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    This morning I was sitting with another ten patients in my GP practice when a very agitated young man in a hoody came in shouting and demanding to see a Doctor. He accused the Receptionists of taking him ‘for a ride’ of ignoring him on the phone for 20 minutes at 10p a minute. As it happened one of the partners came past the desk. The young man now screamed at him: I need to talk to you, he grabbed the Doctor’s shirt. The situation could have gotten very ugly, Police, custody the lot… As it happens this Doctor is […]
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    Morton Warner – Emeritus Professor, Welsh Institute for Health and Social Care, University of South Wales INTRODUCTION Both NHS and Social Care organisations are hierarchical. How can we bind them together without yet another reorganisation? Networks are key, but to date have only been played at. This is potentially disastrous, because horizontally organised networked activity is known to be superior to hierarchical activity whenever the problems to be solved are complex and delivery systems fragmented. EVIDENCE ON NETWORK DEVELOPMENT As far back as 1997 I said that the future of cooperative working, both within the NHS and in its relationship with […]
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    WANTED– A SOCIALIST HEALTH SERVICE An SMA discussion document. Probably 1966 ” . . , it is essential to struggle, not merely for particular advances in particular fields, but for a socialist advance in the National Health Service as a whole.  We believe that democratic Regional Health Authorities can provide the basis for this advance and that no half measures will serve, and we call upon the Labour Movement to join us in campaigning for this end”. SOCIALIST MEDICAL ASSOCIATION 13 Prince of Wales Terrace, London, W.8 (WEStern 7770) PRICE SIXPENCE (plus postage 3d.) “.. it is essential to struggle, not […]
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    Socialist Medical Association Edinburgh & South-East Scotland Branch Conference Report Lauriston Hall, Edinburgh  Saturday 27th March,1965 The Conference Chairman, Councillor Mrs Nealon welcomed the delegates and introduced the speaker as a former Parliamentary Secretary in the Ministry of Health.  She stressed the need of making some of our permissive legislation statutory. Mr, Blenkinsop, M.P, for South Shields, discussed the need, now that a Labour Government was in power, for reviewing the whole future development for the National Health Service. There had been much recent concern about the place for general practice within the Health Service. G.P.’s had felt themselves neglected […]
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    REPORT OF THE COMMITTEE OF ENQUIRY INTO THE COST OF THE NATIONAL HEALTH SERVICE Presented to Parliament by the Minister of Health and the Secretary of State for Scotland by Command of Her Majesty January 1956 Cmd. 9663 MEMBERSHIP OF THE COMMITTEE: C. W. GUILLEBAUD, Esq., C.B.E. (Chairman) Dr. J. W. COOK, F.R.S. Miss B. A. GODWIN, O.B.E. Sir JOHN MAUDE, K.C.B. Sir GEOFFREY VICKERS, V.C. The first section of the report, not reproduced here, is devoted to the Memorandum “The Cost of the National Health Service in England and Wales” by Brian Abel-Smith and Richard Titmuss, (Cambridge, 1956) SUMMARY […]
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    After five years of experience of the N.H.S. we are becoming increasingly convinced of the need for closer integration of the preventive and curative aspects of medicine.  This need for co-operation and integration should affect training for the service as well as the actual service itself. Though the public has benefited to a great extent from the service it has often involved considerable inconvenience to patients because of its organisational failures, and the public is often more aware of the benefits obtained by administrators,doctors and other health workers that the benefits obtained by the sick patient.  The bad conditions still […]
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    Presentations and conclusions from our seminar Health and Social Care Integration in the New Policy Landscape 12th October 2012 Ailsa Cameron and Rachel Lart – Is integration the Burning platform for change – a literature review. Integrated Care is not defined very well but at patient level we know what it means – something like whole person care The imperative is because Integrated care gives a better experience of care If “state” and public services have a role in wellbeing it should perform that role well. No evidence it delivers better outcomes No evidence it delivers cost savings in fact better care may […]
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      Professionals intuitively recognise “frail” older people as more shrinked, and slowly moving. This phenotype is beautifully described by the Finnish painter Helene Schjerfbeck in the self-portraits up to her ninth decade. Increasingly, there has been a welcome policy move in recognising older individuals as a really valuable part of Society. The emphasis should be on ‘living well’, even with comorbidities. Some have rightly attacked blaming the ‘woes’ of the NHS on “the ageing population”. The lack of definitive diagnostic criteria for ‘frail people’ through DSM or ICD has been a stumbling block, but professionals tend to recognise frail individuals […]
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    Giving NHS patients the right to choose where to be treated for free by any qualified healthcare provider, including private ones if they can meet NHS standards and costs, is one of the most potentially transformative policies of the Coalition Government. It will empower ordinary people to make the kinds of healthcare choices that, frankly, only the rich have been able to make thus far. While few would disagree with the progressive aspect of this, the competition between providers needed to deliver the choice patients want has been controversial. This controversy has largely been manufactured, however, by vested interests on […]
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    I took my son recently to the Manchester Dental Hospital.  It’s part of Central Manchester NHS Foundation Trust where he was born and where the regional genetics centre diagnosed his condition – which affects both his fingers and his teeth The very charming dentist knew nothing about his medical history and didn’t have access to his hospital notes, because the Dental Hospital have their own paper records,  so I had to give her what was doubtless a garbled version of his medical history.  They took a very fancy X-ray of his teeth, but when I asked for a  copy I was told […]
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    I have followed recent discussions on health service integration with interest. It raises a wide range of different issues and there are just one or two that I would like to comment on. Some years ago now I did research for a PhD on disciplinary cases and the social and cultural factors affecting the management of poor care in nursing. (See for eg http://wes.sagepub.com/content/20/4/687.short  or http://wes.sagepub.com/content/20/2/223.short ) Then in 2011 I carried out research for a future book on the history of regulation in nursing. This amongst other things entailed reading enquiry reports on poor care dating right back to […]
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