My research on the NHS at the Royal Devon & Exeter Hospital, the U.K.
I had a chance to stay at Royal Devon & Exeter Hospital (Wonford) as well as Peninsula College of Medicine and Dentistry (University of Exeter) from the 2nd of March through the 27th. During my stay, I conducted research on the NHS (National Health Service), the comprehensive government public-health service in the U.K., through an interview with Professor David Melzer, clinical placement at the Emergency Department, and a visit to a local general practice (St. Leonard’s Practice). Let me briefly touch upon what I have learned about the NHS.
Virtually the entire population in the U.K is covered by the NHS. The NHS has distinguishing features such as (1) it is primarily financed by general taxes, (2) it is free at the time of usage, and (3) General Practice (GP) and hospitals are divided, playing different roles.
With respect to (1) and (2), Professor Melzer stressed that the NHS, providing generally good health care at relatively low cost, was a rather efficient system compared with health care systems in other countries like the U.S. Indeed, the total expenditure on health as a percentage of its GDP is 9.3 % in the case of UK, while it is 16.9 % in the US, according to statistics from 2012. On the other hand, the access to medicine in the U.K. seemed in a way limited, as patients cannot go and see a doctor at a hospital unless their registered GP writes a referral for them. This is why GPs are sometime called “gate keepers”.
Consequently, the Emergency Department (ED) at Royal Devon & Exeter was invariably crowded with patients as it was the only department at the hospital which patients could visit without referrals from GPs. To handle a large number of incoming patients, they had a triage system and it seemed to be an example of striking a balance between the need to rapidly treat an urgent patient and the requirement to keep the NHS as efficient as possible. The local general practice (St. Leonard’s Practice) also had a system of quickly referring a patient to a hospital when it is urgent, while treating patients with chronic diseases less urgently.
I cannot fully elaborate on my research on the NHS, but I would like to continue my study of health care systems from a broader viewpoint of public health policies, making the most of this experience in the U.K.