Skip to main content
Top
Published in: Health Care Analysis 3/2019

Open Access 01-09-2019 | Original Article

Empathy and Efficiency in Healthcare at Times of Austerity

Author: Angeliki Kerasidou

Published in: Health Care Analysis | Issue 3/2019

Login to get access

Abstract

Efficiency is an important value for all publicly funded healthcare systems. Limited resources need to be used prudently and wisely in order to ensure best possible outcomes and waste avoidance. Since 2010, the drive for efficiency, in the UK, has acquired a new impetus, as the country embarked on an ‘age of austerity’ purportedly to balance its books and reduce national deficit. Although the NHS did not suffer any direct budget cuts, the austerity policies imposed on the welfare system, including social and mental healthcare, have had a direct and detrimental impact on the healthcare service. This paper draws from a qualitative study conducted in three A&E Departments in England to explore the effects of austerity policies on the everyday experiences of doctors and nurses working in Emergency Departments. It discusses the operationalisation of efficiency in A&E, in a climate of austerity, and its effects on the experiences and practices of healthcare professionals. It uses the empirical data as a springboard to highlight the role of structures and regulations, in this case targets and protocols, in how core healthcare ethical values, such as empathy, are exercised in practice. It provides an analysis of the normative role structures and regulations can play on the perception and practice of professional duties and obligations in healthcare.
Literature
1.
go back to reference Timms, S. (2010). Budget 2010: Securing the recovery. London: Her Majesty’s Treasury. Timms, S. (2010). Budget 2010: Securing the recovery. London: Her Majesty’s Treasury.
3.
go back to reference Alston, P. (2018). Statement on visit to the United Kingdom, by Professor Philip Alston. United Nations: United Nations Special Rapporteur on extreme poverty and human rights. Alston, P. (2018). Statement on visit to the United Kingdom, by Professor Philip Alston. United Nations: United Nations Special Rapporteur on extreme poverty and human rights.
4.
go back to reference Hastings, A., Bailey, N., Bramley, G., Gannon, M., & Watkins, D. (2015). The cost of the cuts: The impact on local government and poorer communities. Joseph Rowntree Foundation. Hastings, A., Bailey, N., Bramley, G., Gannon, M., & Watkins, D. (2015). The cost of the cuts: The impact on local government and poorer communities. Joseph Rowntree Foundation.
5.
go back to reference Hood, A., & Phillips, D. (2015). Benefit spending and reforms: The coalition governemnt’s record. London: Institute of Fiscal Studies. Hood, A., & Phillips, D. (2015). Benefit spending and reforms: The coalition governemnt’s record. London: Institute of Fiscal Studies.
6.
go back to reference McNicoll, A. (2015). Mental health trust funding down 8% from 2010 despite coalition’s drive for parity of esteem. Community Care. McNicoll, A. (2015). Mental health trust funding down 8% from 2010 despite coalition’s drive for parity of esteem. Community Care.
7.
go back to reference Spending Revivew 2010: George Osborne wields the axe. (2010, 20 October). BBC News. Spending Revivew 2010: George Osborne wields the axe. (2010, 20 October). BBC News.
8.
go back to reference Appleby, J., Baird, B., Thomson, J., & Jabbal, J. (2015). The NHS under the coalition government. Part two: NHS performance. London: The King’s Fund. Appleby, J., Baird, B., Thomson, J., & Jabbal, J. (2015). The NHS under the coalition government. Part two: NHS performance. London: The King’s Fund.
9.
go back to reference The King’s Fund (2017). Does the NHS need more money?: The King’s Fund, London. The King’s Fund (2017). Does the NHS need more money?: The King’s Fund, London.
10.
go back to reference Murray, R., Jabbal, J., Thomson, J., Baird, B., & Maguire, D. (2017). Quarterly monitoring report: June 2017. London: The King’s Fund. Murray, R., Jabbal, J., Thomson, J., Baird, B., & Maguire, D. (2017). Quarterly monitoring report: June 2017. London: The King’s Fund.
11.
go back to reference Robertson, R., Wenzel, L., Thomspon, J., & Charles, A. (2017). Understadning NHS financial pressures: How are they affecting patient care?. London: The King’s Fund. Robertson, R., Wenzel, L., Thomspon, J., & Charles, A. (2017). Understadning NHS financial pressures: How are they affecting patient care?. London: The King’s Fund.
12.
go back to reference Maybin, R., Charles, A., & Honeyman, M. (2016). Understanding quality in district nurisng services: Learning from patients, carers and staff. London: The King’s Fund. Maybin, R., Charles, A., & Honeyman, M. (2016). Understanding quality in district nurisng services: Learning from patients, carers and staff. London: The King’s Fund.
13.
go back to reference Department of Health and Social Care (2010). 2010 to 2015 government policy: NHS efficiency. In: D. O. H. A. S. Care (Ed.). Department of Health and Social Care (2010). 2010 to 2015 government policy: NHS efficiency. In: D. O. H. A. S. Care (Ed.).
14.
go back to reference NHS Improvement (2016). 2020 Objectives. NHS Improvement. NHS Improvement (2016). 2020 Objectives. NHS Improvement.
16.
go back to reference Smith, P. C. (2012). What is the scope for health system efficiency gains and how can they be achieved. Eurohealth, 18(3), 3–6. Smith, P. C. (2012). What is the scope for health system efficiency gains and how can they be achieved. Eurohealth, 18(3), 3–6.
17.
go back to reference NHS Providers (2017). Mission Impossible? The task for NHS Providers in 2017/18. NHS Providers. NHS Providers (2017). Mission Impossible? The task for NHS Providers in 2017/18. NHS Providers.
18.
go back to reference Jeremy Hunt ditches four-hour target as A&E crisis deepens. (2017, 9 January). The Guardian. Jeremy Hunt ditches four-hour target as A&E crisis deepens. (2017, 9 January). The Guardian.
19.
go back to reference Department of Health and Social Care. (2018). The Government’s mandate to NHS England for 2018–19. London: Department of Health and Social Care. Department of Health and Social Care. (2018). The Government’s mandate to NHS England for 2018–19. London: Department of Health and Social Care.
20.
go back to reference HM Treasury (2018). Budget 2018. HM Treasury. HM Treasury (2018). Budget 2018. HM Treasury.
21.
go back to reference NHS Providers (2018). Commitments to mental health sends right message but more support for core services needed. NHS Providers (2018). Commitments to mental health sends right message but more support for core services needed.
22.
go back to reference NHS Improvement (2018). Annual report. NHS Improvement. NHS Improvement (2018). Annual report. NHS Improvement.
23.
go back to reference NHS Providers (2018). Making the most of the money: Efficiency and the long-term plan. NHS Providers. NHS Providers (2018). Making the most of the money: Efficiency and the long-term plan. NHS Providers.
25.
go back to reference Francis, R. (2013). Report of the mid staffordshire NHS foundation trust public inquiry. London: The Stationary Office. Francis, R. (2013). Report of the mid staffordshire NHS foundation trust public inquiry. London: The Stationary Office.
26.
go back to reference Government says NHS hospitals can wring out another £300 m in efficiency savings. (2017, 8 November). Independent. Government says NHS hospitals can wring out another £300 m in efficiency savings. (2017, 8 November). Independent.
28.
go back to reference Hojat, M., Mangione, S., Nasca, T. J., Cohen, M. J., Gonnella, J. S., Erdmann, J. B., et al. (2001). The Jefferson scale of physician empathy: Development and preliminary psychometric data. Educational and Psychological Measurement, 61(2), 349–365.CrossRef Hojat, M., Mangione, S., Nasca, T. J., Cohen, M. J., Gonnella, J. S., Erdmann, J. B., et al. (2001). The Jefferson scale of physician empathy: Development and preliminary psychometric data. Educational and Psychological Measurement, 61(2), 349–365.CrossRef
32.
go back to reference Switankowsky, I. (2000). Sympathy and empathy. Philosophy Today, 44(1), 86–92.CrossRef Switankowsky, I. (2000). Sympathy and empathy. Philosophy Today, 44(1), 86–92.CrossRef
33.
go back to reference Bloom, P. (2016). Against empathy: The case for rational compassion. London: Vintage. Bloom, P. (2016). Against empathy: The case for rational compassion. London: Vintage.
34.
go back to reference Prinz, J. (2011). Is empathy necessary for morality? In A. Coplan & P. Goldie (Eds.), Empathy (pp. 211–229). Oxford: Oxford University Press. Prinz, J. (2011). Is empathy necessary for morality? In A. Coplan & P. Goldie (Eds.), Empathy (pp. 211–229). Oxford: Oxford University Press.
35.
go back to reference Prinz, J. (2011). Against empathy. Southern Journal of Philosophy, 49, 214–233.CrossRef Prinz, J. (2011). Against empathy. Southern Journal of Philosophy, 49, 214–233.CrossRef
39.
go back to reference Chin, J. J. (2002). Doctor-patient relationship: From medical paternalism to enhanced autonomy. Singapore Medical Journal, 43(3), 152–155.PubMed Chin, J. J. (2002). Doctor-patient relationship: From medical paternalism to enhanced autonomy. Singapore Medical Journal, 43(3), 152–155.PubMed
42.
43.
go back to reference Kerasidou, A., & Horn, R. (2018). Empathy in healthcare: The limits and scope of empathy in public and private systems. In: T. Feiler, J. Hordern, & A. Papanikitas (Eds.), Marketisation, ethics and healthcare: policy, practice and moral formation (pp. 163–173, Key Themes in Health and Society). London: Routledge. Kerasidou, A., & Horn, R. (2018). Empathy in healthcare: The limits and scope of empathy in public and private systems. In: T. Feiler, J. Hordern, & A. Papanikitas (Eds.), Marketisation, ethics and healthcare: policy, practice and moral formation (pp. 163–173, Key Themes in Health and Society). London: Routledge.
45.
go back to reference Roberts, A., Marshall, L., & Charlesworth, A. (2012). A decade of austerity? The funding pressures facing the NHS from 2010/11 to 2021/22. In: N. Trust (Ed.). London: Nuffield Trust. Roberts, A., Marshall, L., & Charlesworth, A. (2012). A decade of austerity? The funding pressures facing the NHS from 2010/11 to 2021/22. In: N. Trust (Ed.). London: Nuffield Trust.
51.
go back to reference The King’s Fund (2017). What’s going on with A&E waiting times?: The King’s Fund, London. The King’s Fund (2017). What’s going on with A&E waiting times?: The King’s Fund, London.
55.
go back to reference Boker, J. R., Shapiro, J., & Morrison, E. (2004). Teaching empathy to first year medical students: Evaluation of an elective literature and medicine course. Education for Health, 17(1), 73–84.CrossRefPubMed Boker, J. R., Shapiro, J., & Morrison, E. (2004). Teaching empathy to first year medical students: Evaluation of an elective literature and medicine course. Education for Health, 17(1), 73–84.CrossRefPubMed
56.
go back to reference Dutton, J. E., Worline, M. C., Frost, P. J., & Lilius, J. (2006). Explaining compassion organizing. Administrative Science Quarterly, 51, 59–96.CrossRef Dutton, J. E., Worline, M. C., Frost, P. J., & Lilius, J. (2006). Explaining compassion organizing. Administrative Science Quarterly, 51, 59–96.CrossRef
57.
60.
go back to reference Eisenberg, L. (1977). Disease and illness. Distinctions between professional and popular ideas of sickness. Culture, Medicine and Psychiatry, 1(1), 9–23.CrossRefPubMed Eisenberg, L. (1977). Disease and illness. Distinctions between professional and popular ideas of sickness. Culture, Medicine and Psychiatry, 1(1), 9–23.CrossRefPubMed
61.
go back to reference Stiglitz, J. E. (2014). Europe’s austerity zombies. Project Syndicate. Stiglitz, J. E. (2014). Europe’s austerity zombies. Project Syndicate.
62.
go back to reference Blyth, M. (2013). Austerity: The history of a dangerous idea. Oxford: Oxford University Press. Blyth, M. (2013). Austerity: The history of a dangerous idea. Oxford: Oxford University Press.
63.
go back to reference Austerity policies do more harm than good, IMF study concludes. (2016, 27 May). The Guardian. Austerity policies do more harm than good, IMF study concludes. (2016, 27 May). The Guardian.
64.
go back to reference Emmerson, C. (2017). Two parliaments of pain: The UK public finances 2010 to 2017. London: Institute of Fiscal Studies.CrossRef Emmerson, C. (2017). Two parliaments of pain: The UK public finances 2010 to 2017. London: Institute of Fiscal Studies.CrossRef
Metadata
Title
Empathy and Efficiency in Healthcare at Times of Austerity
Author
Angeliki Kerasidou
Publication date
01-09-2019
Publisher
Springer US
Published in
Health Care Analysis / Issue 3/2019
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI
https://doi.org/10.1007/s10728-019-00373-x

Other articles of this Issue 3/2019

Health Care Analysis 3/2019 Go to the issue