Wednesday 11 November 2009

11/11/09

 

Getting into Medical School pt 1

NHS

NHS set up 1948, free healthcare

Before only the wealthy were charged.

There was an increase in demand because:

  • those who would have died, lived on to suffer more illnesses to be treated
  • costs of drugs and treatment increased
  • people’s expectations rose
  • pay rose for less hours

1990 reforms

  • Groups of hospitals became NHS trust which offer healthcare as product to GPs
  • GPs shop around for the best price and can use surpluss from funds into own practice.
  • increased focus on primary care over secondary ( though it could be argued that it is cheaper to lock those people than adequately dealing with them in the community – Mental Health Foundation estimates c £540m )

1997 reforms – New NHS: Modern, Dependable

  • change internal market to Integrated Care, which leads to 500 Primary Care Groups with 100, 000 patients
  • GPs connects via internet
  • Cancer has specialist appointment in 2 weeks
  • NHS Direct
  • Savings

Rationing Drugs in 1999

  • Due to low funds
  • Age Concern said elderly were getting poorer treatment. BMA retort that illness acts differently according to age
  • No guidance as to which drugs to prescribe lead to different treatment in different areas

National Institute for Clinical Excellence in 1999

  • combines with Health Development Agency to become National Institute for Health and Clinical Excellence
  • balance clinical effectiveness with cost-effectiveness
  • was against Relenza

2004 reforms - NHS Foundation Trust

  • apply for Trust status
  • run by local community governors
  • offer higher pay
  • can borrow money from gov
  • has to treat patients privately to give back money

Bird Flu

  • Avian Influenza A (H5N1) most common
  • No error fixing mechanism of DNA
  • Antigentic Shift by merging with other Influenza A strains
  • Fear could combine with human flu

Severe Acute Respiratory Syndrome

  • fever, body and headache, dry cough and breathing difficulty

Methicillin Resistant Staphylococcus Aureus

  • 5000/100000 die
  • poor hygiene
  • Independent report cases doubled despite £1bil investment

Human Genome Project

  • Every gene mapped in early 2000
  • turned out that diseases caused by a number of genes

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