The Cassel Hospital, London

1996 ◽  
Vol 30 (5) ◽  
pp. 672-680 ◽  
Author(s):  
Paul Coombe

This paper is an account of the principles and practices of treatment offered at the Cassel Hospital, London, with a particular focus on the Inpatient Families Unit. The Cassel Hospital is an internationally renowned therapeutic community, the operation of which is based on psychoanalytic principles and which has operated within the British National Health Service for nearly 50 years. An account of the historical development of the hospital is given as well as a description of its structure and function. The following three innovative structures are elaborated: a complex network within which patients can develop, Cassel-style nursing care, and nurse-therapist supervision. Theoretical underpinnings are outlined, which together with two case studies facilitate an appreciation of the capacity of the therapeutic network to foster the successful treatment of a range of severely disordered individuals and families. Such treatment may approach a level perhaps otherwise unattainable and which is widely applicable in the public hospital and clinic settings in Australia.

2005 ◽  
Vol 33 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Christopher Newdick

Most now recognize the inevitability of rationing in modern health care systems. The elastic nature of the concept of “health need,” our natural human sympathy for those in distress, the increased range of conditions for which treatment is available, the “greying” of the population; all expand demand for care in ways that exceed the supply of resources to provide it. UK governments, however, have found this truth difficult to present and have not encouraged open and candid public debate about choices in health care. Indeed, successive governments have presented the opposite view, that “if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone.” And they have been rightly criticized for misleading the public and then blaming clinical and managerial staffin the National Health Service (NHS) when expectations have been disappointed.


Author(s):  
George R. Boyer

This chapter explores the story of the 1942 Beveridge Report and the beginnings of the welfare state. The policies proposed by Beveridge and the 1945–48 legislation were logical extensions of government's expanding role in social welfare policy beginning with the Liberal Welfare Reforms. This does not mean that the importance of the postwar legislation should be downplayed. Because of the adoption of the National Health Service, universal coverage, and equality of treatment, Britain after 1948 deserves to be called a welfare state, while Edwardian and interwar Britain do not. Unfortunately, despite the enthusiasm with which the public greeted the welfare state, the postwar policies did not eliminate economic insecurity.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Joy Tweed ◽  
Louise M. Wallace

PurposeThe purpose of the study is to examine how Non-Executive Directors (NEDs) in the English National Health Service (NHS) commissioning bodies experienced their role and contribution to governance.Design/methodology/approachSemi-structured interviews were conducted with a purposive sample of 31 NEDs of Primary Care Trusts (PCTs) and 8 Clinical Commissioning Group (CCG) NEDs. Framework analysis was applied using a conceptualisation of governance developed by Newman, which has four models of governance: the hierarchy, self-governance, open systems and rational goal model.FindingsNEDs saw themselves as guardians of the public interest. NEDs’ power is a product of the explicit levers set out in the constitution of the board, but also how they choose to use their knowledge and expertise to influence decisions for, as they see it, the public good. They contribute to governance by holding to account executive and professional colleagues, acting largely within the rational goal model. CCG NEDs felt less powerful than in those in PCTs, operating largely in conformance and representational roles, even though government policy appears to be moving towards a more networked, open systems model.Originality/valueThis is the first in-depth study of NEDs in English NHS local commissioning bodies. It is of value in helping to inform how the NED role could be enhanced to make a wider contribution to healthcare leadership as new systems are established in the UK and beyond.


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