Health and Social Care Act 2012: A Critical Analysis

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HEALTHCARE POLICY
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Table of Contents
Introduction......................................................................................................................................3
Factual and Conceptual understanding of the Health and Social Care Act 2012 in UK.................3
Experience and Criticisms of the implementation of the 2012 Act in UK......................................5
Conclusion.......................................................................................................................................7
References........................................................................................................................................8
Appendices......................................................................................................................................9
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Introduction
The term Health Care can be defined as proper maintenance of health through prevention or
treatment from any kind of illness. A proper Health care is given by health professionals through
various kinds. A famous word has been known to everyone that if you have good health then you
have good life. Health Care is delivered by any kind of Government Agencies or Private
Agencies. It is essential to have a proper health care awareness in our society or region. In the
essay, a detailed study of UK HealthCare System and Social Care Act of 2012 is being
discussed. A strong overview on UK’s Health Care Policy facilitates readers’ understanding of
the underpinning of mentioned policy. In order to present a comprehensive outlook of this
policy, this essay as well considers evidenced criticism of UK’s Health Care Policy.
Factual and Conceptual understanding of the Health and Social Care Act
2012 in UK
It has been seen that UK Health Care Policy is very popular amongst the world. Everyone wants
a quick overview on UK’s Health and Social care system. Just because it stands amongst on top
10 countries which have best health care policies (Osipovič, 2016). United Kingdom is 1st
country to have best Healthcare system in European Union Countries. Reason for having best
health care system in the UK is the prominent rules and regulation followed by the UK
Government (Refer to appendix 1).
UK Government gives good healthcare assurance to all its citizens because it doesn’t have any
kind of bias things in their healthcare system. They usually provide good healthcare to all rather
than caring about age or color. UK Government provides good health care to any kind of religion
or socio-economic status. It has been seen that their healthcare and social care system have a
uniformed service which covers all aspects.
UK Government has given certain rights to their citizens regarding health care being. Giving full
health care status to anyone who is the citizen of The United Kingdom is the first priority of UK
health care system. It gives rights to know the identity of doctors and nurses. It gives assurance
to health care in safe environment without any harassment. It respects the religious views of their
citizens. UK Government gives a choice to end-of-life during major health issues and they do
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respect the privacy of their citizens.UK Government have separate departments to solve any kind
issues regarding healthcare. For example - Issues regarding billing of health care policies, etc.
The purpose for amending Health and Social Care bill was to improve the health care system of
UK by touching the massive scale without having any political mandate. After the election of
2010 when the UK Health and Social Care Act was amended in 2012, the newly elected
government came up with innovative and well developed plans which completely reforms
National Health Care Commission in The United Kingdom. According to the presiding Chief
Executive Officer of The National Health Service Commission (NHS), as per the view of
Osipovič et al. (2016:64) Health Care System of England should be uniform that it can be seen
through space. The Health and Social Care Act 2012 Bill was presented in 2012 and got passed
through very difficult path in Parliament after getting a strong opposition from many health care
workers , colleges and different unions. This bill was come into effect in 2013.
Main reason for introducing The Health Care Act was huge financial pressure facing by NHS at
that moment of time (Parliament.uk, 2019). But the act unable to demonstrate the increasing
patient choice and buying power of major health services. It has also been that the main motive
of the act was providing legal aspect and privatizing National Health Service (NHS)
(Legislation.gov.uk, 2019).
The act gives billion of pounds to health care units because National Health and Services was
going through serious financial crisis (Legislation.gov.uk, 2019).It abolished the “Duty to
provide” motive by replacing it through “Duty to Promote Health Service” motive
(Legislation.gov.uk, 2019).The act removed daily management from England Government and
engaged nongovernmental body that clearly means the privatization of NHS. It also abolished
Primary Care Trusts and put forward Clinical Commissioning (CCGs) to look after National
Health Services in England. It is also seen that 60% of NHS were given to (CCGs) for primary
care (Legislation.gov.uk, 2019). Clinical Commissioning were given duty to provide the
essential services to the ill patients. The Act gives free hand to NHS to arrange their funds from
private sectors.
In context of shortcomings of Health Care Act 2012, it is important to lay attention the fact that
HSC act 2012 fails to deliver over the expectations which became serious issue for the general
election. HSC act brought complexity which was bit confusing for good governance. The act was
distractive from its main motive of Good Health Care to all. It was being admitted by many
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scholars that making mass changes in NHS had given a negative impact which, was the biggest
mistake ever done by the Government.
Experience and Criticisms of the implementation of the 2012 Act in UK
The Health and Social Care Act, 2012 (HSCA) was introduced keeping in mind the
modernization and improvisation of the technologies, increase in demand for health care and
increasing cost that were not taken into consideration by the National Health Services (NHS).
This happened because the principles of NHS are old fashioned and those principles will not be
able to meet the expectations for the demand of 21st century. So, an independent board of NHS
was established that will take care of the allocation of resources and also provide guidance on
commission. Apart from this, other features of this Act includes strengthening of the role of Care
Quality Commission, developing Monitor, a body responsible for regulating NHS foundation
trust, increases the power of the General Practitioner (GP) to commission services for their
patients, and many other.
In June, 2014 it was seen that 80% of the General Practitioners panicked due to excessive
pressure of work which might lead to mistakes or poor care to the health of patients (Bernal,
2017:14). Employment was a huge issue created for the enactment of this act. In 2013, Royal
College of Nursing presented a report on estimations that NHS was facing a crisis of workforce
with approximately 20,000 unfilled vacancies of nursing all over England. Another organization
namely Bart health NHS Trust dealing with the largest PFI debt (Private Financial Initiative)
gave a review in October, 2013 that 161 full time post would be demolished and 472 nursing
posts were to be put down to lower pay scale, i.e., their wages were going to be cut down(Allan,
2017:205). These actions demoralized the staffs which further led to carefree services for the
needed.
When the HSC Act, 2012 was passed, a lot of issues came into existence. Difficulties were faced
by the patients when they needed reference to a hospital or to a specialist in case of non urgent
care. Some of the treatments were proclaimed to be given to a specific amount (Glover-Thomas,
2013:281). When treatments were no available anymore for certain cases then the patient party is
left for private treatment with huge expenses. Treatments that were carried out were provided by
private organizations, whose primary priority was profit. Moreover, the patients had to wait long
enough for their treatment or to avail a hospital bed. Some other difficulties that were faced
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excessive travel for treatment, including A&E department, poor quality of care and staff morale
and if the health problem of any patient is complex then the treatment would be split between the
private organizations and NHS. These issues were in perspective to the patients.
The main aim of HSC Act, 2012 was minimization of cost and since tenders were given to the
private organizations, full focus was on profitable returns (Patients4nhs.org.uk, (2019). Contracts
were mainly given to the lowest bidder for the tender and the quality was not a priority. So they
started to employ untrained staff and preferred nurses instead of doctors. Within the
organization, due to financial pressures, staffing level started to fall apart. This led to a huge
pressure on the staffs. Due to the privatization of NHS, movement of their staff to the private
sector was recorded under poor terms and conditions. Even those who were employed to NHS
had to re-apply for job or had to face a decrease in their wage. Due to all these reasons numerous
NHS organizations faced extreme decrease in morale.
All of this happened to the NHS organization because the government wanted to cut down the
public sectors and open it to the public firms. This kind of situation occurred because of the
government reforms and their intensive attempt to bring privatization. Most of the NHS services
are handled by multinational organizations and investment companies. Among the NHS services,
the companies can choose any service (mostly profit returning) for which they are willing to
compete. For this reason, the other non-profitable services (A&E, elderly care and chronicle
illness) got neglected. Before the introduction of the HSC Act, profit was not a factor of priority
for the NHS. But since private companies were involved so their only motive was to make profit
for the shareholders.
During the General Elections held in 2015, the National Health Services became one of the
major issues of discussion. King’s Fund, an independent body from the government who offer
advices based on political or economical trouble, recognized that the HSC Act was disastrous.
This was acknowledged by them through the services of the NHS organizations that were
decreasing promptly, elevated records for waiting list and the General Practitioners and mental
health services were in serious damage. Another think tank, IPPR concluded that the HSC Act
split the commission, amplified complications at National levels and strengthened competition
within the NHS. Many others are also there who consider this act to be a big mistake committed
by the government.
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From a comparative study of the full time managers and the proprietors in health care services in
the country, it can be clearly observed that the employment in the direct sector is less than the
indirect sector (Refer to Appendix 2). This has happened clearly due to the privatization of the
NHS. Many employees lost their job in procedures related to re-applications with modified terms
and conditions. Due to cost cutting for profit maximization, wages for the employees were
reduced. Cheap and inefficient staffs were hired. So people started to get less interested in this
sector and this led to reduction in the number of employees in the health care sector.
Moreover, with further study from the surveys made by several other analysts and patients
themselves, it was seen that NHS patients who needed emergency cures were neglected and put
into a huge waiting list for the other private client who was ready to pay more for their treatment.
The elderly patients who were up for operations were not operated and given priority until their
life was in threat. For all this malpractices a two level health service came into existence where
priority was laid on rich patients rather than sick and elderly. Since people were put on waiting
lists, they were bound to move to private hospitals for their cure.
Conclusion
Analyzing all the information collected and observed, it can be seen that implication of the
Health and Social Care Act, 2012 proved to be a bad step taken by the government for the
Nation. It fragmented the National Health Services and demoralized their principle objectives to
provide health care service equally for all the people who needed treatment. Moreover, due to
privatization of NHS, services deteriorated for health care and profit was emphasized more rather
than the condition of the patient. The act also brought complications at national level and
increased the competition within the NHS. Lastly, richer people were given more focus rather
than emergency or elderly patient. Adding up all the points from this analysis it can be concluded
that this act could be used in a better manner if proper features were implemented.
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References
Journals
Allan, H. T., Dixon, R., Lee, G., Savage, J., & Tapson, C. (2017). Governing body nurses’
experiences of clinical commissioning groups: an observational study of two clinical
commissioning groups in England. Journal of Research in Nursing, 22(3), 197-211.
Bernal, J. A. L., Lu, C. Y., Gasparrini, A., Cummins, S., Wharham, J. F., & Soumerai, S. B.
(2017). Association between the 2012 Health and Social Care Act and specialist visits and
hospitalisations in England: A controlled interrupted time series analysis. PLoS
Medicine, 14(11).
Glover-Thomas, N. (2013). The Health and Social Care Act 2012: The emergence of equal
treatment for mental health care or another false dawn?. Medical law international, 13(4), 279-
297.
Osipovič, D., Allen, P., Shepherd, E., Coleman, A., Perkins, N., Williams, L., ... & Checkland,
K. (2016). INTERROGATING INSTITUTIONAL CHANGE: ACTORS'ATTITUDES TO
COMPETITION AND COOPERATION IN COMMISSIONING HEALTH SERVICES IN
ENGLAND. Public administration, 94(3), 823-838.
Websites
Parliament.uk, (2019), Summary of the Health and Social Care Act, 2012, Available at:
https://services.parliament.uk/bills/2010-11/healthandsocialcare.html
Patients4nhs.org.uk, (2019) Failure of the HSC Act ‘reforms’ Available at:
http://www.patients4nhs.org.uk/the-health-and-social-care-act/
Legislation.gov.uk, (2019), Health and Social Care Act 2012, Available at:
http://www.legislation.gov.uk/ukpga/2012/7
Statista.com, (2019), Number of employed full-time managers and proprietors in health and care
services in the United Kingdom (UK) in 2018, by occupation (1,000s), Available at
:https://www.statista.com/statistics/768330/managers-in-health-and-care-services-employed-uk/
[Assessed on 25 April 2019]
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Appendices
Appendix 1: expenditure in health care sector in UK
(Source: Statista.com, 2019)
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Appendix 2: Bar diagram showing health care practice managers and proprietors
employment in UK, 2018 (in thousands)
(Source: Statista.com, 2019)
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