Comparision of Specialy Care & Primary Care Management & Policy in the British Healthcare System

Introduction

Despite consensus in the Britain and abroad that primary care is a critical component of any health care system, there is a considerable imbalance between primary and specialty care in the Britain. The proportion of specialists is over 70% of all patient care physicians, whereas in other industrialized countries 25 to 50% of physicians are specialists. The current specialty physician supply in the Britain is more than sufficient to meet the demand for treatments that all physicians agree are necessary, regardless of specialty. (Harrison, pp. 105) Based on staffing patterns in classic Health Maintenance Organizations (HMOs), research indicates there are about 3.1 times more pathologists, 2.5 times more neurosurgeons, 2.4 times more general surgeons, 2.0 times more cardiologists and neurologists, 1.9 times more gastroenterologists, 1.8 times more ophthalmologists, and 1.5 times more radiologists in the nation than would be needed. Furthermore, the interest of medical students in primary care careers dropped from 36% in 2004 to 14% in 2008. This review paper examines factors associated with the imbalance between primary and specialty care, the consequences of such an imbalance, and suggests strategies to balance primary and specialty care in UK health care system. Moreover, ultimately to improve the health status of populations, nations should strive to balance medical, behavioural, and social interventions. To provide a common conceptual base, I will first draw out the major distinctions between primary and specialty care. (Marmot, pp. 108)

Health-care systems in UK

Health-care systems throughout the world struggle to maximise health gain whilst controlling health expenditure. Public confidence in a nation's health system is also important, and politicians tend to respond rapidly to any perceived crisis. (New, pp. 1593-1601) Prime examples of recent crises in the UK include the flurry of media interest in the level of spending on health care, arguments about the availability of beds in intensive-care units, and disquiet over quality of care in such areas as cancer treatment. (Coulter, pp.1197-8) In the UK it is a public service (a quaint notion to some Americans). Deeply ingrained beliefs in market principles, the virtues of entrepreneurship, and the competitive advantage of innovation drive the US health-care business. By contrast, a fear of real markets and a resistance to competition, a dependence on bureaucratic control and central regulation, and a stifling of innovative change underlie many UK public-service ideals. UK places trust in a certain degree of social responsibility on the part of health-care providers.

Defining Primary And Specialty Care

Throughout the world, primary care is considered to be the basic level of healthcare provision. Despite the near-universal agreement of the importance of primary care, the concept of 'general practice' is increasingly threatened by interests vested in the technological aspects of medical care generally associated with subspecialism. The purpose of this chapter is to highlight the special contributions made by primary care within health services systems and to suggest that a continued focus on primary care will be necessary for further progress ...