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The Politics of Health in the United Kingdom

Introduction

Public health provision in the UK continues to face a myriad of challenges which have impacted quality, access and cost. As a result, there are so many issues which need to be addressed to enable the country to attain its short-term and long-term healthcare goals. The ‘Healthy Lives Healthy People’ is a strategy that was introduced by the government to give guidelines on how improvements in public health systems in England need to be carried out. This was adopted in 2010 after the Conservatives led by Prime Minister David Cameron took control of the government (Secretary of State for Health 2010, p. 6). One of the major reasons that led to the formulation of the white paper is that it seeks to empower communities to take control of various public health issues they are facing. The government has established a universal framework that outlines how public health issues are addressed to ensure healthcare services become more accessible to all.

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Policymakers in government have a crucial role to play to ensure every person living in England can access affordable, quality healthcare services. Long-term investments are also crucial in public health. They enable both public and private healthcare providers to understand existing healthcare challenges and how they can be addressed (Royal College of Psychiatrists 2010, p. 11). Even though there is a shift towards increased devolution in the provision of healthcare services to smaller units, the government should focus on overall issues that determine healthcare quality and access. Health policy is a combination of ideas and proposals made by the government to influence and set standards that determine how healthcare systems in the country operate. Health policy is directly influenced by political, economic as well as social factors which exist in a certain country (Collins, Drake & Deacon 2013, p. 97). In the UK, the government, led by the Prime Minister liaises with other stakeholders to develop systematic approaches that determine how healthcare services in the country are done.

In England, the ‘Healthy Lives, Healthy People’ strategy intends to make healthcare services more accessible to communities living in different parts of the country. The strategy’s main focus involves empowering devolved public healthcare service units in different locations to make them more effective to deal with various healthcare needs. The strategy seeks to improve outcomes in different health programs that are initiated by the government in various settings. However, there are inequalities in the overall healthcare system in England which hinders equitable access to healthcare in the country (Cooper 2011, p. 111). There are many high risk groups which are not able to access quality healthcare services due to cost, ignorance, low incomes, inadequate number of specialised professionals and inappropriate interventions. All these factors have an impact on the way healthcare policies in different communities are implemented. Some healthcare settings suffer from inadequate skills shortage for specialised health services which affect people living nearby.

This strategy was formulated at a time when Britain, just like many other countries was reeling from effects of the global economic downturn. The establishment of the new health system will be affected by these economic challenges. The government has a big responsibility to enforce these challenges to increase the quality of public health services. The pace of change in various key public health systems should be a matter of concern to the government because they are inadequate for the country’s healthcare needs. Currently, many public health sector bodies have been forced to make their operations leaner and more efficient to conform to prevailing economic conditions in the country. Healthcare providers, health professionals and other stakeholders also need time to understand how these changes will affect their operations. One of the key issues that needs to be considered is how budgeting will be done (Burns, Catty & White 2009, p. 952). The department of health needs to consult other stakeholders in public healthcare systems to ensure scarce resources are channelled to priority areas to avoid wastage.

The skills of healthcare workers in different healthcare settings need to be assessed to find out if they are able to perform healthcare functions as outlined in the new healthcare policy. Healthcare workers need to be exposed to different healthcare problems to make them more competent in their duties. They also need to understand how to solve various healthcare needs in different environments. Inadequate healthcare workers make it difficult for patients to access quality healthcare services in various locations (Lundahl & Burke 2009, p. 1238). Staffing shortages affect the quality of healthcare services offered in public health facilities because patients have to wait longer before they are attended to. The government needs to allocate more funds to train healthcare workers to make them acquire high quality skills (Sin & Lyubomirsky 2009, p. 473). Public health facilities also need to fund various preventive initiatives to change people’s attitudes and perceptions on various healthcare issues. Public health service providers need to have strong collaborations with people in different community settings to improve the quality of healthcare services they provide.

Key Factors

Mental health problems in the UK are estimated to cost the exchequer more than £100 million annually. The government needs to do more to ensure mental health patients get quality healthcare services to improve their wellbeing. There are many people who are affected with mental health problems due to depression, old age, loss of economic opportunities and drug abuse (Norman & Ryrie 2013, p. 97). One of the key elements of the ‘Healthy Lives, Healthy Living’ health strategy is to empower local communities to participate in decisions that affect health outcomes in areas they are living. The government proposes that a ring-fenced budget will be use to channel funds to public health service organisations to make them well equipped to deal with various health issues. However, the strategy fails to specify the criteria that various local governments need to use as they allocate funds for different healthcare needs. Administrative conflicts between different parties in local councils may impact positively on healthcare funding in various communities.

Conservative Party’s political ideologies influenced the formulation and implementation of this strategy. The strategy proposes that people’s conditions and behaviour need to evaluated to make them change their attitudes and perceptions towards various forms of public health services. Patients with mental health need more specialised care that addresses the root causes of their problems to give them a better chance of recovery. The health strategy white paper focuses on specific lifestyles of people in different environments they are living in (Norman & Ryrie 2013, p. 103). It looks at other factors that impact on peoples’ wellbeing and proposes ways in which they can be addressed to enable more people get equitable access to quality health services. The issue of mental health in schools needs to be given more attention to deal with various psychological conditions children face as they grow up.

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A comprehensive strategy that involves parents, teachers and community social workers needs to be established. This will help young people to deal with various mental health problems they are facing. Even though the strategy proposes that responsibility for healthy wellbeing in the country needs to be shared, the white paper has not done enough to address issues faced by mentally ill young people living in low income communities. It is estimated that the number of young people suffering from anxiety and depression disorders has risen by 70% in the past two and a half decades (Norman & Ryrie 2013, p. 109). This situation is a grim indicator that more needs to be done to understand risk factors which make young people vulnerable to various mental disorders. Mental health disorders in young people needs to be dealt with quickly to ensure this group of patients does not suffer from severe mental breakdowns in their adulthood.

Patient centred strategies need to be used to help young people deal with various mental health challenges they are facing. Educational and community health programs can equip more people with knowledge on how to deal with various mental health conditions. The strategy focuses on using local government bodies to influence their residents to take charge of their health and wellbeing by changing their behaviour and attitudes on various healthcare issues. However, this approach may not yield the desired outcomes because some local government bodies lack the necessary expertise to carry out effective health initiatives meant to increase awareness. Some of them do not have specialised facilities and systems to deal effectively with various mental health challenges that affect their residents (Horowitz & Garber 2006, p. 406). Therefore, this makes such health initiatives inappropriate and ineffective.

Changes in attitudes are important to make people understand what they need to do live positive lives. The Royal College of Psychiatrists estimates that more than three quarters of psychiatric disorders in young people occur before they turn 25. Public mental health services need to be strengthened to give more attention to various mental disorders that affect people in different parts of the country. The program needs to do more to enhance the quality of health services offered to mental health patients (Horowitz & Garber 2006, p. 410). Mental health services need to be strengthened to ensure more people have access to preventive healthcare services in the country. All social services in various communities should focus on improving accessibility of mental health services in different communities. This will ensure all people are protected from various mental health problems they are likely to face in their communities. More efforts need to be directed towards empowering communities to develop peer intervention programs to give adequate support to mental health patients.

Evidence for Mental Problems

The issue of social class in healthcare provision needs to be given a lot of attention because it has an impact on equitable healthcare service distribution across the country. The government’s health policy seeks to empower the NHS to address various inequalities in healthcare which make it difficult for some people to get timely interventions. Since the strategy seeks to strengthen screening programs, this will help in early detection of mental health problems in patients before they become chronic (Mental Health Network 2009, p. 8). A reduction in employment opportunities in various sectors of the economy is likely to result in higher occurrences of mental health disorders. As a result, the impact of the economic downturn on mental health problems in various communities in the country needs to be freshly assessed. This will guide the government to assess needs that exist in various health systems and how they affect access to healthcare services. More attention is given to physical healthcare services in the country at the expense of mental health programs.

Local healthcare systems serving different communities lack specialised care programs that deal with mental health disorders. All communal public health systems need to be equipped with suitable mental health programs that address mental health needs facing their populations (Mental Health Network 2009, p. 11). There are specific mental health needs which are prevalent in various societies. For instance, low income neighbourhoods are predominantly affected by different forms of substance abuse and addictions which affect the mental health of people living there. Therefore, mental health programs need to be better equipped to deal with different types of addictions in different environments. Sensitisation programs in schools and social areas need to be used to encourage people to avoid poor choices that are likely to impact negatively on their mental health. Lifestyle choices have a big contribution to cases of substance abuse and they need to be addressed to reduce the prevalence of mental health disorders that are caused by drug and alcohol addictions.

Mental health programs should target environmental factors that are in particular areas to make them more suitable for populations living there. For instance, incarcerated people suffer from various mental health problems in prisons and remand facilities. Law enforcement agencies in the country need to be empowered to help prisoners deal with personal problems in incarceration to protect them from various mental health problems. In such instances, research programs need to be strengthened to make such people deal with various health challenges they are facing while still in prison and after they have been released. Mental health patients who commit serious offences need to be monitored to ensure they are not a danger to themselves and other people in communities they are living in. One way of addressing this issue is by encouraging people to change their attitudes and perceptions towards mental health patients (Thornicroft, Rose & Kassam, A 2007, p.192).

It is estimated that 25% of people living in the UK are likely to suffer from one or more forms of mental health disorders in their lifetimes. Anxiety and depression are the most common manifestations of mental health problems in the UK affecting both men and women. Statistics also estimate that there are more women than men suffering from different types of mental disorders. It is estimated that 10% of children and close to 9 out of every 10 prisoners are affected by different mental disorders. These statistics confirm that public health systems are not well equipped to deal with various mental health problems faced by people in different communities. It is estimated that about 400 out of 100,000 people in the society are likely to get involved in self harm activities (Makhija 2007, p. 47). Most suicide cases which have been reported in the country have been committed by males (Fraser & Blishen 2009, p. 8). This shows that many men suffering from various psychological conditions are not willing to seek professional help compared to women.

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Alternative Solutions

The ‘Healthy Lives, Healthy Living’ policy needs to address these grim statistics that people living with mental health disabilities face in the society. The issue of stigma needs to be dealt with to help people who are dealing with various stressful situations to come out and get interventions to help them overcome their situations. This will encourage more people in the country to look for more information regarding mental health disorders that affect them and their close family members (Fraser & Blishen 2009, p. 11). Since suicide is one of the leading causes of death in young males aged 35 and below, suitable programs need to be put in place to reduce incidents of self harm among young males. The national health strategy put in place by the government is looking for solutions to address various factors that contribute to poor health in various communities. As a result, information gathering approaches are being strengthened to enable the NHS understand specific areas of need that need more investments.

More information needs to be gathered and analysed to find out factors that lead to mental health disorders and their effects on patients. For instance, people need to be made aware about various suicidal instincts exhibited by their friends and family members to enable them assist affected parties in the shortest time possible. Incidents of bullying and abuse expose young children to different types of mental disorders as they grow up. Parents need to find out specific symptoms that show their children are suffering from various psychological ailments (Wilson & Lipsey 2007, p. 135). They need to be given more information to ensure their children are not exposed to substance abuse, violence and pornography. Many cases of mental health in the country begin in childhood and become more severe when such patients are not treated early enough. As a result, such people are likely to find it difficult to get employed and they may become dependent on social welfare when they grow up.

Collaborative health approaches should be used to help the country deal with social and economic problems that expose people to various mental health problems. The strategy needs to focus more on people of low socio economic status, who are likely to suffer from different forms of discrimination. Other high risk groups such as juvenile convicts, the unemployed, homeless people, old people and substance addicts need to be included in specific mental health initiatives. Loneliness, shame and abandonment are some of the risks that predispose people to different mental health problems. People in high risk groups are ostracised by other people and this social exclusion makes them susceptible to various mental disorders. Health systems in local councils need to have proper therapies to deal effectively with various mental health issues (Wilson & Lipsey 2007, p. 139). Recovering mental health patients need to be used as peer volunteer counsellors in different communities to reduce the stigma attached to various mental conditions that affect people. This will encourage people who are facing different mental disorders to come forward to look for solutions to help them deal with their conditions before they deteriorate.

Current policies need to be modified to ensure all local public health facilities in the UK are well equipped to deal with various mental health disorders that occur in their communities. There is a shortage of psychiatrists and mental health experts to deal with mental disorders that happen in different communities across the country. Policy makers need to encourage collaborations between local councils to share ideas and resources to help them tackle various mental health problems effectively. Mental health experts need to work closely with administrators of local councils. This will help them assess needs that exist in different locations to ensure resources are allocated based on existing priorities (Pryjmachuk 2011, p. 52). This will help local administrations to find out if services that are provided through public health facilities are adequate for existing mental health needs.

Conclusion

In conclusion, the strategy needs to focus more on preventive health approaches to help people living with mental disorders in various communities. The policy seeks to decentralise many health services in the country. In the long term this will reduce inequalities which have affected universal healthcare provision in England and other parts of the UK. However, the strategy provides only general remedies to various mental health issues that affect people living in different communities. All health systems need to have outreach programs that monitor and give support to mental health patients. The issue of stigmatisation of mental health patients needs to be addressed to ensure they are not subjected to ridicule by members of communities they are living in. This will make more people seek assistance for different mental disorders they are facing.

References

Barker, P 2009, Psychiatric and mental health nursing: the craft of caring, CRC Press, London.

Burns, T, Catty, J & White, S 2009, ‘The impact of supported employment and working on clinical and social functioning: results of an international study of individual placement and support’, Schizophrenia Bulletin, vol. 35 no. 5, pp. 949–958.

Collins, E, Drake, M & Deacon, M 2013, The physical care of people with mental health problems: a guide for best, Sage, London.

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Cooper, DB 2011, Care in mental health-substance use, Radcliffe Publishing, London.

Fraser, M & Blishen, S 2009, Supporting young people’s mental health, Mental Health Foundation, London.

‘Healthy lives, healthy people: our strategy for public health in England’ 2010, Department of Health White Paper, United Kingdom Government, London.

Horowitz, JL & Garber, J 2006, ‘The prevention of depressive symptoms in children and adolescents: a meta-analytic review’, Journal of Consulting and Clinical Psychology, vol. 74 no. 3, pp. 401–415.

Lundahl, B & Burke, BL 2009, ‘The effectiveness and applicability of motivational interviewing: a practice friendly review of four meta-analyses’, Journal of Clinical Psychology, vol. 65 no. 11, pp. 1232–1245.

Makhija, N 2007, ‘Childhood abuse and adolescent suicidality: a direct link and an indirect link through alcohol and substance misuse’, International Journal of Adolescent Medicine and Health, vol. 19 no. 1, pp. 45–51.

Norman, I & Ryrie, I 2013, The art and science of mental health nursing: principles and practice, McGraw Hill, Berkshire.

Pryjmachuk, S 2011, Mental health nursing: an evidence based introduction, Sage, London.

Sin, NL & Lyubomirsky, S 2009, ‘Enhancing wellbeing and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta- analysis’, Journal of Clinical Psychology, vol. 65 no. 5, pp. 467–487.

Thornicroft, G, Rose, D, & Kassam, A 2007, ‘Stigma: ignorance, prejudice or discrimination?’, British Journal of Psychiatry, vol. 190, pp. 192–193.

Walker, C & Fincham, B 2011, Work and the mental health crisis in Britain, Wiley, New York.

Wilson, S & Lipsey, M 2007, ‘School-based interventions for aggressive and disruptive behavior: update of a meta-analysis’, American Journal of Preventive Medicine, vol. 33 no. 2, pp. 130–143.

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