This chapter examines the provision of health care services. It first considers the way in which NHS services are commissioned. Secondly, it covers the issue of resource allocation, including the special issues raised by rationing in a pandemic. It examines different rationing strategies, and considers the role of the National Institute of Health and Care Excellence, and the use of judicial review to challenge funding decisions. Finally, it examines public health law, and role of the state in encouraging healthy behaviour and addressing health inequalities.
Chapter
2. The Provision of Healthcare Services: The NHS, Resource Allocation, and Public Health
Chapter
1. The contemporary health-care environment
This chapter provides an overview of the contemporary health-care environment, with particular reference to the National Health Service (NHS) and its core principles, as well as its constitution. Access to health services, as set out in section 3(1) of the National Health Service Act 2006, is also discussed, together with the quality of care provided for individuals. In addition, the chapter looks at the findings of the Francis Report, which conducted a public inquiry into acknowledged failings in the Mid Staffordshire NHS Foundation Trust, the government response to the report, and the future of the NHS. In addition, there is a section on public health and the COVID-19 pandemic.
Chapter
3. Community Care
This chapter examines the delivery of community care services. It discusses services for mentally disordered persons; the entitlement, nature, and scope of the duties owed under the National Health Service and Community Care Act (NHSCCA 1990); alternative mechanisms for securing services; and the use of personal budgets and direct payments. The chapter argues that most of the time, local social service authorities and National Health Service bodies do cooperate reasonably well in the delivery of community care services, particularly for service users with learning disabilities. The draft the Care and Support Bill holds the potential to radically simplify the legal framework in which community care services are delivered, making the system more transparent and intelligible to both users and professionals. The increased use of personal budgets and direct payments could empower service users in a way that has not been possible in the past.
Chapter
6. Assisted reproduction
This chapter deals with the statutory provisions governing assisted reproduction, with particular reference to the Human Fertilisation and Embryology Act 1990 (as amended) and the Human Fertilisation and Embryology Authority. It also explores the issue of access to services and whether these are available on the National Health Service, together with the ethical and legal issues surrounding the use and storage of gametes and embryos, surrogacy arrangements, and screening of embryos. Relevant cases are considered, where appropriate.
Chapter
3. The Governance of the Health System
A. M. Farrell and E. S. Dove
This chapter examines the governance of the health system in the UK. In the UK, there are four health services which are often referred to collectively as the National Health Service (NHS). A general overview of the UK health system is provided, which includes examining how health policy is made and how health decision-makers are held to account, what public bodies are involved in the health system, and how the health system is financed. Consideration is given to the impact of current political devolution arrangements in the UK, which has resulted in health care and public health becoming the responsibility of the devolved administrations of Northern Ireland, Scotland, and Wales. Thereafter, each of the UK’s four health services are examined in more detail, focusing on their organisational structure, specific health initiatives, and their approach to patient safety and quality improvement.
