scholarly journals The whirligig of time

1998 ◽  
Vol 22 (4) ◽  
pp. 263-267
Author(s):  
Anthony Ryle
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Social Medicine ◽  
General Paralysis ◽  
Causes Of Disease ◽  
The Way

Had I been invited to write a professional ‘Prospect’ when I qualified almost half a century ago, rather than this retrospect, it would have contained no reference to psychiatry or psychotherapy. Glimpses from the long stone corridor of Frien Barnet into vast bare wards inhabited by patients in striped hospital clothing (or has memory conflated this with images of Belsen?) and demonstrations of cases of, rather than of people with, echolalia or mania or ‘general paralysis of the insane’ (dementia paralytica), which were my student introduction to psychiatry, were aversive rather than attractive. But many of the values and attitudes which have shaped my later attitudes to psychiatry were already evident, rooted in the belief that the most destructive war in history should prepare the way for a juster world, and influenced by my father's enthusiastic advocacy of the National Health Service (NHS) and by his move from clinical to social medicine, a move through which he sought ‘to study the ultimate as well as the intimate causes of disease∗.

Adolescent Psychiatry Services

1995 ◽  
Vol 166 (3) ◽  
pp. 306-310 ◽  
Author(s):  
Tony Jaffa
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Adolescent Psychiatry ◽  
Clinical Care ◽  
Psychiatric Services ◽  
High Quality ◽  
History Of ◽  
The Uk ◽  
The Way

BackgroundThe way in which psychiatric services for adolescents in the UK are developing will be affected by recent changes in the organisation of the National Health Service.MethodThe history of these services, and the different opportunities for development are reviewed.ResultsWays in which high-quality clinical care can still be provided are indicated.ConclusionAdolescent psychiatric services should be judged on their ability to provide such care, not merely on their ability to survive.

Social Science and Health Policy in the United Kingdom: Some Contributions of the Social Sciences to the Bureaucratization of the National Health Service

1974 ◽  
Vol 4 (3) ◽  
pp. 453-470 ◽  
Author(s):  
Peter Draper ◽  
Tony Smart
Keyword(s):  
Social Sciences ◽  
United Kingdom ◽  
Health Policy ◽  
National Health Service ◽  
Health Service ◽  
Social Science ◽  
National Health ◽  
Social Medicine ◽  
Organizational Studies ◽  
The United Kingdom

A current and major health policy, the first fundamental reorganization of the administrative structure of the National Health Service (NHS), is reviewed in this paper. The shake-up in the administration of the NHS is seen as having two main components: a partial integration of the three separate administrative branches, and an injection of a particular kind of managerial ideology. This “management revolution” is seen as consisting essentially of a powerful thrust toward central and bureaucratic control of the NHS. Social sciences in the broad sense–ranging from work study (organization and methods study) through social medicine and sociology to economics-are reviewed in relation to their contributions to this bureaucratization of the NHS. It is shown that narrow and out-of-date organizational studies and technocratically oriented social medicine have contributed significantly, if sometimes unwillingly and unwittingly, to the drive toward centralization and bureaucratization. Rejecting a highly bureaucratic form of organization for a national health service, the authors discuss briefly some developments which reflect a more decentralized and more adaptive pattern of administration. The paper suggests that independent research foundations with a strong interest in health have a responsibility to break the incestuous relationships which have developed with the health department in some instances. It is suggested that foundations, professional associations, unions, and consumer groups could promote the maturation of “medical sociology” and “administrator's social science” into a full-blooded sociology of health. Currently social science within the health field in the United Kingdom is seen as being both underfinanced and prostituted to the interests of medical and administrative power groups. A participatory framework for social science is outlined as an alternative to the current models which are based on Taylorism or “scientific management.”

scholarly journals The National Health Service (NHS) in ‘crisis’: the role played by a shift from horizontal to vertical principles of equity

2018 ◽  
Vol 15 (1) ◽  
pp. 1-17
Author(s):  
Sheena Asthana ◽  
Alex Gibson
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
Health Inequalities ◽  
National Health ◽  
Access To Health Care ◽  
Horizontal Equity ◽  
Equal Access ◽  
Care Needs ◽  
The Way

AbstractExplanations of the state of ‘crisis’ in the English National Health Service (NHS) generally focus on the overall level of health care funding rather than the way in which funding is distributed. Describing systematic patterns in the way different areas are experiencing crisis, this paper suggests that NHS organisations in older, rural and particularly coastal areas are more likely to be ‘failing’ and that this is due to the historic underfunding of such areas. This partly reflects methodological and technical shortcomings in NHS resource allocation formulae. It is also the outcome of a philosophical shift from horizontal (equal access for equal needs) to vertical (unequal access to equalise health outcomes) principles of equity. Insofar as health inequalities are determined by factors well beyond health care, we argue that this is an ineffective approach to addressing health inequalities. Moreover, it sacrifices equity in access to health care by failing to adequately fund the health care needs of older populations. The prioritisation of vertical over horizontal equity also conflicts with public perspectives on the NHS. Against this background, we ask whether the time has come to reassert the moral and philosophical case for the principle of equal access for equal health care need.

Psychoanalytic Group Therapy in an NHS Psychotherapy Department

2007 ◽  
Vol 40 (1) ◽  
pp. 109-124 ◽  
Author(s):  
Patrick Keown ◽  
Anne Ward ◽  
Sue Davison
Keyword(s):  
National Health Service ◽  
Group Therapy ◽  
Health Service ◽  
Service Delivery ◽  
Group Psychotherapy ◽  
National Health ◽  
Time Points ◽  
Uk National Health Service ◽  
Time Frames ◽  
The Way

In this article we compare a recent audit of the group psychotherapy service at the Maudsley Hospital with Foulkes's description of the same Unit during his tenure there. During this time huge changes have occurred in the NHS (UK National Health Service) both in service delivery and in the way audit is carried out — the main reason why we believe that comparing the two time frames will be of interest to those working in this field. We will also present some more detailed findings from the more recent audit. To set the scene, a description is offered of how the service was organized at these two time points.

Opportunities for the Dental Team Arising Out of the New Arrangements for Primary Dental Care

2005 ◽  
Vol os12 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Stephen Lambert-Humble
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Dental Care ◽  
Evidence Base ◽  
Training And Development ◽  
Employment Training ◽  
Innovative Solutions ◽  
The Way ◽  
Outside The Box

Many changes are occurring in the delivery of dental care to patients as a result of the implementation of a series of Government initiatives to improve the services to patients throughout the National Health Service (NHS). Dentistry is no exception, and the whole dental team should benefit from new opportunities that have opened up as a result of these changes. This paper outlines a number of these initiatives, and describes some of the potential opportunities that may develop for each group within the dental team. Many of these changes are already in the pipeline, many depend on funding, and many depend on a change in the mindset of established organisations and institutions to think ‘outside the box’. The author believes that none of the changes outlined or discussed in this paper challenge the position or status of any group; however, they do require all members of the dental team to examine the way in which they work, to look at the evidence base for these ways of working, and then perhaps look for innovative solutions to the employment, training and development of all members of the team.

Trust, trustworthiness and sharing patient data for research

2020 ◽  
pp. medethics-2019-106048
Author(s):  
Mark Sheehan ◽  
Phoebe Friesen ◽  
Adrian Balmer ◽  
Corina Cheeks ◽  
Sara Davidson ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Data Sharing ◽  
National Health ◽  
Patient Data ◽  
Research Institutions ◽  
Public Dialogue ◽  
The Public ◽  
Public Ethics ◽  
The Way

When it comes to using patient data from the National Health Service (NHS) for research, we are often told that it is a matter of trust: we need to trust, we need to build trust, we need to restore trust. Various policy papers and reports articulate and develop these ideas and make very important contributions to public dialogue on the trustworthiness of our research institutions. But these documents and policies are apparently constructed with little sustained reflection on the nature of trust and trustworthiness, and therefore are missing important features that matter for how we manage concerns related to trust. We suggest that what we mean by ‘trust’ and ‘trustworthiness’ matters and should affect the policies and guidance that govern data sharing in the NHS. We offer a number of initial, general reflections on the way in which some of these features might affect our approach to principles, policies and strategies that are related to sharing patient data for research. This paper is the outcome of a ‘public ethics’ coproduction activity which involved members of the public and two academic ethicists. Our task was to consider collectively the accounts of trust developed by philosophers as they applied in the context of the NHS and to coproduce an argumentative position relevant to this context.

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