Introduction to Healthcare
This essay will identify and examine the factors that have, and continue to, influence health care policy and practices within the ever changing health service. It will particularly concentrate on the changes in the National Health Service (NHS) within the last decade and the impact that this has had on the Operating Department Practitioner profession. The National Health Service (NHS) was launched on 5th July 1948 by Aneurin Bevan, the then Minister of Health. Its 3 core principles were to meet the needs of everyone, to be free at the point of delivery and be based upon clinical need and not the ability to pay. The services were to be predominantly funded from general taxation. (NHS, 2011). The Porritt Report (Great Britain. Parliament. House of Commons, 1963) resulted in Enoch Powell’s Hospital Plan (Great Britain. Parliament. House of Commons, 1962) which proposed the development of district general hospitals. In 1968 the Department of Health (DoH) was created by the then Labour Government. Its objective was to provide information on public health and it is still responsible for standards of healthcare and sets strategic frameworks. (Great Britain. Department of Health, no date) The Lewin Report (Great Britain. Department of Health and Social Security, 1970) was commissioned by the Central Health Services Council (CHSC) to examine the organisation of work in operating theatres and address staffing issues. The need for this arose from several developments highlighting the ever increasing burden on operating staff. Constantly increasing workloads coupled with increasingly complex procedures culminated in severe understaffing. The need for skilled workers and a clear recognition that scope of practice should be clarified were key factors in this report. There were also recommendations for dedicating operating theatres to be put aside for emergencies, consistency in shift patterns and compilation of operating lists. Information was also to be recorded about procedures performed. This culminated in a need to delegate a considerable amount of duties from nurses in the operating department to Operating Department Attendants. Subsequently this resulted in the creation of the role of Operating Department Assistants. These are the predecessors of the current Operating Department Practitioners. In addition there was a clear recognition that this role needed to be developed in the future on a much broader scale and consequent duties should include more contact with service users. There was also a specific recommendation that they “take their place within the theatre team at the instrument table and perform safety checks of instruments, swabs and needles in conjunction with a second person and report such checks to the surgeon”. These recommendations are still used in theatres today. The Black Report (Great Britain. Department of Health and Social Security, 1980), commissioned in 1977 by the Labour Secretary of State David Ennals and published under the Conservative Government concluded that the overall health of the country had improved but there was still widespread health inequalities. These were mainly economic, and it was found that those in lower socio-economic groups were twice as likely to die as those in higher groups. Subsequently the Whitehead Report (Great Britain. Department of Health and Social Security, 1987), The Acheson Report (Great Britain. Department of Health.1998) and the Marmot Review (Great Britain. Department of Health, 2010) have all reached the same conclusion. The Health of the Nation (Great Britain. Parliament. House of Commons, 1992) set 27 targets to boost public health and introduced the concept of prevention and wellness rather than the previous NHS mind-set of an illness service. The NHS and Community Care Act (Great Britain, 1990) led to the reorganisation of the NHS and the move to “purchase-provider”. The large public hospitals that had become self-governing...
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