Brief that will affect national health or not.

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Brief Background

Public healthcare in the United Kingdom is provided by the National Health Service where all citizens with permanent residence status have free access to healthcare. This program’s budget comes from the general taxation funds. The provisions of public healthcare differ from one territory of the United Kingdom to the other (Triggle, 2008). Healthcare programs throughout the United Kingdom have been created to aid citizens in taking care of their well-beings.

Importance of Public Health

Public health does not generally concern with the individual level, but with the population level. With basically everyone in a location as the market, it is not easy for governments to device systems that will cater to everyone and in all aspects. The Nuffield Council on Bioethics (2007) stated that the central issue in public health is whether it is acceptable for the state to establish policies that will affect national health or not.

Liberties of individuals to act on their own health care on their own preferences are considered. However, the Council (2007) notes that constraining liberties to some extent play an important role in assisting people to act autonomously in the first place, like in establishing primary and secondary education as compulsory acts.

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States, including liberal states, have the responsibility to cater to people’s universal needs, whether individually or collectively. Thus, healthcare programs are created that aim to reduce illness and promote health among the people. These programs also aim to ensure that health care is easily available to anyone qualified for it (members of its nation).

Difficulties in Promoting Health

One reason the government has difficulties with promoting public health is that since the devolution of powers in the UK, the different nations implemented different healthcare systems amongst themselves. NHS Confederation boss Gill Morgan stated that the UK basically has four different systems albeit with the same set of values (Triggle, 2008).

England, Scotland, Wales, and Northern Ireland have the same or similar healthcare goals but execute their systems differently. For example, in England, hospitals and community centres compete with the private sector for patients, while in Scotland; the private sectors have limited involvement. In Wales, health agencies work well with their local governments, while in Northern Ireland; political issues hamper innovations in the system.

The problem with this diverse system is that patients from one nation compare services they receive from patients of other nations. Joyce Robins of a patient group called Patient Concern said that the differences were “breeding envy” (Triggle, 2008) from patients across the UK. Patients of one nation observe patients from other nations and wonder why they do not receive the same services as the other. This incites negative reactions towards nations’ healthcare systems.

Health agencies do attend to the issue of promoting health by facilitating promotional activities. But they usually focus on only one health determinant at a time. The World Health Organization (1998) as cited in Ziglio, et al. (2000) observed that changes from these promotions were minimal and did not produce any major impact on the determinants of health or the development of policies.

Health promotion then must be dynamic and relentless in order for it to produce visible and positive results. All patients cannot be pleased by a single healthcare system thus government agencies must take note on improvements suggested by citizens to further improve public healthcare in the UK.


Triggle, N., 2008. NHS ‘now four different systems.’ BBC News, [online] 2 January. Available at: [Accessed 9 January 2011].

Nuffield Council on Bioethics, 2007. Public health: ethical issues. [pdf] London: Nuffield Council on Bioethics. Available at: [Accessed 9 January 2011].

Ziglio, E., Hagard, S. and Griffiths, J., 2000. Health promotion development in Europe: achievements and challenges. [pdf] Great Britain: Oxford University Press. Available at: [Accessed 9 January 2011].

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