Community care as a health care priority : a local perspective

Abstract

Health care access is universal locally; however this does not necessarily resolve the issues encountered by individuals facing poverty, disability, degenerative conditions and their dependents. Poverty on its own presents challenges in coping with day to day activities. If this is coupled with chronic illness, disability and terminal illness, to name a few, the ramifications are significant, effecting the standard of living and quality of life of the individual and dependents. A large number of the most prevalent health problems are chronic in nature, leaving individuals requiring long-term care and support. The higher prevalence of chronic conditions such as dementia and diabetes, are leading to higher dependency levels resulting in an increased demand on care services. Community care, as part of health care, is something to which individuals are morally entitled as a necessary condition for a life worthy of human dignity. Adopting a philosophy of community care, based on social justice, can safeguard human dignity by empowering individuals, families and communities to be in a better position to maintain or restore their health and well-being. A socially inclusive community, engaged in addressing health, illness, and caring for the more vulnerable members, is one which moves from the institutionalisation paradigm, to person-centred care. The focus of which, being on the dignity of the individual and the value of the community. If the appropriate infrastructure does not currently exist to address these needs, then ethics should compel the creation of such a setup. Keeping in mind the principles of social justice namely equity, access, participation and quality, the core objectives for community care identified are to improve the quality of life for vulnerable and dependent individuals and their informal carers; and to deliver coordinated and seamless care, which strengthens the well-being of individuals and groups through empowerment. Empowering communities to promote health, prevent disease, treat illness and support individuals through care delivered within communities is important to achieve these objectives. As a result this dissertation examines community care within the local health care setting. Chapter one looks into community care as a concept as well as within the local scene. The first chapter also considers local health care and related demographics. Chapter two and three, address policy and ethical principles respectively. Policies, strategy documents and other communication from the World Health Organisation and European institutions, namely the European Commission, are given particular importance in chapter two. Due consideration is also given to local policy development and strategies. In particular the Health Vision 2000 as well as the strategy document released earlier this year, A National Health Systems Strategy (NHSS) 2014-2020. Ethical principles are considered in the third chapter, where the focus is twofold; Namely three consecutive reports titled National Report on Strategies for Social Protection and Social Inclusion, as well as the community care consultative exercise carried out locally in 2007. The fourth chapter follows by considering how community care can be enhanced locally. This is done by looking at the capability to be healthy concept adopted from the capability approach. [...]