7. Devolution and the Territorial Constitution

This chapter focuses on the UK’s territorial constitution, that is, the governance arrangements that result in power being dispersed rather than concentrated in a single set of national institutions. Devolution involved creating new governments in Scotland, Northern Ireland, and Wales, and investing them with powers that were previously exercised at a UK level. Devolution in the UK is therefore intended to be part of the answer to questions that must be confronted in all political systems: where should governmental power lie? And at what level should laws be enacted and the business of government transacted? Local government plays a key role in decision-making, policy formulation, and the delivery of public services across a wide range of areas, including education, housing, personal social services, transport, and planning control.

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Fatal Self-poisoning in the UK and the Paracetamol/Dextropropoxyphene Combination

Human Toxicology ◽

10.1177/096032718400300115 ◽

1984 ◽

Vol 3 (1_suppl) ◽

pp. 145s-174S ◽

Cited By ~ 9

Author(s):

P.S. Dwyer ◽

I.F. Jones

Keyword(s):

Northern Ireland ◽

Causes Of Death ◽

Mortality Data ◽

Specific Reference ◽

Combination Product ◽

Analgesic Drugs ◽

Wide Range ◽

Wide Variability ◽

The Uk ◽

Direct Investigation

1 Coroners' files have been examined to ascertain the numbers of deaths involving self-poisoning with analgesic drugs with specific reference to the paracetamol/dextropropoxyphene combination. The period of study was 1976-1980. This report concentrates on cases in England, although reference is made to similar deaths occurring in Scotland and Northern Ireland. 2 Data have been collected extensively on a wide range of issues concerning fatal self-poisonings mainly by visiting coroners' offices in England to make direct investigation of records. 3 The total number of cases where the paracetamol/dextropropoxyphene combination can be considered as ingested in the self-poisoning episode is underestimated. The number of cases involving alcohol and/or other drugs taken together with the combination product is particularly underestimated. 4 Involvement of people aged 30 years and below comprises 32% of all cases. 5 'Gesture' overdoses comprise an estimated 14% of all cases in England. 6 An analysis of fatalities from cases where quantities in post-mortem blood of dextropropoxyphene < 1 μg/ml and paracetamol < 50 μg/ml are found and of cases where death occurs within 2 h of ingestion of the overdose has been carried out. The results are inconclusive. In most cases alcohol and/or other drugs are found to be involved. Critical inspection of coroners' files shows relatively few of these cases where the combination product is ingested on its own. 7 There is wide variability in the data available in coroners' files. In many cases data of value to this research are not recorded. Medical history and quantitative levels of drugs suspected (particularly dextropropoxyphene) are particular examples of factors which may not be recorded. 8 Office of Population, Censuses and Surveys (OPCS) mortality data are based on certified causes of death. Because of the underestimate of the involvement of this combination product and the under-reporting of other drug and/or alcohol ingestion with the combination, care must be exercised in quoting or drawing conclusions from OPCS statistics.

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Investigation into Telephone Enquiries Made to the Leeds Disabled Living Center

British Journal of Occupational Therapy ◽

10.1177/030802268805100808 ◽

1988 ◽

Vol 51 (8) ◽

pp. 270-272 ◽

Cited By ~ 4

Author(s):

Janet Stowe

Keyword(s):

Social Services ◽

Occupational Therapists ◽

Initial Contact ◽

Disabled People ◽

Paramedical Staff ◽

Wide Range ◽

Telephone Calls ◽

The Uk ◽

Source Of Information ◽

Valuable Service

Disabled Living Centres (DLCs), of which there are 23 in the UK, provide a valuable service of information for those involved in all aspects of life of disabled people. Most initial contact with the Leeds DLC is made by telephone. All incoming telephone calls were monitored over a 3-month period during 1986–87, with the aim of discovering who was telephoning the centre, for what purpose and from where they had heard of the centre. 145 calls were received: 33 from disabled people, 25 from their carers, 60 from medical and paramedical staff and 27 from others. The source of information covered a wide range, including hospitals (17), occupational therapists and physiotherapists (17), and social services (11). Nearly half of the reasons for calling were for information about equipment. Few (8%) disabled callers and their carers had discussed their problem with their GP. Information about such resource centres must be readily available to both disabled people and those involved in their care.

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Local government reform: Community planning and the quality of life in Northern Ireland

Administration ◽

10.1515/admin-2015-0009 ◽

2015 ◽

Vol 63 (2) ◽

pp. 31-57 ◽

Cited By ~ 2

Author(s):

Colin Knox ◽

Paul Carmichael

Keyword(s):

Quality Of Life ◽

Local Government ◽

Northern Ireland ◽

Social Services ◽

Central Government ◽

Community Planning ◽

Reform Process ◽

Legal Power ◽

The Uk

Abstract Local government in Northern Ireland has undergone a significant reform process in terms of both the number of councils (from twenty-six to eleven) and their functional responsibilities. Councils in Northern Ireland have always been regarded as the ‘poor relation’ of central government or non-departmental public bodies which deliver many of the services performed by local government in other parts of the UK (education, social services, housing). The reforms in Northern Ireland, while devolving relatively minor additional functions, offer councils a significant role in community planning – the legal power to hold central departments to account for services provided by them in local areas. This paper argues that councils can use this power to improve the quality of life of their inhabitants.

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Social Union

State and Nation in the United Kingdom ◽

10.1093/oso/9780198841371.003.0009 ◽

2021 ◽

pp. 153-169

Author(s):

Michael Keating

Keyword(s):

United Kingdom ◽

Health Education ◽

Northern Ireland ◽

Social Services ◽

Population Based ◽

The Other ◽

Social Citizenship ◽

The United Kingdom ◽

The Uk ◽

Undeserving Poor

Unionists have defended the United Kingdom as a social or ‘sharing’ union in which resources are distributed according to need. It is true that income support payments and pensions are largely reserved and distributed across the union according to the same criteria. Scotland, Wales and Northern Ireland are net beneficiaries. On the other hand, welfare has been detached from older understandings of social citizenship and ideas of the deserving and undeserving poor (strivers and skivers) have returned. Spending on devolved matters including health, education and social services is not equalized across the union. Instead, the Barnett Formula, based on historic spending levels and population-based adjustments, is used. Contrary to the claims of many unionists, there is no needs assessment underlying it, apart from a safeguard provision for Wales. The claim that the UK is a sharing union thus needs to be qualified.

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The structure of the NHS in the UK

Essential Dental Public Health ◽

10.1093/oso/9780199679379.003.0025 ◽

2013 ◽

Author(s):

Blánaid Daly ◽

Paul Batchelor ◽

Elizabeth Treasure ◽

Richard Watt

Keyword(s):

Northern Ireland ◽

Health Service ◽

Philosophical Approach ◽

Health Care Professions ◽

Planning Approach ◽

Wide Range ◽

Care Systems ◽

History Of ◽

The Uk ◽

Second World

The National Health Service was created at the end of the Second World War. Its structure has remained relatively stable until the 1970s. Since then, politicians have continued to reform it at an ever-increasing rate and, in 2012, the biggest change to the English NHS structure was implemented (Reynolds and McKee 2012). The question as to why the reforms are being undertaken is crucial. Growing demands, changing epidemiology, better understanding of the determinants of health, and evolving societal values have all influenced the process. Perhaps most crucial is the latter. It is probably more appropriate to describe the current NHS as four differing NHS care systems that are coterminous with the legislative bodies that exist within the UK, namely England, Northern Ireland, Scotland, and Wales. Not only are the planning arrangements becoming more divergent, but also the philosophical approach underpinning each system is beginning to follow very different paths. The NHS has almost never taken a typical theoretical planning approach but rather has evolved due to the wide range of factors and influences involved. These include the changing power of health care professions, the need to ration services, adoption of economic theory (market forces and the internal market), and, not least, changing governments with differing political stances. The importance of understanding the history of the service and the lessons of the past are that they inform the present and can provide an indication of how the future may look. This chapter outlines the major influences on the NHS since its inception, describes the major problems currently faced by the NHS, and provides an overview of the ways in which clinical services are currently delivered. It will not give a detailed description of the structure of the health service, not least as by the time the book is published a new structure will exist. The current structure of the health service in each of the four countries of the UK will be available on this book’s website, and updated as changes occur.

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Older people, pensions and poverty: An issue for social workers?

International Social Work ◽

10.1177/0020872810396253 ◽

2011 ◽

Vol 54 (3) ◽

pp. 344-360 ◽

Cited By ~ 3

Author(s):

Liam Foster

Keyword(s):

Social Work ◽

Social Workers ◽

Social Services ◽

Work Practice ◽

Social Work Practice ◽

Policy Formulation ◽

The Uk ◽

The Relationship ◽

The Eu

Poverty is encountered by the majority of users of social services but is often overlooked in social work practice. This article explores the relationship between poverty in older age, pension receipt and the role of social policy formulation in the UK with particular reference to New Labour governance. It also briefly explores the EU context before considering the implications for social work.

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Effective Consumer Consultation in the Planning and Delivery of Health and Social Services: A New Zealand Case Study: A Comparative Study of the Theory and Practice of Government Organisations in Engaging Consumers in Consultation

10.26686/wgtn.16992415 ◽

2021 ◽

Author(s):

◽

Julz Britnell

Keyword(s):

Decision Making ◽

Social Services ◽

World Health Organisation ◽

Theory And Practice ◽

World Health ◽

Local Health ◽

Health And Social Services ◽

Planning Decisions ◽

The Uk ◽

The Right

<p>About 600 million people in the world live with disabilities (World Health Organisation, 2007). Over the past ten years there has been increasing calls for government organisations in the health and disability sector to involve consumers in their decision-making, service design and general governance. This has led government health and disability organisations in different countries to try and find ways to ensure consumers are consulted with and involved in decision-making processes (Coney, 2004). The potential benefits of effective consumer consultation are better quality services, policy and planning decisions that a more consumer focused, improved communications and greater ownership of the local health services. For consumers effective consultation can mean they get better outcomes of treatment and support, a more accessible and responsive service and improved health. For the community consultation can help bring about a reduction in health inequalities and provide a health service better able to meet the needs of its constituents (Anderson et al., 2002). There are a number of real and perceived barriers to consumer consultation. Consumers may be anxious that their views will not be taken seriously, that they will look foolish or that they won’t understand what’s being talked about. Staff and organisations might be anxious that their work will be criticised, that there will be unrealistic demands to change services or that their role and authority might be undermined (Fletcher & Bradburn, 2001). For consultation to work there needs to be commitment from the organisation to plan and provide adequate resources. Developing a strategy is critical before organisations start down this path. The UK Audit Commission (2003) believe developing a strategy will help organisations to define exactly what the purpose of the consultation is, what they want to achieve, help them identify the relevant stakeholders and assess what level of engagement to undertake. Consultation is an important part of designing, delivering and managing effective health and social services. There are many different ways of engaging consumers and finding the right way for each organisation takes planning, commitment, time and energy.</p>

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Effective Consumer Consultation in the Planning and Delivery of Health and Social Services: A New Zealand Case Study: A Comparative Study of the Theory and Practice of Government Organisations in Engaging Consumers in Consultation

10.26686/wgtn.16992415.v1 ◽

2021 ◽

Author(s):

◽

Julz Britnell

Keyword(s):

Decision Making ◽

Social Services ◽

World Health Organisation ◽

Theory And Practice ◽

World Health ◽

Local Health ◽

Health And Social Services ◽

Planning Decisions ◽

The Uk ◽

The Right

<p>About 600 million people in the world live with disabilities (World Health Organisation, 2007). Over the past ten years there has been increasing calls for government organisations in the health and disability sector to involve consumers in their decision-making, service design and general governance. This has led government health and disability organisations in different countries to try and find ways to ensure consumers are consulted with and involved in decision-making processes (Coney, 2004). The potential benefits of effective consumer consultation are better quality services, policy and planning decisions that a more consumer focused, improved communications and greater ownership of the local health services. For consumers effective consultation can mean they get better outcomes of treatment and support, a more accessible and responsive service and improved health. For the community consultation can help bring about a reduction in health inequalities and provide a health service better able to meet the needs of its constituents (Anderson et al., 2002). There are a number of real and perceived barriers to consumer consultation. Consumers may be anxious that their views will not be taken seriously, that they will look foolish or that they won’t understand what’s being talked about. Staff and organisations might be anxious that their work will be criticised, that there will be unrealistic demands to change services or that their role and authority might be undermined (Fletcher & Bradburn, 2001). For consultation to work there needs to be commitment from the organisation to plan and provide adequate resources. Developing a strategy is critical before organisations start down this path. The UK Audit Commission (2003) believe developing a strategy will help organisations to define exactly what the purpose of the consultation is, what they want to achieve, help them identify the relevant stakeholders and assess what level of engagement to undertake. Consultation is an important part of designing, delivering and managing effective health and social services. There are many different ways of engaging consumers and finding the right way for each organisation takes planning, commitment, time and energy.</p>

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Policy Rogue or Policy Entrepreneur? The Forms and Impacts of “Joined-Up Governance” for Child Health

Children ◽

10.3390/children8030221 ◽

2021 ◽

Vol 8 (3) ◽

pp. 221

Author(s):

Celine Cressman ◽

Fiona A. Miller ◽

Astrid Guttmann ◽

John Cairney ◽

Robin Z. Hayeems

Keyword(s):

Decision Making ◽

Child Health ◽

Social Services ◽

Formal System ◽

Governance Structure ◽

Two Dimensions ◽

Developmental Screening ◽

Comparative Case Study ◽

Governance System ◽

Governance Arrangements

Joined-up governance (JUG) approaches have gained attention as mechanisms for tackling wicked policy problems, particularly in intersectoral areas such as child health, where multiple ministries that deliver health and social services must collaborate if they are to be effective. Growing attention to the need to invest in early childhood to improve health and developmental trajectories, including through developmental screening, illustrate the challenges of JUG for child health. Using a comparative case study design comprised of the qualitative analysis of documents and key informant interviews, this work sought to explain how and why visible differences in policy choices have been made across two Canadian jurisdictions (Ontario and Manitoba). Specifically, we sought to understand two dimensions of governance (structure and process) alongside an illustrative example—the case of developmental screening, including how insiders viewed the impacts of governance arrangements in this instance. The two jurisdictions shared a commitment to evidence-based policy making and a similar vision of JUG for child health. Despite this, we found divergence in both governance arrangements and outcomes for developmental screening. In Manitoba, collaboration was prioritized, interests were aligned in a structured decision-making process, evidence and evaluation capacity were inherent to agenda setting, and implementation was considered up front. In Ontario, interests were not aligned and instead decision making operated in an opaque and siloed manner, with little consideration of implementation issues. In these contexts, Ontario pursued developmental screening, whereas Manitoba did not. While both jurisdictions aimed at JUG, only Manitoba developed a coordinated JUG system, whereas Ontario operated as a non-system. As a result, Manitoba’s governance system had the capacity to stop ‘rogue’ action, prioritizing investments in accordance with authorized evidence. In contrast, in the absence of a formal system in Ontario, policy ‘entrepreneurs’ were able to seize a window of opportunity to invest in child health.

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