-716.
Papachristou, I. and Bosanquet, N., 2020. Improving the prevention and diagnosis of melanoma
on a national scale: A comparative study of performance in the United Kingdom and
Australia. Journal of Public Health Policy, 41(1), pp.28-38.
Sandy, J.R., 2019. Making a difference for children born with a cleft in the UK. Journal of
Orthodontics, 46(1_suppl), pp.77-80.
Tackmann, E. and Dettmer, S., 2019. Measures influencing post-mortem organ donation rates in
Germany, the Netherlands, Spain and the UK. Der Anaesthesist, 68(6), pp.377-383.
Wilson, K. and Khansa, L., 2018. Migrating to electronic health record systems: a comparative
study between the United States and the United Kingdom. Health Policy, 122(11),
pp.1232-1239.