Regulating nursing homes - Caring for older people in the private sector in England
Regulating nursing homes - Caring for older people in the private sector in England
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DOI：
10.1136/bmj.323.7312.566
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发表时间：
2001-09-08
影响因子：
105.7
通讯作者：
Pollock, AM
中科院分区：
文献类型：
--
作者：
Kerrison, SH;Pollock, AM
在联合王国，超过一半的卫生保健床位是在独立的老年人疗养院;这是最初为改变社会保障支付基础而引入的政策1的结果，现在是针对长期护理的私有化。卫生部的官方统计数据表明，1979年至2000年期间，英格兰NHS的床位总数从480 000张减少到189 000张，而主要以盈利为目的的独立部门的床位数量，美国和澳洲的经验显示，当局缺乏政治意愿，在维护居民利益的同时，损害业界及其股东的利益。3 4在澳大利亚，该行业成功地游说，以不太有效的认证计划取代法律上可执行的法规;这造成了灾难性的后果。在美国，该行业成功地反对了对最低工作人员人数实行严格标准，结果是居民的健康状况不断下降。随着美国大型跨国公司的子公司进入英国，英国养老院的居民面临相当大的风险5;其中一些公司因欺诈和挪用政府资金以及虐待病人而受到美国的审查。3本文件探讨英国护养院的新规管架构是否为病人提供足够保障。
Over half of all beds allocated for health care in the United Kingdom are in independent nursing homes for older people; this is a result of policies initially introduced to change the basis of social security payments1 and now directed towards privatising long term care. Official statistics from the Department of Health indicate that between 1979 and 2000 the total number of beds in the NHS in England decreased from 480 000 to 189 000, while the number of beds in the independent sector, which is run mainly for profit, increased from 23 000 in 19832 to 193 000 in 2000.Experiences in the United States and Australia have shown the lack of political will to promote the interests of residents against the interests of the industry and its shareholders. 3 4 In Australia the industry successfully lobbied to replace legally enforceable regulations with less effective accreditation schemes; this has had disastrous consequences. In the United States the industry successfully opposed the introduction of robust standards for minimum numbers of staff, and the result is continuously declining health outcomes for residents. The risks to residents of nursing homes in the United Kingdom are considerable as subsidiaries of large US multinationals enter the United Kingdom5; some of these companies have come under scrutiny in the United States for fraud and embezzlement of government funds and for abusing patients. 3 This paper considers whether the new regulatory framework for nursing homes in the United Kingdom offers adequate protection for patients.