Yıl: 2021 Cilt: 36 Sayı: 5 Sayfa Aralığı: 350 - 365 Metin Dili: Türkçe İndeks Tarihi: 15-02-2022

COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ

Öz:
İngiltere sağlık sistemi; kökenlerini Beveridge’in Ulusal Sağlık Hizmeti’nden alan, toplumun tamamını kapsayan ve büyük oranda genel vergilerle finanse edilen bir sistemdir. Sağlık ve Sosyal Bakım Yasası ile yeni oluşumlar kurulmuştur. Birinci basamak hekimleri kapı tutucu rolündedir. İkinci basamak sağlık hizmetleri devlete ait “tröst” adı verilen hastanelerde sunulmaktadır. İngiltere’de COVID-19 pandemisine etkili bir hazırlık yapıldığı söylenemez. İlk vaka 30 Ocak 2020’de, ilk ölüm ise 2 Mart’ta görülmüştür. COVID-19’a ulusal yanıt, Halk Sağlığıİngiltere tarafından ve birçok bilimsel danışma grubu tarafından merkezi olarak yönetilmektedir. Pandemiyle mücadele sloganları; pandeminin başında “Sakin Ol ve Devam Et”, Mart-2020 sonunda “Evde kal, USH’yi koru, hayat kurtar”, Mayıs’ta “Dikkatli olun, virüsü kontrol altına alın ve hayatları kurtarın”, Ağustos’ta ise “Ellerini yıka, maske kullan ve mesafe bırak” olmuştur.1 Temmuz 2020 itibariyle İngiltere’deki toplam vaka sayısı 244.856 olup, 100 binde 435’tir. Toplam ölüm sayısı ise 100 binde 51’dir (28.936). Yaşam beklentisinin en düşük olduğu yoksun bölgeler pandemiden en fazla etkilenen bölgelerdir. Olumsuz bir tabloyla pandemiye yakalanan İngiltere sağlık sisteminde, mevcut sorunlar daha da derinleşmiştir.
Anahtar Kelime:

England Health System in COVİD-19 Pandemic

Öz:
The health system of England that originate from Beveridge’s National Health Service, covers the entire society and is financed largely by general taxes. New formations were established with the Health and Social Care Law. Primary care physicians serve as gatekeepers. Secondary care health services are provided in state-owned hospitals called “trust”.It cannot be said that there is an effective preparation for the COVID-19 pandemic in England. The first case was seen on 30th of January 30, and the first death on 2nd of March. The national response to COVID-19 is managed centrally by Public Health-England and many scientific advisory groups. The slogans of struggle with pandemic; at the beginning of the pandemic “Keep Calm and Continue”, at the end of March-2020 “Stay at home, protect the NHS, save lives”, in May “Be careful, control the virus and save lives”, in August “Wash your hands, use mask and keep a distance.As of 1 July 2020, the total number of cases in England is 244.856 and 435 per 100 thousand. The total number of deaths is 51 per 100 thousand (28.936). Deprived areas with the lowest life expectancy are the regions most affected by the pandemic. In the UK health system, which has been caught in a pandemic with a negative picture, the existing problems have deepened.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • Aksakoğlu G, Giray H. (2016) Birleşik Krallıkta Ulusal Sağlık Hizmetinin Öyküsü. Toplum ve Hekim, 21;5-6 (335-343).
  • Aldridge RW, Lewer D, Katikireddi SV, Mathur R, Pathak N, Burns R ve ark. (2020) Black, Asian and Minority Ethnic groups in England are at increased risk of death from COVID-19: indirect standardisation of NHS mortality data. Wellcome Open Res. 24;5:88. doi: 10.12688/wellcomeopenres.15922.2.
  • Amnesty International UK web sayfası (2020) UK among highest COVID-19 health worker deaths in the World. Erişim tarihi: 23 Ağustos 2020, https://www.amnesty.org.uk/press-releases/ uk-among-highest-covid-19-health-worker-deaths-world
  • Bakhai M. (2020) Advice on how to establish a remote ‘total triage’ model in general practice using online consultations, Erişim tarihi: 20 Eylül 2020, https://www.england.nhs.uk/coronavirus/ wp-content/uploads/sites/52/2020/03/C0098-total-triage-blueprint-september-2020-v3.pdf
  • BBC News web sayfası (2020a) Coronavirus: Face coverings to be mandatory on public transport. Erişim tarihi: 25 Eylül 2020, https://www.bbc.com/news/uk-52927089
  • BBC News web sayfası (2020b) Coronavirus: NHS volunteers to start receiving tasks. Erişim tarihi: 20 Eylül 2020, Erişim adresi: https://www.bbc.com/news/uk-52196459
  • Booth R. (2020) Government rejected radical lockdown of England’s care homes. Erişim tarihi: 20 Temmuz 2020, https://www. theguardian.com/world/2020/may/28/government-rejected-radical-lockdown-england-care-homes-coronavirus
  • Care Quality Commission web sayfası (2020) The independent regulator of health and social care in England. Erişim tarihi: 10 Ağustos 2020, https://www.cqc.org.uk/about-us
  • Carroll WD, Strenger V, Eber E, Porcaro F, Cutrera R, Fitzgerald DA, ve ark. (2020) European and United Kingdom COVID-19 pandemic experience: The same but different. Paediatr Respir Rev. 35:50-56. doi: 10.1016/j.prrv.2020.06.012. Epub 2020 Jul 4.
  • Coronavirus Act web sayfası (2020) Erişim tarihi: 20 Temmuz 2020, https://www.legislation.gov.uk/ukpga/2020/7/contents/ enacted/data.htm
  • Department of Health & Social Care web sayfası (2020a) Policy paper UK pandemic preparedness. Erişim tarihi: 28 Ekim 2020, https://www.gov.uk/government/publications/uk-pandemic-preparedness
  • Department of Health & Social Care web sayfası (2020b) COVID-19: Government announces moving out of contain phase and into delay. Erişim tarihi: 20 Eylül 2020, https://www.gov. uk/government/news/covid-19-government-announces-moving-out-of-contain-phase-and-into-delay
  • Department of Health & Social Care web sayfası (2020c) Coronavirus (COVID-19) Scaling up our testing programmes. Erişim tarihi: 20 Temmuz 2020, https://assets.publishing.service. gov.uk/government/uploads/system/uploads/attachment_data/ file/878121/coronavirus-covid-19-testing-strategy.pdf
  • Department of Health & Social Care web sayfası (2020d) Weekly statistics for NHS Test and Trace (England) and coronavirus testing (UK) Erişim tarihi: 28 Ekim 2020, https://www.gov.uk/ government/publications/nhs-test-and-trace-england-and-coronavirus-testing-uk-statistics-22-october-to-28-october/ weekly-statistics-for-nhs-test-and-trace-england-and-coronavirus-testing-uk-22-october-to-28-october#nhs-covid-19-app-in-england-and-wales
  • Department of Health & Social Care web sayfası (2020e) Demographic data for coronavirus (COVID-19) testing (England): 28 May – 26 August Erişim tarihi: 20 Eylül 2020, https://assets. publishing.service.gov.uk/government/uploads/system/uploads/ attachment_data/file/914787/Demographic_data_for_coronavirus__COVID-19__testing__England__-_28_May_to_26_ August.pdf
  • Eke, E. ve Kişi M. (2019) Geçmişten günümüze İngiltere sağlık politikaları: Ulusal sağlık sistemi odaklı güncel bir perspektif. OPUS– Uluslararası Toplum Araştırmaları Dergisi, 11(18) 2687-2707. doi: 10.26466/opus.548218
  • European Centre for Disease Prevention and Control web sayfası (2020) Data on country response measures to COVID-19. Erişim tarihi: 20 Ekim 2020, https://www.ecdc.europa.eu/en/publications-data/download-data-response-measures-covid-19
  • Ewbank L, Thompson J, McKenna H, Anandaciva S. (2020) NHS hospital bed numbers: past, present, future, Erişim Tarihi: 10 Ağustos 2020, https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers#:~:text=The%20total%20 number%20of%20NHS,patients%20treated%20has%20increased%20significantly
  • Government Office for Science web sayfası (2020) Scientific Advisory Group for Emergencies, Erişim tarihi: 20 Eylül 2020, https://www.gov.uk/government/publications/scientific-advisory-group-for-emergencies-sage-coronavirus-covid-19-response-membership/list-of-participants-of-sage-and-related-subgroups
  • Greene T, Harju-Seppänen J, Adeniji M, Steel C, Grey N, Brewin CR ve ark. (2020) Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19. BMJ 3:24. doi: https://doi.org/10.11 01/2020.10.21.20216804.
  • Healthwatch web sayfası (2020) Erişim Tarihi: 10 Ağustos 2020, https://www.healthwatch.co.uk/what-we-do
  • Hobbs FDR, Bankhead C, Mukhtar T, Stevens S, Perera-Salazar R, Holt T, ve ark. (2016) National Institute for Health Research School for Primary Care Research. Clinical workload in UK primary care: a retrospective analysis of 100 million consultations in England, 2007-14. Lancet. 387(10035):2323-2330. doi: 10.1016/S0140-6736(16)00620-6.
  • Horton R. (2020) Alarming new data shows the UK was the ‘sick man’ of Europe even before Covid. Erişim tarihi: 20 Ağustos 2020, https://www.theguardian.com/commentisfree/2020/ oct/18/alarming-data-britain-sick-man-europe-before-covid
  • Hunter DJ. (2020) Covid-19 and the Stiff Upper Lip - The Pandemic Response in the United Kingdom. N Engl J Med. 16;382(16):e31. doi: 10.1056/NEJMp2005755. Epub 2020 Mar 20.
  • Independent SAGE web sayfası (2020) Erişim tarihi: 20 Eylül 2020, https://www.independentsage.org/
  • Institute for Health Metrics and Evaluation web sayfası (2020) COVID-19 Projections. Erişim tarihi: 20 Eylül 2020, https://covid19.healthdata.org/united-kingdom/england?view=total-deaths&tab=trend
  • Interim NHS People Plan web sayfası (2019) Erişim Tarihi: 15 Ağustos 2020, https://www.longtermplan.nhs.uk/wp-content/ uploads/2019/05/Interim-NHS-People-Plan_June2019.pdf
  • Johns Hopkins Center for Health Security (2019). Global Health Security Index. Erişim tarihi: 14 Eylül 2020, https://www. ghsindex.org/wp-content/uploads/2019/10/2019-Global-Health-Security-Index.pdf
  • Kursumovic E, Lennane S, Cook TM. (2020) Deaths in healthcare workers due to COVID-19: the need for robust data and analysis. Anaesthesia. Aug;75(8):989-992. doi:10.1111/ anae.15116.
  • Mahase E. (2020) Coronavirus: UK screens direct flights from Wuhan after US case. BMJ. 22;368:m265. doi:10.1136/bmj. m265. PMID: 31969317.
  • Mason R. (2020) UK experts call for coronavirus inquiry to prevent deadly second wave. 2020. Erişim tarihi: 20 Ağustos 2020, https://www.theguardian.com/politics/2020/jun/05/ uk-experts-call-for-coronavirus-inquiry-to-prevent-deadly-second-wave
  • McCabe R, Schmit N, Christen P, D’Aeth JC, Løchen A, Rizmie D, ve ark. (2020) Adapting hospital capacity to meet changing demands during the COVID-19 pandemic. BMC Med. 16;18(1):329. doi:10.1186/s12916-020-01781-w.
  • MHRA Medicines & Healthcare products Regulatory Agency web sayfası (2020) Erişim Tarihi: 14 Ağustos 2020, https:// www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency
  • National Risk Register Of Civil Emergencies (2017). Cabinet Office, 70 Whitehall, London.
  • NHS Clinical Commissioners web sayfası (2020) Erişim Tarihi: 14 Ağustos 2020, https://www.nhscc.org/ccgs/
  • NHS Digital web sayfası (2020) General Practice Workforce. Erişim Tarihi: 15 Ekim 2020, https://digital.nhs.uk/data-and-information/publications/statistical/general-and-personal-medical-services/30-september-2020
  • NHS England and NHS Improvement web sayfası (2020). Erişim tarihi: 20 Eylül 2020, https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/cancer-alliance-information-on-managing-cancer-referrals-19-march-2020.pdf
  • NHS England web sayfası (2020a) Clinical commissioning groups (CCGs) Erişim Tarihi: 14 Ağustos 2020, https://www. england.nhs.uk/commissioning/who-commissions-nhs-services/ ccgs/
  • NHS England web sayfası (2020b) COVID-19 Daily Deaths. Erişim tarihi: 28 Ekim 2020, https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-daily-deaths/
  • NHS England web sayfası (2020c) COVID-19 Vaccinations Archive, COVID-19 weekly announced vaccinations 25 March 2021-revised. Erişim tarihi: 30 Nisan 2021, Erişim adresi: https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-vaccinations/covid-19-vaccinations-archive/
  • NHS Providers web sayfası (2020) Erişim Tarihi: 15 Ağustos 2020, https://nhsproviders.org/
  • NHS web sayfası (2020) Services and treatments. Erişim Tarihi: 14 Ağustos 2020, https://www.nhs.uk/common-health-questions/nhs-services-and-treatments/
  • NHS Trust Development Authority (2019) annual report and accounts 2018/19. ISBN: 978-1-5286-1456-6. Wellington House, 133-155 Waterloo Road, London.
  • NICE web sayfası (2020) National Institute for Health and Care Excellence. Erişim Tarihi: 14 Ağustos 2020, https://www.nice. org.uk/
  • OECD web sayfası (2019a) Data Health Spending Erişim Tarihi: 14 Ağustos 2020, https://data.oecd.org/healthres/health-spending.htm
  • OECD web sayfası (2019b) Data Doctors, Nurses, 2019b. Erişim Tarihi: 15 Ağustos 2020, https://data.oecd.org/healthres/ doctors.htm#indicator-chart
  • Perrigo B, (2020) Coronavirus Could Hit the U.K. Harder Than Any Other European Country. Here’s What Went Wrong, Erişim tarihi: 20 Ağustos 2020, https://time.com/5823382/britain-coronavirus-response/
  • Propper C, Stoye G, Zaranko B. (2020) The Wider Impacts of the Coronavirus Pandemic on the NHS. Fisc Stud. 3:10.1111/1475-5890.12227. doi: 10.1111/1475-5890.12227.
  • Public Health England web sayfası (2020) Responsibilities. Erişim tarihi: 10 Ağustos 2020, https://www.gov.uk/government/ organisations/public-health-england/about
  • Royal College of Nursing web sayfası (2020) Building a better future for nursing: have your say. Erişim tarihi: 20 Ağustos 2020, https://www.rcn.org.uk/get-involved/building-a-better-future-for-nursing
  • Scally G, Jacobson B, Abbasi K. (2020) The UK’s public health response to covid-19. BMJ. 15;369:m1932. doi: 10.1136/bmj. m1932. PMID: 32414712.
  • Spiteri G, Fielding J, Diercke M, Campese C, Enouf V, Gaymard A, ve ark. (2020) First cases of coronavirus disease 2019 (COVID-19) in the WHO European Region, 24 January to 21 February 2020. Euro Surveill;25(9):2000178. doi: 10.2807/1560- 7917.ES.2020.25.9.2000178.
  • The British Medical Association web sayfası (2020) Erişim Tarihi: 15 Ağustos 2020, https://www.bma.org.uk/
  • The Health Foundation web sayfası (2020a) Dismantling PHE in the midst of a pandemic carries serious risks, Erişim tarihi: 20 Eylül 2020, https://www.health.org.uk/news-and-comment/ news/dismantling-phe-in-the-midst-of-a-pandemic-carries-serious-risks
  • The Health Foundation web sayfası (2020b) PHE reorganisation is highly risky and justification for the change has not been fully set out. Erişim tarihi: 20 Eylül 2020, https://www.health. org.uk/news-and-comment/news/phe-reorganisation-is-highly-risky-and-justification-has-not-been-fully-set-out
  • The Health Systems and Policy Monitor web sayfası (2020) European Observatory on Health Systems and Policies. United Kingdom. 1 Eylül 2020, https://www.hspm.org/countries/england11032013/countrypage.aspx
  • The King’s Fund web sayfası (2020a) The NHS budget and how it has changed. Erişim Tarihi: 10 Ağustos 2020, https://www. kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget
  • The King’s Fund web sayfası (2020b) NHS Workforce. Erişim Tarihi: 10 Ağustos 2020, https://www.kingsfund.org.uk/projects/ nhs-in-a-nutshell/nhs-workforce
  • The King’s Fund web sayfası (2020c) Health and wellbeing boards explained. Erişim Tarihi: 14 Ağustos 2020, https://www.kingsfund.org.uk/publications/health-wellbeing-boards-explained
  • The King’s Fund web sayfası (2020d) The NHS budget and how it has changed. Erişim Tarihi: 14 Ağustos 2020, https://www. kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget
  • UK Government web sayfası (2020a) Coronavirus in the UK. Erişim tarihi: 30 Ekim 2020, https://coronavirus.data.gov.uk/
  • UK Government web sayfası (2020b) Policy paper, Coronavirus (COVID-19) action plan. Erişim tarihi: 30 Temmuz 2020, https://www.gov.uk/government/publications/coronavirus-action-plan
  • UK Government web sayfası (2020c) Temporary approval of home use for both stages of early medical abortion 2020c. Erişim tarihi: 20 Eylül 2020, https://www.gov.uk/government/publications/temporary-approval-of-home-use-for-both-stages-of-early-medical-abortion--2
  • UK Government web sayfası (2020d) Government launches Vaccine Taskforce to combat coronavirus. Erişim tarihi: 20 Eylül 2020, https://www.gov.uk/government/news/government-launches-vaccine-taskforce-to-combat-coronavirus
  • UK Government web sayfası (2020e) Chancellor extends furlough scheme until October, Erişim tarihi: 20 Ekim 2020, https://www.gov.uk/government/news/chancellor-extends-furlough-scheme-until-october
  • UK Government web sayfası (2020f) Beauty salons set to reopen for some services next week under new government guidelines. Erişim tarihi: 20 Ağustos 2020, https://www.gov.uk/ government/news/beauty-salons-set-to-reopen-for-some-services-next-week-under-new-government-guidelines
  • UK Government web sayfası (2020g) COVID-19: our action plan for adult social care. Erişim tarihi: 20 Eylül 2020, https:// www.gov.uk/government/publications/coronavirus-covid-19-adult-social-care-action-plan/covid-19-our-action-plan-for-adult-social-care#controlling-the-spread-of-infection-in-care-settings
  • UK Government web sayfası (2020h) NHS frontline workers visas extended so they can focus on fighting coronavirus. Erişim tarihi: 20 Eylül 2020, https://www.gov.uk/government/news/ nhs-frontline-workers-visas-extended-so-they-can-focus-on-fighting-coronavirus
  • UNISON web sayfası (2020) Coronavirus: your rights at work. Erişim tarihi: 20 Ağustos 2020, https://www.unison.org.uk/coronavirus-rights-work/
  • Wenhan C. (2020) The UK was a global leader in preparing for pandemics. What went wrong with coronavirus? Erişim tarihi: 25 Haziran 2020, https://www.theguardian.com/commentisfree/2020/may/01/uk-global-leader-pandemics-coronavirus-covid-19-crisis-britain
  • Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE ve ark. (2020) Factors associated with COVID-19-related death using OpenSAFELY. Nature. Aug;584(7821):430-436. doi: 10.1038/s41586-020-2521-4.
  • World Health Organization web sayfası (2020) COVID-19 Health System Response Monitor, United Kingdom. Erişim tarihi: 25 Ekim 2020, https://www.covid19healthsystem.org/countries/ unitedkingdom/countrypage.aspx
  • World Health Organization web sayfası (2015) European Health Information Gateway. Erişim Tarihi: 14 Ağustos 2020, https://gateway.euro.who.int/en/indicators/hfa_476-5050-hospital-beds-per-100-000/visualizations/#id=19532&tab=table
  • Yates T. (2020) Why is the government relying on nudge theory to fight coronavirus? Erişim tarihi: 20 Ağustos 2020, https://www.theguardian.com/commentisfree/2020/mar/13/wh
APA Usturalı Mut A (2021). COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. , 350 - 365.
Chicago Usturalı Mut Ayşe Nur COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. (2021): 350 - 365.
MLA Usturalı Mut Ayşe Nur COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. , 2021, ss.350 - 365.
AMA Usturalı Mut A COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. . 2021; 350 - 365.
Vancouver Usturalı Mut A COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. . 2021; 350 - 365.
IEEE Usturalı Mut A "COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ." , ss.350 - 365, 2021.
ISNAD Usturalı Mut, Ayşe Nur. "COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ". (2021), 350-365.
APA Usturalı Mut A (2021). COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. Toplum ve Hekim, 36(5), 350 - 365.
Chicago Usturalı Mut Ayşe Nur COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. Toplum ve Hekim 36, no.5 (2021): 350 - 365.
MLA Usturalı Mut Ayşe Nur COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. Toplum ve Hekim, vol.36, no.5, 2021, ss.350 - 365.
AMA Usturalı Mut A COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. Toplum ve Hekim. 2021; 36(5): 350 - 365.
Vancouver Usturalı Mut A COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ. Toplum ve Hekim. 2021; 36(5): 350 - 365.
IEEE Usturalı Mut A "COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ." Toplum ve Hekim, 36, ss.350 - 365, 2021.
ISNAD Usturalı Mut, Ayşe Nur. "COVID-19 PANDEMİSİNDE İNGİLTERE SAĞLIK SİSTEMİ". Toplum ve Hekim 36/5 (2021), 350-365.