Healthcare IT infrastructure varies widely in developed countries, as indeed does the organisation and funding of various health services. Overall, developing countries have populations that are ageing and becoming more demanding. This, coupled with technological progress, pushes up operational costs faster than the general growth in prices or even incomes. The resulting cost-control pressures are one of the main drivers of IT expenditure. Improving service is also important but is generally secondary.
The United Kingdom of Great Britain and Northern Ireland (UK) is made up of four constituent countries, namely: England, Scotland, Wales and Northern Ireland. The United Kingdom has been a member of the European Union since 1972. Members of the European Parliament (MEPs) were elected on the basis of a proportional system with party lists for the first time in 1999.The leading causes of death in the United Kingdom are diseases of the circulatory system including both cerebrovascular diseases and ischemic heart disease. Cancer accounts for over 200 deaths per 100 000 population and is followed by diseases of the respiratory system, which account for about 110 deaths per 100 000 population. Of cancer deaths the most common are from lung, breast, colorectal and prostate cancer which together account for about 62 000 deaths each year.
The National Health Service (NHS) came into operation in 1948 following the provisions of the NHS Act of 1946. This Act was of crucial importance in establishing the post-Second World War pattern of health service finance and provision in the United Kingdom. It introduced the principle of collective responsibility by the state for a comprehensive health service, which was to be available to the entire population free at the point of use. Freedom from user charges was a key feature of this approach which placed heavy emphasis on equality of access. Some of the main elements of the present day organisational structure of the NHS can be traced back to the major changes that were introduced through the NHS Act of 1973.
Although early policy on privatisation in relation to the NHS was restricted mainly to contracting-out of ancillary services i.e. laundry, catering and cleaning, the government’s belief in the superior efficiency of private sector practice led to major changes in management arrangements. Public health medicine has a long history in the United Kingdom. Its origins can be traced back to the middle of the nineteenth century when the main Acts of Parliament concerning public health issues were passed. A total of 17 pieces of legislation were passed between 1848 and 1890, of which six affected the delivery of public health services through administrative and structural changes. It was, however, the Public Health Act of 1875 which represented landmark legislation. This consolidated previous legislation, giving a clear account of the powers and responsibilities of local sanitary authorities. It laid the foundations for modern public health.
Many successes were achieved by the turn of the century including improvements to water supply and sewerage, street cleaning, working and living environments and personal hygiene. The strong legislative framework combined with the growing power and effectiveness of local Medical Officers of Health made a crucial contribution to these improvements.
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