Health Management & Social Care Study Notes

Chapter: Cultural and Political Disagreements and Tensions

Hey everyone! Welcome to this chapter. We're going to explore a really interesting topic: why people and organisations sometimes disagree about health and social care. Think of it like a big debate – different teams have different ideas, values, and goals. Understanding these disagreements is super important because they affect the health policies and services we all use every day. Don't worry if this sounds tricky at first, we'll break it all down with simple examples!


1. Culture Clash: Different Views on Health & Sickness

What one person thinks is the best way to stay healthy might be completely different from another person's view, especially when they come from different cultural backgrounds. In Hong Kong, we see a fascinating mix of Chinese and Western ideas about health.

Contrasting Chinese and Western Understandings of Health

Let's look at the key differences. Imagine your body is a garden...

Traditional Chinese Medicine (TCM) View:

  • Holistic Approach: Sees the body, mind, and spirit as one connected system. It's about overall balance. (Like tending to the whole garden – soil, water, sunlight – to keep all plants healthy).
  • Balance is Key: Health is the harmony between Yin (陰) and Yang (陽) and the smooth flow of Qi (氣), or life energy. Illness happens when this balance is disturbed.
  • Health Consciousness: Focuses on prevention through diet, herbal medicine, acupuncture, and lifestyle choices to maintain balance. (Like regularly watering and fertilising the garden to prevent weeds from growing).
  • Seeking Help: A person might first visit a TCM practitioner, drink herbal teas, or try dietary therapy when they feel unwell. The family is often very involved in care decisions.

Western Medicine View:

  • Biomedical Approach: Focuses on specific diseases, symptoms, and pathogens (like bacteria or viruses). It's more about identifying and fixing a specific problem. (Like spotting a weed in the garden and using a specific tool or chemical to remove only that weed).
  • Cause and Effect: Health is seen as the absence of disease. Illness is caused by a specific, identifiable agent.
  • Health Consciousness: Often focuses on treating illness after it appears, using medication, surgery, and other interventions. Prevention is also important (vaccines, health screenings), but the focus is often on tackling specific health risks.
  • Seeking Help: A person will typically visit a doctor in a clinic or hospital for diagnosis and a prescription. Health decisions are often seen as more individual.

Everyday Example: If you catch a cold, a Western approach might be to take paracetamol to reduce the fever and pain. A Chinese approach might be to drink "leung cha" (涼茶) or a ginger-infused soup to restore the body's balance and expel "heatiness" or "coldness".

Key Takeaway

Neither view is "right" or "wrong" – they are just different ways of understanding health. These cultural differences influence how people take care of themselves and what kind of help they look for when they're sick. Respecting these differences is crucial in social care.


2. The Big Debate: Who Should Provide & Pay for Care?

This is a huge political tension in many societies, including Hong Kong. Who has the main responsibility for providing and funding healthcare and social care? Is it the government (the public sector) or individuals and private companies (the private sector)?

Analogy Time! Think of it like transportation. The public sector is like the MTR or public buses – funded by the government (and fares) to serve everyone. The private sector is like taking a taxi or owning a car – you pay more for a more direct, personal service.

Key Points of Conflict:

Medical Charges
This is about how much patients should pay out-of-pocket in public hospitals and clinics. The government heavily subsidises public healthcare, but there are still fees.

  • The Tension: Raising fees could help cover costs, but it might make healthcare unaffordable for the poor. Keeping fees low ensures access for everyone, but puts a huge financial strain on the government (and taxpayers!).

Public vs. Private Sector Roles
Should the public and private health sectors be partners or rivals?

  • Competitive Role: They might compete for the same pool of doctors and nurses, driving up costs.
  • Complementary Role: They can work together. For example, public hospitals handle most emergencies and complex cases, while the private sector offers more choice, shorter waiting times for non-urgent procedures, and different levels of service. This can help reduce the burden on the public system.

Privatisation
This is the idea of shifting services that were once provided by the government to private companies.

  • Arguments For: Supporters say it can increase efficiency, offer more choices to consumers, and reduce the government's financial burden.
  • Arguments Against: Critics worry that it could lead to inequality, where only the rich can afford the best care. They argue that healthcare is a basic right, not a product to be sold for profit.

Key Takeaway

The debate between the public and private sectors is a balancing act. It’s about finding a way to provide affordable, accessible, and high-quality care for everyone without overwhelming the system. There are no easy answers, which is why it's a constant source of political tension.


3. You're the Boss! The Shift in Patient Rights

There has been a major shift in the relationship between healthcare professionals and the people they serve (the clients or patients).

The "Old Way" (Authoritative Power)

  • In the past, the professional was seen as the all-knowing authority. This is often called the "doctor knows best" model.
  • Patients were expected to be passive and simply follow instructions without asking many questions.

The "New Way" (Client Involvement & Rights)

  • Today, there is much more emphasis on clients' rights. People are more educated and have access to information (hello, internet!).
  • Clients now expect to be active partners in their own care. They have a right to be informed and to be involved in making decisions.
  • This is called shared decision-making, where the professional provides their expert medical opinion, and the client provides their personal values, preferences, and goals. Together, they choose the best path forward.

Did you know? The concept of "informed consent" is a legal and ethical requirement. This means a healthcare provider must fully explain a treatment, including its benefits and risks, so you can make an informed choice to accept or refuse it. This is a perfect example of client involvement in action!

Key Takeaway

The power has shifted from being solely with the professional to being shared with the client. This move towards patient empowerment respects individual autonomy and often leads to better health outcomes because the care plan fits the person's life and values.


4. Teamwork Trouble: Tensions Between Institutions

Health and social care isn't delivered by just one group. It involves many different institutions: public hospitals, government departments, NGOs (non-governmental organisations), private clinics, elderly homes, and more. Sometimes, they don't work together smoothly.

Group Project Analogy: Imagine a school project with members from different classes. One person wants to make a video, another wants to write a report, and a third wants to do a presentation. If they don't coordinate, they might compete for resources (like the one library computer), do overlapping work, and end up with a messy, disconnected project. It's the same with health and social care organisations!

Why do Tensions Happen?
  • Competing for Resources: Institutions often compete for limited government funding, public donations, and even for clients.
  • Different Visions and Goals: A hospital's main goal might be to treat an elderly person's illness and discharge them quickly. An NGO's goal might be to ensure that person has long-term support and a safe home environment. These different perspectives can clash.
What Happens When Tensions Flare Up? (Resultant Crisis in Service Delivery)

When institutions don't collaborate, it's the service users who suffer. This can lead to:

  • Decline in Service Quality / Malpractice: Important information might not be shared between a hospital and a care home, leading to mistakes in care.
  • Ineffective Use of Resources: Two different NGOs might unknowingly offer the same service to the same group of people in one district, while another district has no service at all. This is a waste of money and effort.
  • Obstructed Service Delivery: A patient's care journey becomes fragmented. For example, an elderly person is discharged from the hospital, but the community care team wasn't informed, so no one is there to help them at home.
  • Policies Not Endorsed: Sometimes, good health policies fail because different political parties or powerful institutions disagree on them, causing a stalemate.
So, How Do We Fix It? (Possible Solutions)

The key is to build partnerships and collaboration! The syllabus suggests developing policies that encourage institutions to work together. This can mean:

  • Creating formal networks for communication.
  • Sharing data and client information (securely, of course!).
  • Jointly planning services to avoid gaps and overlaps.
  • Focusing on a shared goal: the well-being of the client.
Key Takeaway

No single organisation can meet all of a person's health and social care needs. Effective care requires a team approach. Overcoming tensions and fostering collaboration between institutions is essential for a seamless and effective system that truly helps people.