1,721,130 research outputs found
The past and future of the NHS: new labour and foundation hospitals
No full textThe government's current policies on hospital provision rest on a partial critique of previous attempts at planning health care. New Labour alleges that the National Health Service's monolithic, top-down structures have failed to deliver an equitable service, and argues that the recuperation of what is claimed to be a neglected mutualist tradition in British socialism can rectify the democratic deficit in health care.Developments under the NHS cannot be characterised simply as a top-down bureaucracy in the current fashion of government spokespersons. For this fails to acknowledge the real achievements of central planning in improving the distribution of resources. And it is arguable that the failures of top-down hospital policy were due as much to external circumstances as to technical weaknesses in the ability to plan services.The inter-war period, characterised as a mixed economy of welfare, should not be celebrated as a positive example of localism, and its health-care system should not be celebrated as a positive example of mutualism. New Labour's proposals may indeed merely reproduce the shortcomings of the unrepresentative governing bodies of pre-NHS hospitals.The establishment of foundation hospitals is being pursued for largely pragmatic and electoral reasons, with the attendant (but not publicly acknowledged) risk of fragmenting and dividing the service, and of reproducing features which the supervisory and regulatory state of the 1930s was unable to deal with satisfactorily
Planning, markets and hospitals
No full textImproving access to hospital services has been a goal of public policy in Britain for over seventy years, but the means by which this goal is to be attained have changed significantly over time. Drawing substantially on original research,
Planning, Markets and Hospitals represents a systematic attempt to access the strengths and weaknesses of different forms of planning and coordination of hospital development.
The period covered includes: services prior to 1948; wartime hospital policy; the successes and failures of the mixed economy of health care in the inter-war period; the national hospital plan of 1962 and ultimately the market based reforms of 1991 and the changes since.
This book makes a fresh contribution to enduring debates about planning and regulation of health care, about the governance of welfare services and about the appropriate role for voluntary, commercial and charitable provision of services. It reinterprets previous histories of hospital policy and questions whether current policies will reconcile competing goals of equity and choic
Individual voluntary participation in the United Kingdom: an overview of survey information
No full textThe measurement of voluntary activity is not straightforward; definitional and methodological questions affect the responses. This is true within the context of the UK but also in other countries of the developed world (Archambault 1993, Kendall and Knapp 1993, Gidron and Katz 1998, Salamon and Sokolowski 2001). The existence of definitional difficulties and ambiguities has a detrimental impact on the quality of academic research and policy-making in this sphere. Firstly, it impedes orderly collection of statistical information on volunteering in administrative sources. Also, it complicates the collection of survey information: the absence of well-understood and widely-agreed concepts of voluntarism in the public mind introduces uncertainty in people’s responses. To date, however, there has not been an attempt to compare findings of different surveys systematically. This paper aims to fill the gap in research by reviewing the available surveys for the UK. It focuses specifically on the methods used to obtain information on volunteering and the comparability of the results generated by different surveys
Voluntarism, municipalism and welfare: the geography of hospital utilization in England in the 1930s
No full textThis paper provides a comprehensive analysis of the pattern of hospital utilization (rather than provision) in England prior to the establishment of the NHS, showing the extent to which the probability of obtaining hospital treatment was a function of residence. Access to hospital care depended on the vigour of voluntarism and the political priorities of local governments. The pattern of voluntary hospital utilization is shown to have been markedly unequal, but the effect of municipal provision was to reduce disparities in access to services. The paper demonstrates variations in hospital utilization and discusses contemporary assessments of the situation. This work contributes to debates about the efficacy of non-profit forms of welfare delivery; it provides a novel British study to complement American work in this field. It also raises questions about the contemporary vogue for partnerships in health care delivery between the public and private sectors, arguing that such proposals rest on an optimistic view of history
Reconciling equity and choice? Foundation hospitals and the future of the NHS
No full textProvisions for the creation of "NHS Foundation Trusts" in the Health and Social Care Bill 2003 have polarised the Parliamentary Labour Party. This paper, by a leading expert on the history and geography of health care restructuring in the UK argues that the reform has the potential to undermine an efficient, integrated and equitable NHS, free at the point of use and planned according to social need
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