13 Health and Social Care Policies

Highlights:

1. Developing and Implementing Policies

Factors leading to the differences in polices in different countries

Local economy – economic conditions affect the amount of resources to be allocated
Global economy and world financial organisations e.g. World Bank
Social context e.g. famine
Private-public debates and tensions e.g. privatization of health and care services
Social value and political concerns e.g. smoking policy
Cultural understandings of health and social care and its implication on policies

Demands for new policies

Emerging problems, e.g. outbreak of a disease
Changing needs of individuals, families and communities
Increasing demand for services
Demographic changes and the implications for the needs of care services. e.g. birth and death rate, life expectancy, ageing population, etc. care sector expansion, increasing health and care expenditure
Improving effectiveness or efficiency
Reducing inequalities

Instruments of policies

Formulating health and social policies

Roles of the World Health Organization (WHO) and local Non-governmental Organisations (NGOs) in the process and cycle of public policy making – identification (problem / need), formulation, adoption, implementation and evaluation

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2. Conflicting agendas

Private vs. public responsibility

Expansion of public sector due to the increasing demand for health and care services
Concerns for public expenditure on care sector
Degree / extent of personal role on health and social care
Conflicting direction and potentials : Financing principles – percentage to be paid by users and tax payers

Social services

Within healthcare system
- (1) primary care vs secondary / tertiary care
- (2) public sector vs private sector
Within social welfare system – different target groups: which group needs more support and care?
Within organisations /agencies – balance the costs within organisations : staff cost, facilities and equipment investment, quality of services maintenance, services expansion etc
Conflicting direction and potentials :
- Priorities of resource allocation to related parties and organisations
- Cost-effectiveness vs. clients’ satisfaction

3. Cultural and political disagreements

Cultural disagreement

Contrasting Chinese and Western cultural understandings of health and illness: health consciousness, different attitudes towards seeking helps for health and social needs

Political disagreement

The debates and practical / political conflicts between the roles of the individuals (private sector) and the public or government in the provision of social care and health services responsibility of the government e.g.
- Medical charges
- Competitive or complementary roles between the public sector and the private sector
- Privatisation

The emphasis of clients’ right and involvement

Traditional professional power were seen as authoritative
Clients have more awareness of their rights and involve more in the decision making

Formulating health and social policies

Roles of the World Health Organization (WHO) and local Non-governmental Organisations (NGOs) in the process and cycle of public policy making – identification (problem / need), formulation, adoption, implementation and evaluation

4. Tensions among different institutions

Tensions