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Question 1:
To what extent can healthcare be considered a business? Discuss the extent to which health care can be considered a business with reference to a health care system of your choice. Is there evidence to suggest that the use of business principles in health care can lead to improved quality and cost improvements?
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Keywords: what extent, healthcare, business, business principles, quality and cost improvement.
Some areas you may wish to consider include:
? Why have business principles been applied to healthcare? Are the challenges facing health care unique or are they shared with more traditional forms of ?business??
? How does the history, governance, regulation and culture of the particular health care system impact upon the concept of health care as a business?
? What are the key characteristics of a market in health care and where does this differ from traditional markets in the private sector. How do these differences impact upon the results of using business principles in health care?
? Think about which business principles have been introduced eg introduction of general management, opening up of the market, private finance initiatives, patient as consumer. Have these principles improved quality and lest to cost improvement. Think of some of the quality improvement tools which have been introduced, how have these helped/not helped and what does this tell you?
? How appropriate is it to view the patient as a ?consumer? and what are the implications of this perspective?
? Why is the more recently explicit reference to business principles, as in the British White Paper, causing such disquiet?
? Business and healthcare are often viewed as polarities, cowboy capitalism vs. angels of mercy, is there a new way of viewing healthcare which will help it to meet the increasing and changing demands, without losing its heart?
? You might want to look at some examples, both positive and negative, of the application of business principles in practice. Look at ATOS in Tower Hamlets, http://www.guardian.co.uk/society/2011/apr/12/nhs-privatisation-future-policy, or Virginia Mason Medical Centre in Seattle for examples.
? You might also want to look at some of the literature around ?stakeholder capitalism?, patient as consumer and corporate social responsibility.
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In addition, the following may also be useful,
Clarke, J. (2005), New Labour?s citizens: activated, empowered, responsibilized, abandoned? Critical Social Policy, 25, 4: 447?63.
Department of Health. High Quality Care For All: NHS Next Stage Review final report.London: The Stationery Office; 2008
Department of Health. Equity and Excellence: Liberating the NHS. London: The Stationery Office; 2010
Gilmartin ML and Freeman RE (2002) Business Ethics and Health Care: A Stakeholder Perspective. Health Care Manage Rev, 27(2), 52?65
Greener, I. (2007) Choice and Voice? A Review, Social Policy and Society, 7,2: 255-265.
Greve, B. (2003), When is choice possible in social security? European Journal of Social Security, 5, 4: 323?38.
Greener, I. (2008) Towards a history of choice in UK health policy. Sociology of health & illness, 31: 309-324.
Henderson, S. & Petersen, A. (2002) Consuming health: the commodification of health care, Routledge.
Propper C, Sutton M, Whitnall C,Windmeijer F. Did ?Targets and Terror? Reduce Waiting Times in England for Hospital Care? The BE Journal of Economic Analysis & Policy2008;8:5. See http://www.bepress.com/bejeap/vol8/iss2/art5
Werhane PH (2000) Business Ethics, Stakeholder Theory, and the Ethics of Healthcare Organizations. Cambridge Quarterly of Healthcare Ethics, 9, 169?181
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