Nurse Staffing Issues and Patient Care Quality Essay

Nurse Staffing Issues and Patient Care Quality - Essay Example From the paper it is clear that there are various factors which have contributed to reduced staffing levels in nursing. The nationwide gap between the number of available positions and the registered nurses qualified and willing to fill them is increasing. The needs of today’s higher acuity patients for more care contributes to the staffing crisis. As the research stresses poor remuneration of registered nurses have prompted most of them to practice in the private sector and neglect the public sector which serves majority of people in the population. Patients’ higher acuity calls for skilled nurses who can give them specialized care they need. The number of qualified nurses to give such care is small contributing to the gap. In policy making, there is a misconceived perception that hiring fewer nurses can reduce the costs and increase profitability in the health care sector. However, increasing the nursing staff in a hospital leads to higher quality patient care and hence increased profits. Adequate staffing and balanced workloads are central to achieving good outcomes in nursing. The problems associated with inadequate staffing of nurses include heavy workload leading to burn out and hence poor health care delivery. Adverse events such as nosocomial infections, shock and failure to rescue patients needing intensive care are some of the problems associated with inadequate nurse staffing in hospitals.

Taxtion Profect Literature review Example | Topics and Well Written Essays - 2250 words

Taxtion Profect - Literature review Example However, the impact of tax travels to the end consumer in a VAT scheme much like other taxation systems since goods and services providers tend to move the taxed amount to the end consumer’s final price receipt (Ebrill et al., 2001). VAT Implementation in the United Kingdom VAT is not a new concept to the United Kingdom (UK) and was in place before the UK signed up for the European Union. The initial implementation of VAT in the UK dates back to 1973 when it was introduced by the national government as an entry condition to join the European Union (EU) (Warren, 1993) (IFS, 2009). VAT is not levied universally on all goods and services in the UK. Instead, VAT is applicable to certain goods and services at varying rates in the UK. Directives concerning the amount of VAT and its application to goods and services are provided both by the UK government and certain EU rules and guidelines. Moreover, VAT rates tend to vary for certain goods imported from outside the EU (HMRC, 2013). VAT Rates Her Majesty’s Revenue and Customs (HMRC) provides for three different VAT rates that are classified as (HMRC, 2013): Standard 20% Reduced 5% Zero 0% Standard VAT rates apply to most goods and services consumed in the UK while reduced rates apply to certain items such as fuels, energy savers, power items etc. On the other hand, zero rates apply to certain other items such as certain food items, public transportation, books, children’s clothes etc. (HMRC, 2013). It must be kept in mind that zero rate VAT items are differentiated from items exempted from VAT. Any items that are exempt from VAT cannot have VAT based taxed applied to them under the law such as on insurance, charitable fundraising, life saving services etc. In contrast, zero rate VAT items are taxable but are charged for at 0%. The retailer may lodge a reclaim with the HRMC for zero rate VAT items but not for VAT exempt items (HMRC, 2013). In addition, VAT law provided by the EU mandates that the m inimum standard rate for EU members has to be 15%. Member states are also allowed to apply a maximum of two different reduced rates that should be at least 5% on certain goods (European Commission, 2006). Moreover, any changes in VAT especially changes concerning decreased VAT rates must be approved by the EU alone (Victor, 2010). Regional Comparisons VAT is applicable throughout the EU and certain member states exhibit exceptionally high VAT rates. Regional comparisons of VAT rates are presented in the table provided below. Table 1 - VAT regional comparison sourced from (Victor, 2010) Country VAT Rate (%) UK 20 Denmark 25 Hungary 25 Sweden 25 Iceland 25.5 Criticisms against VAT VAT is collected at each value addition stage in the provision of goods and services so ideally VAT’s burden should be borne by these stages and their stewards. However, practically VAT banks on the end consumer much like other forms of taxation. This tends to make VAT just as cumbersome for the avera ge consumer as other forms of taxation. In addition, it has been argued that VAT is essentially a regressive form of taxation though proponents of VAT consider it as progressive. The graph presented below presents how different taxes on consumers in the UK tend to vary by the income quartiles. Figure 1 - Tax composiitons and their differences according to income groups in the UK sourced from (Murphy, 2010) Tax collection through VAT is generally lower than expected