Analysis Of Health And Social Care In The Uk
This analysis provides a review on the health and social care services in the UK. This will include an exploration of inequalities with the care sectors from the focus of the policy and individual and a discussion on promotion of equality and individual rights within the care sector. A brief history of social care in the UK will also be given.
A clear understanding of inequalities in health is of critical importance so as to develop policies and interventions that support all sections of the society and direct care, treatment and services in proportion to need. Social workers can play an important role in these inequalities by working with service users in increasing their social and material resources and providing them access to information and support systems as well as maximizing their capacity to managing their health.
At a time when there is a growing population in need of care, yet inequalities in health and social care challenge effective provision of services, the UK government face the central question: how should inequalities in health care be tackled and how can government ensure the promotion of individual rights within the care sector (Alcock, et.al., 2006)In order to explore on this subject, we must first define what we mean by social care.
Social care encompasses a range of services that help people maintain independence, help them manage complex relationships, protect them in vulnerable situations and enable them to play a fuller part in the society (DOH 2006). It includes the provision of personal care, social work, protection and social support services to children and vulnerable adults. The provision of social care is often deemed necessary at old age or when an individual is suffering from long-term illness, learning and physical/sensory disability or mental illness.
The current system in the UK is perceived unfair in the provision services in health care. There are huge disparities in the provision of health care services in parts of the UK with the spearheaded areas experiencing worst health care and deprivation (Ellison & Pierson 2003). The central focus of health inequalities policies have primarily been on health care and NHS funding. While significant progress has been made over the past decade by the National Health Service, inequalities still remain prevalent in the health care (Adams 2007).
Social care has long been in existence as an informal concept through family support, community support and charitable works (Manson, et.al., 2004). The earliest Parliamentary Act that offered formal support to social care was the Poor Law of 1601 (Manson, et.al., 2004). This Act of parliament referred those in need of domestic care, health care, employment and housing to the care of their Parish. The advent of social work in the 19th century offered more formal support to social care.
From medieval times, care was provided mostly by faith organizations or voluntary associations (Manson, et.al., 2004). The coming into power by the liberal government in 1906 was accompanied with the provision of formal health and social care that led to the establishment of the National Health Services (NHS) and the Welfare state in England during the 1940s (Manson, et.al., 2004). This herald a new dawn for social work by making access to formal health and social care services free at the point of need.
The care standards Act of 2000 further increased the recognition of social work with the introduction of a degree in social work and the social workers’ register (Porter & Teisberg 2006). It is a requirement for social workers to hold an Honours degree or postgraduate MA in social work and to register with the General Social Care Council prior to commencing work. With this background knowledge in mind, it is worth examining the types of services provided by agencies in social care.
This is the care that is provided at home and is suited for persons that have less acute need (Francis 2012). Limited nursing care may be provided by a District Nurse when needed. Nursing care is usually provided in care homes especially for the more infirm elderly as such individuals are often in need of medical attention and a greater level of care (Lovell & Cordeaux 1999).
Domiciliary care aims at providing help with a specific task such as bathing or waking up in the morning. Traditionally, family members, friends and partners have provided domiciliary care. There is however a growing number of voluntary and statutory agencies providing domiciliary care services in the UK.
Care UK is one such provider which has been approved to provide domiciliary care services to 55 local authorities in the UK (Francis 2012). Care UK provides domiciliary care to many service users including older people with dementia, children, individuals who are physically disabled and those with sensory impairments as well as serving adults with specialist needs such as mental illness, learning difficulties, HIV and acquired brain injury (Francis 2012).
This can be defined as a temporary relief provided for an elderly or the carer and may take the following forms (Lovell & Cordeaux 1999):
Taking a break away from the daily routine by the elderly such as a going on a holiday.
A short stay in a care home so that the carer can go on a holiday
Increased support at home to enable the carer to pursue his/her interests
Respite care may be as little as a day, a week or even an hour per week depending on the circumstances of the individual. Under the Carers Recognition and Services Act 1995, a carer who provides substantial care to his/her relative, friend, neighbour or partner is entitled to his/her own separate assessment by social services (Lovell & Cordeaux 1999). If assessed as in need of respite care, then this can be arranged by them.
This refers to the care provided to a minor who has been made a “ward” (Curry & Ham 2010). The minor is placed in the hands of a licensed or state certified caregiver who is often referred to as the foster parent. Foster care placement may be voluntary or involuntary. Where the biological parent is not able to provide the needed care to the minor, then voluntary placement may occur. However, where the minor is at risk of physical or psychological harm, then involuntary placement occurs (Curry & Ham 2010).
There are many agencies providing fostering services in the UK. FosterCare UK is one independent non-profit organization established in 2007 to provide foster care services to minors in London and South East (Porter & Teisberg 2006). FosterCare UK recruits, trains, approves and supports foster carers to work with young people with complex and challenging needs (Porter & Teisberg 2006).
Care may as well be provided at community venues such as drop-in and day care centres. A good example is the Community Integrated Care (CIC) group, one of the leading nonprofit social and health care providers in the UK (Porter & Teisberg 2006). CIC is a national and registered charity that works in the community by providing support to people with a diverse range of needs across England and Scotland (Porter & Teisberg 2006). The group provides support to people with learning difficulties, physical disabilities and mental health conditions. It also provides a range of support services to older people with dementia. Further, CIC provides homelessness services such as housing, personal development and training and education to homeless people (Porter & Teisberg 2006).
While there are a number of agencies, both statutory and voluntary, offering social care services to vulnerable individuals, challenges still remain in the provision of such services. Health inequality is one major challenge which has continued to undermine the effective provision of services in the health care.
In the UK, the black and minority ethnic (BME) groups have in general reported ill-health and their dissatisfaction with the care services. A large proportion of the UK population constitutes the white. According to the 2001 census, the white accounted for 92% of the total population while the Black British and Asians accounted for 2% and 4% respectively (DOH 2006). Ethnic differences in the delivery and uptake of health care services have been reported.
For example, access to care for coronary heart disease has been found to be lower among the South Asians (DOH 2006). With reference to prevention, the rates of smoking cessation have been found to be lower in these minority groups compared to the whites (DOH 2006). Additionally, most of these minority groups have indicated higher rates of dissatisfaction with the services provided by the NHS. For example, according to the Healthcare Commission patient surveys, most of the South Asians reported poorer experiences in hospitals as inpatients (DOH 2006).
Many of these minority groups experience higher rates of poverty than the whites, in terms of area deprivation, worklessness, income, and the lack of basic necessities. This perhaps explains the variation in self-reported health. However, other than their socio-economic status, there is a complex interplay of factors that may be responsible for causing such inequalities including discrimination, racism, poor delivery of health care services, biological susceptibility and the differences in culture and lifestyles (DOH 2006).
Policy developments have tried to tackle inequalities in health. Acheson’s Independent Inquiry of 1998 was a key initiative that put health inequalities on the policy agenda (Stuart 2003). It emphasized on how poverty, the wider inequalities and exclusion were impacting on the provision of health care services. Subsequent policies have also recognized inequalities in health as multi-faceted and focused on reducing these inequalities.
The central focus of health inequalities policies have primarily been on health care and NHS funding (Baldock, et.al., 2007). Besides the socioeconomic inequalities, policies have also focused explicitly on equity between the various ethnic groups. Identifying good practice in racial equality and mainstreaming strategies in health services has been the main approach to tackling inequalities (Baldock, et.al., 2007). A number initiatives have been commissioned by the Department of Health to collate good practice in such as Race for Health, Pacesetters and handling problems like language barriers and barrier to access of health care resources (Stuart 2003).
More recently, major reforms have been made to the NHS. The role that Primary Care Trust plays in health care has expanded and changes have been made to practice based commissioning, competition, and involvement of patient as well as plurality of providers (Lewis, et.al 2010). These reforms are seen as making it easier tailor health care services to local populations thus meeting the needs of everyone, including the minority groups.
The Department of Health has also initiated the Mosaic programme, which aims at developing and maintaining good practice in procurement, based on the Commission for Racial Equality guidelines (DOH 2006). Concerns have however been raised by critics that the initiative may not be of benefit to the minority and deprived groups and they have called for an examination of the impact that these reforms may have on equalities.
While there has been a remarkable progress towards reducing inequalities in the health care sector in UK, there is still the need to develop more policies and interventions that support all sections of the society and direct care, treatment and services in proportion to need. This includes advocating for the promotion of individual rights within the care sector.
In this regard, individual rights include, but are not limited to (Adams 2007):
- The right to respect
- Not to be discriminated against
- Right to practice their cultural and religious beliefs
- Making their own choices
- Right to equality or to be treated in a similar manner as the rest of the population
- Treated as an individual
- Right to be treated in a dignified way
- Right to privacy or confidentiality
- Protection from harm and danger
- Right to have access to information, especially where that information concerns them
- Communication using their preferred methods.
There is thus the need for recognition of the immense diversity amongst individuals in the British society and how care agencies, both voluntary and statutory, can accommodate this diversity. This promotion of equality and individual rights is crucial for effective provision of care services. That is, social workers need to treat everyone as an individual, have respect for individual’s diversity and cultural values, promote equal treatment and opportunities for individuals, empower individuals, support them express their needs and experiences, ensure their well-being, work in ways consistent with the individual’s preferences and beliefs, avoid their discrimination and put the individual’s preference at the heart of service provisions through person centred planning approach (Adams 2007).
Social care services are provided to vulnerable individuals to protect them from harm, promote their independence and social inclusion, preserve or advance their physical and mental health, improve their opportunities and life chances, strengthen their families and protect and promote their individual human rights. In spite of the importance of provision of social care services, it is apparent that the current system in the UK is perceived unfair in the provision of health care services. There seems to be huge disparities in health care service provisions in parts of the UK with the spearheaded areas experiencing worst health care and deprivation.
A remarkable progress has however been made towards reducing inequalities in the health A number initiatives have been commissioned by the Department of Health to collate good practice in equality in health such as Race for Health, Pacesetters and major reforms made to the NHS. These are seen as making it easier to tailor health care services to local populations thus meeting the needs of everyone, including the minority groups.
While there has been a remarkable progress made, there is still the need to develop more policies and interventions that support all sections of the society and direct care, treatment and services in proportion to need. Social workers can play an important role in reducing health inequalities by working with service users in increasing their social and material resources and providing them access to information and support systems as well as maximizing their capacity to managing their health.
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