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Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment. / R. C. M Jarvis

Swansea University Author: R. C. M Jarvis

Abstract

The National Health Service (NHS) is seen by many as being at a time of crisis. Demand for care outstrips the human and financial resources available, and the choices that are having to be made with regard to selective funding of treatments are becoming both more public and more tragic. Increasingly...

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Published: 1996
Institution: Swansea University
Degree level: Master of Philosophy
Degree name: M.Phil
URI: https://cronfa.swan.ac.uk/Record/cronfa42682
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spelling 2018-08-31T15:52:04.2222829 v2 42682 2018-08-02 Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment. 38cd41822377267e8f82c4ab93627791 NULL R. C. M Jarvis R. C. M Jarvis true true 2018-08-02 The National Health Service (NHS) is seen by many as being at a time of crisis. Demand for care outstrips the human and financial resources available, and the choices that are having to be made with regard to selective funding of treatments are becoming both more public and more tragic. Increasingly, there are calls for informed public debate about prioritising treatments, or rationing. This thesis argues that the foundation and various reforms of the NHS have all aimed at one common goal: to make health care provision in Britain more efficient. I argue that underpinning the establishment and reforms of the health service has been the mistaken idea that the scarcity of supply relative to demand (and the consequent need to ration care) can be eliminated with more efficient procedures. Faced with the service's continued failure to align supply with demand, unable to gain clear and consistent advice from central agencies, and unwilling to take the drastic step employed by some health commissioners of decommissioning entire areas of treatment, the health commissioners in West Glamorgan took the initiative and established a Local Ethics Committee (Purchaser Advice) to review and give advice relating to commissioning and purchasing issues within the county. This thesis charts the development of the first three years of that unique committee, giving an insight into the processes and methods by which health care is rationed in West Glamorgan. It discusses the philosophical foundations of the review, examines the workings of the committee from the standpoint of the participant observer, and suggests that, as the problems faced by the West Glamorgan health commissioners are those facing commissioners nationwide, the model of ethical review proposed is one that could profitably be adopted elsewhere in the health service. E-Thesis Health care management., Medical ethics, NHS, National Health Service 31 12 1996 1996-12-31 COLLEGE NANME Public Health and Policy Studies COLLEGE CODE Swansea University Master of Philosophy M.Phil 2018-08-31T15:52:04.2222829 2018-08-02T16:24:30.1021998 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health R. C. M Jarvis NULL 1 0042682-02082018162513.pdf 10807451.pdf 2018-08-02T16:25:13.7070000 Output 9551361 application/pdf E-Thesis true 2018-08-02T16:25:13.7070000 false
title Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment.
spellingShingle Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment.
R. C. M Jarvis
title_short Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment.
title_full Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment.
title_fullStr Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment.
title_full_unstemmed Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment.
title_sort Allocation of scarce resources in health care: An ethical review. The West Glamorgan experiment.
author_id_str_mv 38cd41822377267e8f82c4ab93627791
author_id_fullname_str_mv 38cd41822377267e8f82c4ab93627791_***_R. C. M Jarvis
author R. C. M Jarvis
author2 R. C. M Jarvis
format E-Thesis
publishDate 1996
institution Swansea University
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
document_store_str 1
active_str 0
description The National Health Service (NHS) is seen by many as being at a time of crisis. Demand for care outstrips the human and financial resources available, and the choices that are having to be made with regard to selective funding of treatments are becoming both more public and more tragic. Increasingly, there are calls for informed public debate about prioritising treatments, or rationing. This thesis argues that the foundation and various reforms of the NHS have all aimed at one common goal: to make health care provision in Britain more efficient. I argue that underpinning the establishment and reforms of the health service has been the mistaken idea that the scarcity of supply relative to demand (and the consequent need to ration care) can be eliminated with more efficient procedures. Faced with the service's continued failure to align supply with demand, unable to gain clear and consistent advice from central agencies, and unwilling to take the drastic step employed by some health commissioners of decommissioning entire areas of treatment, the health commissioners in West Glamorgan took the initiative and established a Local Ethics Committee (Purchaser Advice) to review and give advice relating to commissioning and purchasing issues within the county. This thesis charts the development of the first three years of that unique committee, giving an insight into the processes and methods by which health care is rationed in West Glamorgan. It discusses the philosophical foundations of the review, examines the workings of the committee from the standpoint of the participant observer, and suggests that, as the problems faced by the West Glamorgan health commissioners are those facing commissioners nationwide, the model of ethical review proposed is one that could profitably be adopted elsewhere in the health service.
published_date 1996-12-31T03:53:26Z
_version_ 1763752654312308736
score 11.01353

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