Elucidating Contemporary Issues in Healthcare Industry

After a period of more than a quarter-century of rapid progress in cancer research, rich and complex knowledge has been generated exposing cancer to be an ailment involving unsteady changes in genetic materials present in a cell (Hanahan and Weinberg 2011, p. 58). The knowledge has put in motion more discoveries of mutations that produce genes known as oncogenes which can transform cells into tumor cells. These not being the only cause of cancer other researchers have associated the diseases with carcinogens. According to Smith et al. (2016), external factors such as asbestos, UV lights, and exposure to some chemicals cause DNA mutations leading to higher likely hood of cancer occurrence. The research further suggests that these exposures can cause cancer in several ways. For example, UV light or radiations cause cells to divide more rapidly exaggerating the reasonable rate of cell division.

Additionally, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) have associated cancer with lifestyle. According to the two research institutions, cancer is caused by improper lifestyle, poor or unhealthy diet and lack of physical activities in most people (Chan et al. 2011). Massive intake of alcohol, red meat, consumption of salt and moldy cereals have also been heavily linked with cancer hence prevention will prompt its reduction or limiting (Park, Paik and Lee 2016, p. 183).

What has led to all this research and discoveries mentioned above is because cancer is the leading cause of death globally and in the UK cancer incidences and mortality have been increasing. For example, there has been an increase of 13% of cancer cases since 1990, and in every year 360,000 people are diagnosed with cancer (Torre et al. 2015, p. 102). The general feeling of the researchers and physicians is that although cancer is one of the most pressing challenges faced by health stakeholders globally, prevention and treatment is a probable achievement and outcome (Catsburg, Miller and Rohan 2014, p. 2450). With this factor being a motivation, some approaches have been put in place to curb the cancer threat and to provide acceptable and better services in the management policies and practices related to this ailment.

Among the options in place are the policies available to reduce the harshness of the disease and new cases of diagnosis and ethical issues related to cancer care and the financial aspect about cancer treatment and control (Ginter 2018). Further, Crisp and Chen (2014, p. 953), suggests that human resources planning and management which entails addressing the issue of physician shortage is also vital in achieving proper provision of health services as far as treatment and prevention of cancer is concerned. Additionally, the crisis in healthcare and issues impacting success are among the themes and topics which will be discussed in this paper to address the health care problems and how to better them for the achievement in the fight against the disease highlighted.

Literature Critique and Relationship between Current Healthcare Management Issues

Local and Government policies

According to Sudlow et al. (2015, p.), cancer statistics are overwhelming in the UK compared to other countries whose economic prowess is at par in Europe. 130,000 people die annually as a result of the disease with the annual NHS costs for cancer services at £5 billion, but the price for society as a whole stands at £18.3 billion as per 2015. The government has in place policies which have proved helpful to keep this reality in check. Since lifestyle is one of the significant causes of cancer as mentioned earlier, the government has put in motion ways of reducing smoking, reducing obesity, improving diet and reducing harmful drinking (Hunt et al. 2018, p. 130). A report on cancer research in the UK, reveals that smoking accounts for 1 out of 4 cases of cancer in the UK. The findings of the study further suggest that the longer one smokes, the higher the risk of contracting cancer. This is caused by the damage of DNA in the lung cells and more cigarette means to build up of damage in the same cell which eventually leads to cancer precisely lung cancer (Stewart and Wild 2017, p.5). Hence a success in reducing smoking will have a more significant impact in the fight against cancer. Still, on lifestyle relation to cancer, harmful drinking limits repairing of DNA damaged by chemicals in tobacco as stated by Nelson et al. (2013, p.645). He further documents that alcohol use increases the risk of cancers of the mouth, throat, larynx, and esophagus. From the recorded data the policy to reduce smoking, and harmful drinking is a positive response in making strides towards the prevention of cancer and reducing new cases of the cancer diagnosis.

Another policy by the UK authorities in keeping the cancer statistics controlled as other nations in the same economic category is creating awareness on the signs of cancer  (Lauby-Secretan et al 2015, pp.2353-2358) . According to the publication, the stakeholder can help people get an early diagnosis. The achievement of creating awareness is done through running national and regional campaigns to inform people about signs of uncommon types of cancer such as bowel, kidney, bladder and ovarian. Early detection of cancer significantly increases the chances of successful treatment of cancers of the breast, cervix, mouth, larynx, colon skin and rectum. Early detection involves two major components; education and screening (Jacobs et al 2016, pp. 945-956) which ushers us in to the next policy according to the UK government which is getting an early diagnosis through screening. The understanding of the policymakers and health stakeholders is that running screening programs will result to early diagnosis hence the disease is more likely to respond to treatment (Lauby-Secretan et al 2015, pp.2353-2358). Early screening is majorly done on cancers of the cervix through testing women for Human papillomavirus (HPV) and cancer of the breast screening. Early detection through screening has led to increased years in cancer survival. This has been explained by Bazargan et al (2015, p.755) in their effort to understand the logic behind a lower 5- years cancer survival rates in African American women than white women in the United States. The difference is associated with early breast and cervical cancer screening.

Critically Evaluating Options Available in Contemporary Healthcare Management

Other policies by the government include improving treatment especially on radiotherapy and improving access to cancer services. The plan aims to give people equal access to cancer services and to advance medication for areas with individuals that have high cancer rates. For instance, the older cancer patients don’t get same standards of treatment as the younger ones hence the policy has put in place ways to provide corresponding services for both young and older cancer patients (Andersen Davidson and Baumeister 2013, p.33). Lastly on policies as a theme to improve healthcare management is helping cancer survivors to live more comfortably. To attaining such a goal, discussions between care providers and cancer survivors are done to address survivor’s needs since most of those who survive after years of treatment have unique needs which include management of chronic physical and social effects of treatment.  (Blanch-Hartigan 2014, p.1578).

Ethical Issues

The ethical issue is another worth noting option in healthcare management.  Cater (2016, p.105) suggests that these issues span from prevention to end of life care. According to Cater, ethical problems are generic to medicine in a general sense since they involve foundational aspects of the centrality of respect for each patient. This translates to providing correct and enough information to allow informed decision making. Additionally, ethical issues will relate to the distribution of health resources equally and removal of vast health differences in healthcare opportunities. Other ethical problems revolve around public health communication about cancer risk, over-diagnosis recognition and the risks related when recommending a cancer screening program and treatment (Xafis 2016, p. 23).

For instance, on the issue of messaging in the control of excessive alcohol consumption, Muhlack et al. (2016, p.97) discuss how the practice is rampant while it’s a known risk factor for cancer and whether the way the legislature handles the issue is justified. A proposed strategy of reducing alcohol consumption in some countries like Australia, for instance, is including a warning label on all alcohol products which worked in tobacco control. Although such warnings have been given on the ground that it’s only for information only, McDonough (2016) argues that the real aim is a behavioral change that will result in harmful reduction. The approach may not be productive since behavior change may not be steered by information alone and the society should be allowed to make their informed choices without legislative interference. For a win-win situation to be attained a balance must be struck between the public’s wholesome needs and proposed interventions (Louise et al. 2015, p.6)

Current Themes and Best Practices in Healthcare Management

Most researchers have argued that routine testing and screening for cancer for earlier detection of the symptoms result in decreased mortality. This fact has been proved severally and encouraged, but Carter (2016, p.106) states that even if a particular population benefits not ever one will help. In some individuals, the detected cancer symptoms may never cause harm what is known as over-diagnosis which results to further testing, psychological medication stress. Before testing and screening, an individual should be well informed and told the risks involved in the process to enable them to make decisions and make an informed judgment whether to participate in a mass screening program.

With the increased need for public awareness, a lot of research is being conducted on the already known case, and this involves individual that are newly diagnosed, in hospitals for treatment or cancer survivors. Some researcher has researched such individuals without their consent and made the information public. In seeking ones approval, Xafis (2016, p.123) suggests that they may not give precise information of what will be shared with the public and to what extent or preferably there is no guarantee that patients understand what is being presented. Additionally, some information involves patients who may not give full details due to problems with recalling the precise facts about their experience or what their being asked for this has been confirmed by trials measuring the quality of understanding (Joffe et al. 2001, p.1775). This has led to sharing information with the public which is not entirely reliable and misleading in some aspects of the research. Seeking consent in research from patients should be made clear and ensuring they understand what they asked and making it clear without equivocation on intended purpose of the information.

Financial Burden

The increased research on cancer has resulted in more therapies being introduced and receiving approval which is putting pressure on health budgets since the drugs are costly. Lipworth, Ghinea, and Kerridge (2016, p.119) have documented the dilemma of stakeholders in maintaining the prices for the drugs affordable for the patients who are desperate to access the medicines which they view to be life-saving. The stakeholders and decision-makers need to balance between treatment achievement and the cost of the drugs since most manufacturers are after making a profit out of ailing individuals. The proposal is that there should be a development of a strategy which will check on accountability and reasonableness which could be used in funding where a need is and negotiating prices for high-cost drugs.

Policies for Reducing Cancer Cases

Among the controversial and heavily debated ethical issues is the end of life issues. This has always focused on physician-assisted suicide or the management in the last stages of cancer. If a patient is dying, the factor to consider in making a choice should be to relieve suffering and ensuring their comfort (Gillam 2016, p.131). But this should not be achieved through the use of illegal drugs such as cannabis. More on the issue, physicians should be open in giving the information to the patient and the family for them to make informed decisions. The options usually available is home care, hospital care or hospices where the primary goal is on reducing the pain of the near to dying patients.

The process of cancer treatment right from the initial stage of screening, diagnosis and treatment is known to be expensive (Guy et al 2013, p.3749) and for the success in the management of the ailment, medical institutions, individuals and other stakeholders have to pull the resources together to meet the financial demand that accompanies it.  Without finance as an important resource, the fight against cancer will be futile and the situation will be from bad to worse hence a very important option available in proper healthcare management in relation to cancer.

Several studies have shown that people with cancer are at higher risk of facing financial difficulties and crisis as compare to those without cancer (Davidoff et al 2013, p.1257). This has been the case since historically dealing with cancer and what it comes with has been the most costly comparing to other conditions the UK. For instance according to a new research headed by Macmillan Cancer Support, cancer treatment will cost NHS not less than £ 1.4 billion every year buy 2020 which is higher by £ 600 million in 2015 with personal expenses for treatment of cancer patients exempted.

Comparing to ten years ago according to Jack et al (2017, p.336), the treatment such as chemotherapy and other cancer supportive drugs are increasingly expensive. The introduction of a new cancer treatment drugs accompanies increased prices than the prior leading to higher out- of- pocket cost whose effect is felt even after many years after the initial diagnosis (Banegas et al 2016, p.56). Moreover, there is likely hood of cancer survivors to register absent at work due to the disease and the time they spend in bed due to poor health which will reduce employment-based health insurance resources to pay medical bills and care hence increasing the financial burden of cancer. In combining all these factors, the financial aspect of the disease is evident and is vital in healthcare betterment. To help solve the financial crisis for cancer patients and to ease their burden in meeting medical care, the proposal by some charitable organizations such as Macmillan Cancer Support is that the banking sector should play a unique role in ensuring that cancer patients and survivors do not fall in financial difficulties. According to the organization, the bank should offer exceptional support and should be flexible in providing products like mortgages, credit cards and loans to help manage the financial impact felt due to the diagnosis (Moffatt, Noble and White 2012)

Early Detection through Screening

In addition other charitable organizations have been in forefront in offering financial support. A report by a charity organization in UK reveals that it has used over £50 million in the last five years to support cancer patients (Middleton 2014, p.39). Apart from direct financial support, the organizations are playing a significant role in calling upon the government to play their part in resolving the financial crisis for cancer patients. Furthermore, albeit the government input is not enough as viewed by many, it plays a significant role in cancer prevention and treatment through NHS. In 2015 the NHS cancer drugs fund was increased to £340 million up from £280 in 2014 and £200 in 2013. According to the report it was projected to rise to £420 in 2016 (Callahan and Darzi 2015, pp.1563-1568). Moreover the report indicates that according to NHS any cancer patient receiving a drug through the cancer drug fund will continue to receive regardless of whether the institution offers it. Though not satisfactory in meeting the needs of every cancer patient, the steps being taken to ease the financial difficulties is commendable there is room to do better as far as the fiscal theme is concerned about cancer healthcare management.

Shortages of Medical Professionals

Another contemporary theme in healthcare management is the issue of shortage of staff and physicians dealing with cancer cases. In the UK the government through the NHS has recognized the problem of expert shortage and plans have been formulated to correct the norm. A promise has been given to add over extra 5000 staff by 2021 in two key areas which are; those who diagnose and those who treat cancer (Graban 2016). This move will make a difference in filling the existing gaps in cancer treatment. The estimate of World Health Organization (WHO) of shortages of physicians, nurses and other health professionals is 4.3 million. In the UK, patients’ surgery and treatment has been postponed or most have been forced to wait for a long period for their turn to come for treatment (Pelzang 2010, p.917). This has caused the psychological problems to the patients and even the spreading of the disease and worsening of the patient’s conditions.

Healthcare Crisis

Lastly in themes is the crisis in healthcare management and cancer treatment. According to Levit et al. (2013, p.7), the cancer care team include those with specialized skills and training, primary care clinicians, and family caregiver. All this should provide a competent workforce in the management of the patient, but the current practice registers a lower standard. The educational framework cannot quickly train the new personnel since there is an alarming shortage and there is uncoordinated care delivery system leaving patients to go through a terrible cancer care delivery system (Levit and Patlak 2009). Further on the crisis in cancer treatment and management, Levit and Patlak suggests that for a long time chemotherapy drugs that have been available have been relatively toxic leading to serious side effects to patients.

Impact of Improving Access to Cancer Services

Conclusion

Themes revolving around health care management about cancer treatment and bettering the conditions of the patients are wide and upcoming but the few highlighted in this paper should be improved to gain ground in the fight against cancer. The governing body should come up with more policies on how to reduce the risk of cancer and the policies in place should be implemented to help the public make choices that will reduce cancer cases significantly. Physicians, nurses, and clinicians should adhere to their professional code in dealing with ethical issues. This involves being ready to give correct information to the patients and the family, so that decision making is always independent. On the financial aspect, cancer drugs manufacturers and researchers need to be more reasonable on the price of the drugs since they are lifesaving while also considering the toxic levels of the product. The government and the institutions concerned should be ready always to give support to cancer survivors. This also involves the return to work formulae after an extended period of sickness which most organizations lack in the UK.

Since the fight against cancer and improvement of healthcare management is highly dependent on the availability of enough physicians, nurses, and clinicians, the government should invest in ensuring their availability. This should include increasing facilities in training institutions and sponsoring more students who want to venture the field, but the short-term way of solving the shortage should involve importing more doctors and skilled professionals in the area to meet the demand.   

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