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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