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Management Issues in the NHS

The National Health Service is a collective name given to the four publicly funded health care systems of the United Kingdom. The health service in England commonly uses the name “National Health Service” without further qualification while the publicly -funded health care organization in Northern Ireland does not use the term “National Health Service” though it is still commonly referred to as the “National Health Service”(Rudolf 2006). The four systems operate independently and it is believed that originally, the three services for England and Wales, Scotland, and Northern Ireland were established by separate pieces of legislation and began operating from 5th July 1948 (Rudolf 2006). The department of Health at that time had responsibility for National Health Service in England and Wales, the Scottish Office on the other side had responsibility for the National Health Service in Scotland and the government of Northern Ireland had responsibility for the public health of Northern Ireland (www.nhshistory.net).

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The National Health Service primarily provides Health care to anyone. These services include primary care, inpatient care, long-term health care, eye tests, dental care, and ophthalmology. The National Health Service is largely funded from the general taxation which includes a proportion of the public from National insurance payment. Normally there is no discrimination when it comes to treatment where a resident from one of the countries of United Kingdom requires treatment in another because the consequent financial matters and paperwork of such inter-working are dealt with between the organizations involved and generally there is no personal involvement by the patient (Harrison 1988).

The current management issue in the National Health Service is the management issue of Health, Safety, and Welfare for the National Health Service Staff. It is an issue of major concern to the National Health Service that should be addressed to enable it to meet its targets, goals and at the same time provides efficient services to the public especially patient care services. In order for the National Health Service to effectively manage the issue of Health, Safety, and Welfare for its Staff, the executives of National Health Service should implement Occupational Service which is described as a service that addresses the impact of work on health and health on work (Allyson 2004). The service, therefore, endures providing competent advice and support of the organization’s objectives. It seeks to reduce the incidence of illness and injury caused by working in the National Health Service. It also seeks to ensure that the objectives of working with the National Health Service fit every employee employed by assessing applicants for employment to ensure that every employee is employed to his/ her appropriate work. This therefore will enable every employee of the National Health Service to be able to achieve his/her full capabilities at work. This will eventually prevent harm to all the patients of the National Health Service and its Staff too. The public will benefit from this hence these occupational health activities will therefore endeavor to provide competent advice, support, and meet long-term goals and targets (Allyson 2004).

Another important aspect of the Occupational Health Service is based on teamwork. This aspect will enable the entire employee of the National Health Service to work together in the union where Specialists, trained doctors, and nurses will provide complementary clinical services at workplacelace enabling other professionals such as physiotherapy and psychology to be easily recognizable. This will also give a chance to other occupational professionals like hygienists and ergonomists a crucial role in the overall delivery of a competent service. National Health Service will eventually benefit from this as it will improve the provision of service by staff and it will help management protect patients, visitors, and others from staff that may represent a hazard (Handy 1998).

Secondly, for the National Health Service to manage the issue of Health, Safety, and Welfare for its Staff the executives managing the organization should ensure that they act fairly to all its employee’s who work in the various parts by exercising good relation to its activities. They also should seek to ensure that high standards of patient care are maintained within the available resources (Handy 1998).

Thirdly, the managers of the National Health Service should implement the Management referral method where managers will seek medical advice for the exiting employees where there is an employment or management issue involving health matters. A manager will then decide to refer the employee according to his/her analysis when there is a possibility of the occurrence of an occupational disease as part of management of the disease or consideration of an early retirement on ill- health grounds. Therefore, the managerial referrals should be in writing and the employee should be made aware of the referrals. They should also be done on a standard form copy that should be made available to the concerned employee immediately this in the end enables mangers to obtain the employee’s good consent for referral by means of full explanation (Mintzberg, 1983).

Fourthly, the executives of National Health Service should put in place specific work hazards where the management of health and safety at work place will systematically assess all work place risks and take reasonable practicable action to minimize those risks. Example employers could give a priority to prevent their employee’s from injury by being exposed to chemicals and substances such as glutaraldehyde by any route which may occur inform of inhalation, ingestion, or contact with skin as required by the Control of Substances Hazardous to Health by putting in place a formal health surveillance programme that will ensure that all employee’s exposed to glutaraldehyde must be given sufficient information, instruction and training to understand the potential problems and precautions they need (Harrison 1988).

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The second issue is the management of doctors which entails the conflicts between the different cultures in the National Health Service and the managers. Since National Health Service is multi-cultural society which comprises of medical, nursing, management and many others- has its own identity and sub-cultures, considering the various specialty groupings existing such as surgeons, psychiatrists, or general practitioners with different characteristics and aims. This means the potential for conflict arising from cultural differences is limitless. Since the tension is between the amount of clinical work done and the amount of money available to pay for it this has had a great impact on overall relationship and needs to be addressed.To handle this conflict successfully it calls for each group to understand each other’s needs and culture though often they think they do but its based on stereotype and often tends to reinforce rather than reduce antagonism (Harrison 1988).

The other approach is the use of extreme power to assert the rightness of one. Though its a tactfully way it is nevertheless quite common in complex and changing environments like that of National Health Service where all allies eventually will be needed in the future conflicts. It makes all the parties to reach at the same resolution with both the parties reaching a tacit recognition that no profession or culture is totally dominant (Harrison 1988).

The third approach advocated for is the one based on values since values endure. It applies not only to doctors and managers but to all other cultures within the National Health Service, all of which despite their conflicts share similar enduring values. These values may include mutual respect which is first essential for respect between the parties which is an acceptance of legitimacy of the separate cultures and an acceptance that other people really hold their believes strongly as others. Another important aspect is sharing of objectives on the basis of values which both cultures share. The doctors and managers will agree on objectives whether short-term, medium or long-term. In the case its short-term objectives the agreement will be on the immediate workload and medium objectives is to decide the level of next year’s contract and the long-term may include sharing of values and agreeing on objectives which will eventually provide the foundations to deal with whatever changes that occur to the National Health Service in future. Other values include honesty, and combating disinformation (Handy 1998).

References

  1. Allyson M Pollock (2004), NHS: The privatization of our healthcare. Verso, ISBN 1-84467-5394
  2. Handy CB (1998) On politics and the management of differences, In Understanding organizations,3rd, Harmonds worth: Penguin
  3. Harrison S (1988), The frontier of control in: Managing the NHS: shifting the frontier? London; Chapman Hall
  4. Mintzberg H, Power in and around organizations, New York: Prentice -Hall,
  5. Rudolf Klein (2006), The New Politics of the NHS: From creation to reinvention, IBSN 1-84467-5394.

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