1. The following sequence outlines how the different parts of the NHS are likely to be involved with Susan's pregnancy:

• She visits her GP who gives her a check-up and then arranges for her to visit a hospital for a scan and other ante-natal checks.
• She then, in consultation with her GP, chooses a hospital for the birth.
• As her pregnancy develops her progress is monitored by both her GP and the doctors and midwives in the Maternity Unit of the hospital.
• For the birth itself, she spends a couple of days in the hospital Maternity Unit.
• After the birth parents and child would be visited at home by a community nurse and would themselves visit the local Child Welfare Clinic at intervals.

a) This sequence has involved many of the different elements of the NHS - identify those elements.

b) Who is making the decisions in this process?

Susan strongly wants to have her child at home but the doctors at the Maternity Unit refuse to allow this, arguing that the risk of complications is too high.

c) How could their decision be justified (think of the market failure theory we introduced in Unit 3)?

d) Do you think that Susan should be allowed to pay to have the birth she wants at home?

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3. GPs have sometimes been called the gatekeepers of the NHS. How does their role as gatekeepers act to minimise the information problems consumers face with health care?

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4. a) Why do waiting lists occur in the NHS? Are they necessarily a sign that the NHS is failing?

b) What is likely to happen to waiting lists in the future. Refer to the data in the appendix for your answer.

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Activities

A1. Use the data in the appendix to decide whether you think that the NHS has been successful. You might use some of the data to plot your own graphs and look for trends.