Investigate How Patient Choice Health And Social Care Essay

Investigate How Patient Choice Health And Social Care Essay The above-mentioned patient choice agenda in healthcare refers to various types of service providers into the NHS. Choice agenda is dynamic and varies according to time and medical providers. Choice alone without competition gives people a false consciousness without real outcome. Therefore choice and competition work well together rather than individually improving quality and efficiency. Even less competitive health-care providers are motivated to upgrade their services to attract customers. Extending choice agenda tends to eliminate inequalities for less affluent patients. Evidence tells us that choice agenda offers equal opportunities for all and minimise inequalities within healthcare (Dixon, 2003). In 2005 MORI carried out a study and discovered that 5o per cent of the general public prefer to select health-care providers outside their local area comparing with four per of people. Therefore, this study tells us that the general public likes the idea to select for alterative health-care providers. However amplifying patient choice may not successfully eliminated inequities (Stevens, ). Offering choice to the general public is less likely to improve equity if mythological varieties exist within the uptake of choice. Wealthy patients have the freedom pick for private health -care providers if they believe local health-care providers offer poor quality of services, less likely to specialise in their condition and have low rating. Therefore the idea of equal access for meeting equal need to all people failed.  [1]   On the whole, the British Social Attitudes Survey outlines that disadvantaged groups, linked to education, income social class, tend to opt for alternative health-care providers far higher than affluent patients. For instance people with an income of  £10,000, females, working class and low level of educational attainments tend to make use of choice agenda far more than well-off people. A similar study was carried out in Helsinki, Finland and found related results empathising working class people like the idea to choose health -care providers to a greater extent than middle class. Therefore, these examples emphasise no differentiation in the uptake of choice between various socioeconomic classes. 2New Labour accepted the neoliberal model developed by Thatchers administration during 1990s. In 1997 under New Labour patient choice increased and here are some important reforms promoting patient choice agenda: Foundation Trusts (FTs) and rating system. These reforms tend to promote cheap and quality services. This is likely to motivate health-care providers contesting for funding which correlates with the capacity of patients treated. On the other hand Payment by Results which pay secondary care providers using a standard for tariff liked with the amount of patients treated. This reform promotes patient choice upon referral from GPs. Therefore this notion of choice agenda tends to improve waiting list times and quality of services. Last but not least the government tend to places a target system that measures the uptake of choice. The government shifted the attention from competition and continued to promote the business model by promoting partnerships between health-care provider s. In order for promote real choice; the market is obliged to provide alternative providers. Private providers have a long legacy operating within the internal market since 1948 as long as they provide services at a standard tariff. The internal operating under New Labour is less focused solely on competition, but is rather promoting efficiency and quality of services. Evidence shows that patients opt for private health-care providers over public health-care providers because providers exhibit good service quality. In general, patient choice tends to enhance competition among providers to attract customers. On the contrary private health-care providers tend to cover limited services such as non-emergency ones. Patients may demand more services rather than less at higher costs which tend to put pressure on providers to deliver services at high standards. Often private medical providers are likely to display egocentric focused on profit making. In general private providers tend to cost more than services offered by the NHS. Hence this market tends to favour wealthy and competitive patients rather than less well-off. In 2010 White Paper, Equity and Excellence: Liberating the NHS, the Coalition government tends to promote patient choice by introducing a Commissioning Board in the NHS. The Board monitors the performance of primary care providers to ensure health-care providers offer high standard of service care and involve patients in decision making. In addition the commissioning board is also made responsible for tacking equity within healthcare. Also, the government is aiming to increase competition and turn secondary care providers into Foundation Trusts becoming a financial regulator focused on tariff princes and competition as well as promote efficiency. Finally the Foundation Trusts tend to become social enterpriser which is likely to involve medical professionals in decision-making. Choice isnt real for patients living in certain areas of the UK. People living in rural areas of London tend to be excluded from selecting health -care providers. Less affluent patients are less motivated to travel long distances because car ownership is low among disadvantaged groups. Also some people in low paid employment are unable to take time off from work preventing them further from exercising choice. In general, people travelling long distances tend to have poor attendance records for primary care appointments. A study conducted by () show that age, gender and social class differences prevents people from exercising choice. People over 60 year olds, housewives and working class tend to limit travelling distances to search for providers (both primary and secondary care). Hence gender, social class and age tend to be factors that determine the uptake of choice for health-care providers. Affluent patients tend have resources to purchase houses in areas near good -quality health -care providers. An example discovered by () argues that young, affluent patients and living in inner city areas of London are likely to opt for alternative medical health-care providers.  [3]  Whereas disadvantaged groups with low levels of education are found to least opt for alternative medical providers. The uptake of choice agenda among poor individuals is likely to improve when subsidised transport is offered to people, providing additional transport costs and better public transport on the outskirts of the UK. Hence improving the above issues tends to encourage poor patients to travel long distances to have their treatments. Also, lack of available information tends to prevent patients from exercising choice for medical providers. It is believed that some people need additional support to choice medical health-care providers. Often, less well-off patients, low levels of education and the elderly require supplementary assistance to make effective choices. These types of groups are less likely to have access to internet connections, sources or/ and social networks that work in hospitals often equipping them with information of various health-care which tends to help them navigate the system. This source has been criticised for being resource intense and a real problem for those who are not computer literature. Published data is a key element for choice that emphasis the performance of various health-care providers. Making use of this type of data tends to make patients autonomous and self-responsible for their own health. In general, health- care providers use ranking systems to upgrade their services. With their reputation at stake, medical providers are motivated to improve quality of services in order to remain in business. Often, disadvantaged groups use performance data more than middle class people to make health care choices. But lack of available data is a major factor perverting them from exercising choices. Patient choice agenda tends to lead to equity. Reid () claims methodological variations in healthcare are far more complex rather than focusing solely on resources. Poor people tend to lack self-confidence and knowledge to converse with health-care providers in medicinal vocabulary. Evidence shows patients poor ability of expression creates imperfect freedom of choice in decision-making amongst individuals. In general, these issues lead to unequal ability to navigate the system. Although providing people with choice rather than a voice tends to be more effective for less well-off patients. Patient choice agenda gives disadvantaged groups the opportunity to be heard and necessary self- confidence to exercise choices. Therefore, choice empowers patients that are least knowledgeable how to manoeuvre the system. Middle class people, on the other hand, have power, resources and skills to manipulate the system in a particular way that suites their interests. Certainly affluent patients are more proactive than less -well of patients in comparison to choice agenda. Hence privileged patients are more articulate, confident and persistent which often this system suites privileged patients rather than poor people. The impact of patient choice on health services delivery tends to provide mix views. Patient choice may improve the quality of services under the internal market in response to waiting list times. GP fund holders improve waiting list times upon referral to hospitals and reduce cost for prescriptions. An example that may fit in this capacity is found in a study conducted by London Patient Choice Project. This study states that patients tend to look for alternative medical providers in order to reduce waiting list times. Certainly competition together with high numbers of health care providers may further reduce waiting list times. However dissatisfied patients with services offered by medical providers tend to opt for the option to search for alternative medical providers that meet their needs. Under the internal market, money dictates the choices patients make, meaning that hospitals lose money patients choose alternative medical providers. Thus health-care providers must responsive to consumer demands in order to remain in business, unless they are likely to face closure. Patients tend to empower medical experts to decide treatments because the doctor knows best. Often, patients shift choice into the hands of doctors, particularly in life-threatening situations. In life threatening situations medical staff is likely to decide treatments on behalf of patients. Therefore, the choice agenda in this case regarding to the quality of treatment tends to have no result. Evidence suggests that seven out of ten patients like better to relocate treatment choices to primary care providers (). This example tells us that people like the idea to have an input in relation to deciding medical providers. In reality, GPs are seen as the gatekeepers for making choices. They act as agents for patients rather than patients exercise choice. Often, patients empower medical providers to select treatments. This happens because people tend to have limited skills and access to information that would inform people of various treatments. Middle class people are often informed of the premium treatments. These people have access to internet and sources like books and journals that inform them of various treatments. People with lower levels of education tend to have access to journals and books which allow them to make meaningful choices. London Patient Choice Pilot study, on the other hand, contradicts this view. This study claims the up-take of choice among people with various levels of education has little significance. Only two per cent difference between people with various levels of education tend to look for hospitals that provide treatment. In conclusion middle class people tend to benefit from choice agenda far more than working class groups. Middle class groups have higher income which allows them to purchase houses near good-quality medical providers. In addition middle classes have access to information and money that drive them to travel further in order to have access to the best services. Do patients what choice? Patients tend to like the idea of a good local medical provider (both primary and secondary providers) rather than travelling longer distances to have their treatment.

Proctor and Gamble: No Links with Satanism Essay

Introduction   Ã‚  Ã‚  Ã‚   It is human nature to be easily lured into tales of the strange and the extraordinary. In fact, any person generally relishes on spinning tales of his/her own probably to attract attention, and for sheer fun, make others believe as if they were true. Nowhere is this more applicable than in the many instances of modern oral traditions. Stories such as the biggest snake reared as a twin of the daughter of the owner of the biggest mall in the city. That this huge snake got lost one day and swallowed one or two customers in the mall. This story has circulated in countless other malls and in plentiful variations.   Ã‚  Ã‚  Ã‚   In the case of one of the world’s biggest manufacturers of household materials, Procter and Gamble experienced one of the unforgettable rumors some malicious people spread in an obvious effort to pull them down. It was allegedly orchestrated by a rival corporation. What happened with Proctor and Gamble that it has suffered losses in business because it was accused of being involved in satanic activity? Just what is the nature of urban legends and its proliferation today inspite of modernism? This paper briefly describes and explains urban legends, the case on the Procter and Gamble and its supposedly satanic connection, and the veracity of the claims to the contrary by the management of the corporation. Discussion   Ã‚  Ã‚  Ã‚   In Microsoft Encarta, urban legends refer to â€Å"contemporary stories that are set in an urban environment and reported as true (sometimes in newspapers) but that contain patterns and motifs that reveal their legendary character† (2006). Why people believe in them and the apparent failure to quash these stories are crucial to our deeper understanding of the nature of this phenomenon.   Ã‚  Ã‚  Ã‚   The myth and controversy that featured well the problem of P&G, gives people in the present time to adjust and â€Å"feel† that urban legends exemplify the fact that at times people would rather believe an unsubstantiated report, even stick to it in the face of obvious lack of proofs. Discussion   Ã‚  Ã‚  Ã‚   What is the case of the Proctor and Gamble company and reasons why the belief that it has satanic alliances? In all likelihood, there was truth to the fact that rival Amway Company made sure that this rumor will reach the public and might probably cause the public to pull out their product support from P&G. Before the controversy, P&G had many little rumors spreading like bush fire. It started with the logo – that of the thirteen stars among the head of a man with horns on his head and the news then communicated that it represented satanic occultism. Later many short stories around the same theme circulated already, i.e. that the CEO of P&G had arranged for an appearance in Donahue show, and supposedly spoke openly of his alliance with the satanic church. Many, after P&G won its lawsuit against Amway, still enjoy the way the story gets around. On a more serious note, what it had escalated to be, authoritarian voices say, was all a part of the fierce marketing approaches that had existed for a time now. After the rumor, approximately 200,000 inquiries were received by the company which all inquired on the satanic church alliance or its friendship with Rev.Sun Myung Moon (known as Moonies) that P&G was accused of. All these were not true because no evidences are available to establish that the P&G CEO or president had this affiliation. Conclusion   Ã‚  Ã‚  Ã‚   Many believe urban legends like what happened with Proctor and Gamble because they think that the strangeness of its logo, are proofs that something â€Å"fishy† is going on. The unstoppable proliferation of the story is deemed to be due to our curiosity of what unfamiliar things are to us. The P&G dilemma remains to be a continued reminder of again, lack of preparations which might probably due to the inconvenient manner of physical preparation. Works Cited Page _____ It’s Back:Rumors of Satanism plague Proctor and Gamble.    accessed june 21, 2007. ______ 5th circuit: Proctor and Gamble ant have another shot at Amway. Associated Praise. Marrs, Texx. Devil companies, Devil Products and Devil logos?    Accessed June 20, 2007.

Tobacco 16th Century

Tobacco in the sixteenth century What is tobacco? The definition of tobacco is leaves of the tobacco plant dried and prepared for smoking or ingestion. For the English settlers in Chesapeake tobacco was there way of surviving. During the sixteenth century a man planted tobacco in Virginia for the first time and found it took well to the climate. Once the tobacco started growing it needed much attention and great care by hand. Workers were needed around the clock to tend to the crops. The settlers realized that tobacco could be there way to riches.The growing of tobacco not only helped the English settlers but also the English monarchy, ships men, and merchants. In 1612 John Rolfe planted seeds of tobacco plants that had been found originally in the West Indies and Venezuela. The plants grew very well and he started to experiment with methods of curing the leaf further enhancing its flavor. Rolfe sent his first shipment of tobacco to London in 1614. After this it became clear to settl ers that they could make a fortune in Virginia by growing tobacco. In 1617 the colonists made their first commercial shipment to England.When the shipments first arrived they product was hardly known but Sir Walter Releigh Helped to make tobacco smoking popular among the English. At first tobacco was sold at a very high price were only the wealthy could partake, but once the English colonist began to grow and ship an abundance of tobacco the price became much lower and tobacco was an indulgence for many. The shipping of tobacco to England saved the Jamestown settlement. Before growing tobacco they couldn’t even grow enough corn to feed themselves.Once the colonist started growing tobacco it became very clear to them that it could be the road to a fortune. The revenue coming in from exporting tobacco kept Chesapeake alive and growing. The king saw all the wealth being made and so he put a tax on importing tobacco giving him a major financial interest. In the end the exporting of tobacco provided a livelihood for many, a fortune for a few, and valuable revenue for ships men, merchants, and the English monarchy. In order to make all the tobacco they shipped to England to gain their wealth the tobacco plantations needed workers.A hired man working on tobacco plantations could make two or three times more in Virginia than in England. Most of the workers on the plantation were indentured servants. These people have their trip to Virginia paid for by someone else then pay the person back by working in the tobacco fields for four to five years. The indentured servants were mostly young, male, and had no skills in the job force. They were thrown on a field and told what to do. Growing tobacco is a very time consuming job. First the fields had to be cleared by hand.Like the Indians the colonist â€Å"clered† fields by cutting a ring of bark from each tree, this was called girdling, killing the tree. Then colonist would use heavy hoes to till the fields. Ho les were then made with sticks and the tobacco seed was placed in each hole. Once the plants matured they were cut down and thrown in a pile to wilt. After the leaves dried a little in the piles they were striped from the stock of the plant and suspended from poles in drying barns or just out in the fields. Last after the leaves were dry, they were seasoned, packed up in casks, and shipped off.During all of this work the men, women, boys, and girls from the age seven and up would smoke tobacco in order to pass the time. As farming went on the owners of the fields’ realized that the indentured servants were hard to control and would soon be free of their contract to them. They first found ways to add time to their contract but found it hard and people were living through their time served. So Between 1670 and 1700 the Chesapeake tobacco plantations discovered slavery and slowly made the transition from servant to slave fixing the problem for the moment.Just when the colonists of Chesapeake thought they would be starving and have no money for the rest of their being John Rolfe showed up and planted tobacco seeds. The seeds grow well and the colonist learned how to make money from all the hard work they were putting forth. They also found cheap ways of getting workers. Pay for an indentured servant and have them work for up to 7 or 10 years or have slave that don’t ever leave the plantation. The tobacco business thrived for everyone entangled in it.Over thirty-million pounds of tobacco was exported from Virginia to England helping make Chesapeake thrive as a colony. Bibliography The Old Dominion in the Seventeenth Century: A Documentary History of Virginia, 1606-1700 /  Edition 1by  Warren M. Billings The American Promise, A compact history, fourth edition, volume 1: to 1877, by: Roark, Johnson, Cohen, stage, Lawson, and Hartmann WWW. fcps. edu/GunstonES/gunstones/speciaLprojects/Jamestown1612. htm Gale Encyclopedia of Biography :John Rolfe

The Importance of the Proclamation of 1763

At the end of the French and Indian War (1756-1763), France gave much of the Ohio and Mississippi Valley along with Canada to the British. The American colonists were happy with this, hoping to expand into the new territory. In fact, many colonists purchased new land deeds or were granted them as part of their military service. However, their plans were disrupted when the British issued the Proclamation of 1763. Pontiacs Rebellion The stated purpose of the Proclamation was to reserve the lands west of the Appalachian mountains for Indians. As the British began the process of taking over their newly gained lands from the French, they encountered major problems with the Native Americans who lived there. Anti-British feelings ran high, and a number of groups of Native Americans such as the Algonquins, Delawares, Ottawas, Senecas, and Shawnees joined together to make war against the British. In May 1763, the Ottawa laid siege to Fort Detroit as other Native Americans arose to fight against British outposts throughout the Ohio River Valley. This was known as Pontiacs Rebellion after the Ottawa war leader who helped lead these frontier attacks.  By the end of the summer, thousands of British soldiers, settlers, and traders were killed before the British fought the Native Americans to a stalemate. Issuing the Proclamation of 1763 In order to avoid further wars and increase cooperation with the Native Americans, King George III  issued the Proclamation of 1763 on October 7th. The proclamation included many provisions. It annexed the French islands of Cape Breton and St. Johns. It also set up four imperial governments in Grenada, Quebec, and East and West Florida. Veterans of the French and Indian War were granted lands in those new areas. However, the point of contention for many colonists was  that  colonists were forbidden from settling west of the Appalachians or beyond the headlands of the rivers that eventually flowed into the Atlantic Ocean.  As the Proclamation itself stated:   And whereas it is ...essential to Our Interest and the Security of Our Colonies, that the several Nations...of Indians...who live under Our Protection should not be molested or disturbed...no Governor...in any of Our other Colonies or Plantations in America, [is allowed to]  grant Warrants of Survey, or pass Patents for any Lands beyond the Heads or Sources of any of the Rivers which fall into the Atlantic Ocean.... In addition, the British restricted Native American trade only to individuals licensed by parliament. We...require that no private Person do presume to make any Purchase from the said Indians of any Lands reserved to the said Indians.... The British would have power over the area including trade and westward expansion. Parliament sent thousands of troops to enforce the proclamation along the stated border.   Unhappiness Amongst  the Colonists The colonists were greatly upset by this proclamation. Many had bought up land claims in the now forbidden territories. Included in this number were  future important colonists  such as George Washington,  Benjamin Franklin, and the Lee family. There was a feeling that the king wanted to keep the settlers confined to the eastern seaboard.  Resentment also ran high over the restrictions placed on trade with the Native Americans. However, many individuals including George Washington felt that the measure was only temporary in order to ensure greater peace with the Native Americans. In fact, the Indian commissioners pushed forward a plan to increase the area allowed for settlement, but the crown never gave final approval to this plan. British soldiers attempted with limited success to make settlers in the new area leave and stop new settlers from crossing the border. Native American land was now being encroached upon again leading to new problems with the tribes. Parliament had committed up to 10,000 troops to be sent to the region, and as the issues grew, the British increased their presence by inhabiting former French frontier fort and constructing additional defensive works along the proclamation line. The costs of this increased presence and construction would result in increased taxes among  the colonists, eventually causing the discontent that would lead to the American Revolution. Source:   George Washington to William Crawford, September 21, 1767, Account Book 2.  George Washington to William Crawford, September 21, 1767, Account Book 2. Library of Congress, n.d. Web. 14 Feb. 2014.