Eliminating Bureaucracy in Healthcare


Prompt access to ideal malaria treatment is central to successful malaria control globally. However, minimal fevers are effectively treated with anti-malaria within 24 hours of system onset. Over the last decades, there has been an upsurge of plans to enhance effective malaria treatment access world widely. Health care professionals are complaining of too much bureaucracy that hinders effective malaria treatment access. Many healthcare workers complain about the big load of paperwork they have to do rather than caring for patients. Therefore, this study describes how healthcare bureaucracy systems impact malaria care given to patients in the UK.


Healthcare Bureaucracy

Fortier & Malloy (2019) argue that healthcare bureaucracy refers to a healthcare institution with multilayered processes and systems.These procedures and policies are designed to sustain controls and uniformity within the institution. Bureaucracy examines the established methods in government or large organizations. In the past decade, organizational dynamics have reshaped health policy. However, healthcare bureaucracy has triggered a more constrained medical professionalism. Most developed nations have embraced democratic principles as an approach of balancing professional norms; contrary, Americans are focusing on the development of a distinct bureaucratic health care regime. The healthcare institutions in America are generally organized as professional bureaucracies that limit the healthcare manager's decision control. Health care is undergoing a profound transition; its organization is changing to outcomes-oriented from being service-oriented. Medical practitioners are complaining of too much bureaucracy. However, healthcare standardization, demands rationalization, and the optimization process is becoming more complex. Many health care organization professionals and frontline staff involved in helping the patients are subjected to escalating numbers of fragmenting directives from above, therefore forced to devise work schedules to cope with problem-solving systems that are ineffective.

Reduction of user fee

Ensuring all malaria patients’ prompt access to effective malaria treatment is a challenge to health systems that are resource-constrained. Policy actions to address the diverse barriers to access to malaria health care should be designed around access dimensions and diversified interventions for the revitalization of public health care systems. Failure to direct more efforts on addressing access barriers among the marginalized and poor society members, malaria will remain a significant cause of mortality and morbidity. Fedeli, Leonida & Santoni (2018) deem user fees as an available form of healthcare financing that is regressive as they highly contribute to the imposition of unaffordable cost burdens on poor households, thus, representing a social exclusion facet subjected to needy families. The author further argues that attacking healthcare's calcified bureaucracy is an ideal solution to skyrocketing healthcare costs. This can be achieved through increasing price transparency, reducing physician paperwork, and eliminating soviet style regulations such as Certificates of Need.

Hopkins & Cunningham (2019) argue that the high cost of treatment is a barrier to access to malarial health care. The high costs prevent people from seeking effective malaria treatment despite the knowledge that appropriate anti-malarial should be used to treat malaria. Marginalized and needy members of the society find for cheap alternative treatments, though ineffective. Hopkins & Cunningham (2019) suggests that user fee should be removed for primary health care, and a policy change should be enacted to ensure all people have access to malaria treatment.

Paperless health care provision

The NHS has experienced numerous attempts to free health practitioners from the shackles of unnecessary paperwork, allowing more time for patient care. The process cuts back bureaucracy in the healthcare system. The bureaucracy and regulation review is necessary for the public, Mid staffs, and political desire for the growth of external assurance. According to Oliver (2017), the NHS is under pressure to restore public confidence, improve patients care quality and promote accountability and openness A smarter system of information use and a digital NHS is vital for the growth of external assurance. According to Lalloo et al. (2016), the regulators lack real-time data while the data gets distributed across the inspectors and regulators.

A single-payer reform cuts Health costs for access to malaria effective treatment. This can be achieved by eliminating insurance intermediaries and radically simplifying payments to hospitals and doctors. Misinformed insurance companies reject tests frustrating the physicians. This causes ineffective access to malarial treatments. Lalloo et al. (2016) argue that economic and financial factors affect the type of provider to be visited, care-seeking timelines, and decisions to seek care for suspected malaria. The decision to seek attention is highly influenced by treatment affordability. Self-medication is prioritized, especially by poor households.The traveling costs to healthcare facilities and the time spent travelling opportunity costs and the waiting period at the facility are also crucial factors. Poor socioeconomic households seek care at informal or lower-level providers. According to Chen et al. (2016), strengthened capacity and role for community health workers contributes to high-quality care.

Slowing down frontline staff administrative burdens

Establishing an agreed set of information, collected and held from one place, considering both local and national requirements of what is needed to deliver effective care, ensures that relevant information is recorded at minimal costs. This is because the data is collected at once and is subsequently used for multiple purposes. According to Oliver (2017), the NHS tolerates far more information being demanded as opposed to the information required to serve its purpose. To this end, the staff, supervising, and regulatory bodies are frustrated as they struggle to use the considerable data effectively. NHS managers, clinicians, and board members and others bust bureaucracy claiming that they spend between one and three hours of their working day collecting and recording information personally. Additionally, about three-quarters of the information collected for national or regulators' requirements usually is irrelevant.

The institutions that generate information requests focus on the impacts of frontline support. Most of the organizations justify their need for data from a legal perspective. However, this information is rarely shared between sectors, organizations, and departments. Although all these bodies have malaria patients in common, it is necessary to have repetitive and separate requests for similar information. Bassat et al. (2016) argue that there is a need to streamline the available data, ensuring that it is shared with the public and patients as well as cutting across diverse, relevant institutions.

Any new request for information should be subject to is policed patient proof. Thus the benefit outweighs the staff time and the cost to collect and provide quality care valuable intelligence. Oliver (2017) argues that there is a need for NHS to catch up with some other sectors and exploit all the technology on offer so that staff can have more time to care for patients. The paperless technology would impact significantly on creating more time for medical practitioners to take care of malaria patients. For instance, the use of barcodes on medications and letters, use of smart devices that take readings, and feed them into databases directly and voice recognition software applied in various parts of NHS to slow down frontline staff administrative burdens. Worth noting the NHS has a variety of the switches that would create up to 50% reductions in the time staff spend on data input, though patchy creating a need to be systematically availed across the entire service.

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Providers’ supplies

Provider supplies such as the availability of drugs, award, and laboratory equipment such as microscopes, excellent infrastructures, and injecting drips attract patients at public health facilities. Additionally, the desire for specialist services inclusive of transfusions, investigations, admissions, and surgery at higher-level facilities attract patients to federal health care providers. On the other hand, first aid at lower-level providers such as community health workers and drug shops attract patients. Bassat et al. (2016) claim that accurate and rapid diagnosis of malaria is integral to the ideal treatment of affected individuals and in the prevention of the further spread of the infection in the community. CDC provides technical and diagnostic assistance on the diagnosis of malaria as a national reference Centre for malaria. Notably, CDC provides specialized tests such as PCR, serology, and drug resistance testing, and microscopic diagnosis.

Health care provider’s positivity

Kosack, Page & Klatser (2017) claim that a positive attitude by the health service provider that includes polite, friendly, empathy, and consolation enhances access to appropriate malarial treatments. The author highlights that health seekers desire the provision of health services with respect, dignity, and humility. Health seekers are more attracted to medical practitioners who offer both consolation and guidance.

Proximity to healthcare

Easy access or proximity to health care providers is a crucial factor reflecting preferences for medical service providers located where transport is easy to afford and secure (Brunette, 2017). Patients frequent where medical provider timeliness of services includes short waiting times and convenient opening hours. This helps malaria patients to access timely treatment due to short waiting hours and accessibility of the clinic's conveniences.

Specific attractions to higher-level medical providers are linked with the qualifications of staff and perceived to provide better quality health services; therefore, patients are recommended by other medical providers to seek these services. A higher level of medical facilities is attractive to malaria patients as they are linked with a higher level of medical providers' experience and formal training. According to patients perceive these providers as competent, with exceptional expertise and ideal to treat symptoms linked with uncomplicated malaria. Patients visit public and private health facilities for their better quality services, which include qualified personnel, availability of drugs, and laboratory services. In essence, this incorporates prompt diagnosis of malaria, ideal treatment, and good follow up advice.


From the literature and the theory above, access to malarial health services in the developed countries focuses on patients and their community's characteristics. This paper has reviewed access to malarial healthcare improvement by bureaucracy elimination in the healthcare systems. It has also reviewed the medical provider's aspect that attracts patients to seek health care services. Diverse characteristics attract patients to providers such as proximity to patients, lower cost of services, positive manner of providers, and timeliness of services and availability of medicines. The paper highlights that access to services necessitates attention to the highlighted aspects that attract patients and recommends that bureaucracy be eliminated for patients to receive prompt and quality health care.


Bassat, Q., Tanner, M., Guerin, P. J., Stricker, K., & Hamed, K. (2016). Combating poor-quality antimalarial medicines: a call to action. Malaria journal, 15(1), 302.

Brunette, G. W. (2017). CDC Yellow Book 2018: health information for international travel. Oxford University Press.

Chen, I., Clarke, S. E., Gosling, R., Hamainza, B., Killeen, G., Magill, A., ... & Riley, E. M. (2016). “Asymptomatic” malaria: a chronic and debilitating infection that should be treated. PLoS medicine, 13(1), e1001942.

Fedeli, S., Leonida, L., & Santoni, M. (2018). Bureaucratic institutional design: the case of the Italian NHS. Public Choice, 177(3-4), 265-285.

Fortier, E., & Malloy, D. (2019). Moral Agency, Bureaucracy & Nurses: A Qualitative Study.

Hopkins, H., & Cunningham, J. (2019). Point‐of‐Care and Near‐Point‐of‐Care Diagnostic Tests for Malaria: Light Microscopy, Rapid Antigen‐Detecting Tests and Nucleic Acid Amplification Assays. Revolutionizing Tropical Medicine: Point‐of‐Care Tests, New Imaging Technologies and Digital Health, 137-158.

Kosack, C. S., Page, A. L., & Klatser, P. R. (2017). A guide to aid the selection of diagnostic tests. Bulletin of the World Health Organization, 95(9), 639.

Kosack, C. S., Page, A. L., & Klatser, P. R. (2017). Better health for everyone». Bulletin of the World Health Organization, 95, 639-645.

Lalloo, D. G., Shingadia, D., Bell, D. J., Beeching, N. J., Whitty, C. J., & Chiodini, P. L. (2016). UK malaria treatment guidelines 2016. Journal of Infection, 72(6), 635-649.

Oliver, D. (2017). David Oliver: Let’s streamline NHS bureaucracy and then leave it well alone. Bmj, 357, j2426.

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