13) Health and Social Care 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., privatisation 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

• taxation
• legislation
• promotion / education

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

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

Conflicting direction and potentials

• Priorities of resource allocation to related parties and organisations
• Cost-effectiveness vs. clients’ satisfaction
• financing principles – percentage to be paid by users and tax payers

Allocation of resources to different parties

• Within healthcare system
  • primary care vs secondary / tertiary care
  • 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

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 was seen as authoritative
• Clients have more awareness of their rights and involve more in the decision making

Tensions

• Competing for clients or resources
• Different visions, expectations and perspectives during the collaborations

Resultant crisis in service delivery

• Quality of services decline / malpractice
• Ineffective use or waste of resources
• Obstruct the coordinated service delivery that best fit the clients
• Health and social care policies not endorsed due to political disagreements

Possible solutions

• develop relevant policies to cultivate partnership and collaboration among institutions