The Organisation Health and Social Care Services
• Statutory Services- have been set up because parliament has passed a law which requires the services to be provided, for example, accident and emergency departments in hospitals, education services for children or home care services for older people.
• Private organisations- are run on profit – making basis and are business, for example, private hospitals and residential homes or private children’s nurseries.
• Voluntary organisations- are run on a non profit making basic, for example, the Women Royal voluntary services (WRVS), or Barnodo’s, an organisation which provides care for children and young people.
However, health and social care is also often provided by people outside these formal agencies and organisations. Informal care maybe provided by family members, friends and neighbours.
An Overview Of Health and Social Care Provision
Statutory sector organisation
The two main providers of statutory services are the national health services (NHS) and local authority services. Statutory services are organised at national, regional and local levels.
The National Health Service (NHS)
The aim of the national health service (NHS) was to provide integrated and co-ordinated health care services to all that were free of charge at the time of use. There were three main parts to the service.
1. Primary care services, which include GP’S, Dentists, Opticians and Pharmacists.
2. Secondary and tertiary care services of the regional and district systems, for example, hospitals and specialist services.
3. Community care and public health services, which had an emphasis on preventive work and health promotion. Early examples of these included vaccination and immunisation programmes against illnesses such as smallpox and whooping cough.
Until recently there were only comparatively minor changes in the way the NHs was structured. However the NHS has now undergone major reforms that have been more far reaching than any other changes under taken since it was set up in 1948.
These reforms are set out in four government white papers:
1. Promoting better health (1987), which concerns primary health care.
2. Working for patients (1989), which discusses the management and provision of services.
3. Caring for people (1989), concerning community care.
4. The new NHS (1998), which sets out the future of the NHS.
In addition to these white papers, the NHS and Community Care Act 1990 had important consequences for the way health and social care agencies are organised. At the centre of the reforms to health and social care was the idea there should be a clear division between purchasing and the provision of services. The idea of purchasers and providers might be best understood by thinking about obtaining estimates for the catering at a wedding reception or some other large social event. You decide it would be too difficult or expensive to provide the catering yourself, so you contact a number of catering firms to supply the estimates. Once you studied the estimates which firm provides the best value for money. You contact the firm again and go ahead to book the supply the catering. In this situation, you are the purchaser of the services. The catering firm you have chosen is the provider of the services, and you have chosen your provider by comparing the services offered by the same market. NHS and social service departments who have responsibility for ‘buying’ service departments (the purchasers – deciding the NHS budget should be spent on and deciding on the allocation of funds for the provision of different services) and those departments which decide who should provide these services, e.g., hospitals, dentists, and district nurses. In the health service the old district health authorities become the purchasers, together with some GP group practices, which become GP fund holders. In social services departments, it was senior managers who become the purchasers. Residential homes, day centres and home care units become the providers.