Health Care and Its Costs: The Development of the National Health Service in England: Department of Health and Social Security. London: HMSO. 1983. Pp 51.  5.95

1984 ◽  
Vol 8 (4) ◽  
pp. 70-71
Author(s):  
G. T. Smith
1972 ◽  
Vol 120 (557) ◽  
pp. 433-436 ◽  
Author(s):  
D. G. Morgan ◽  
R. M. Compton

Department of Health and Social Security statistics show a steady rise in the use of outpatient services from the inception of the National Health Service; since the Mental Health Act of 1959, the numbers of new outpatient and clinic attendances have increased by one-third and one-fifth respectively (D.H.S.S., 1971). However, as our knowledge of the actual functions of out-patient services and their relationship to in-patient care is at best only rudimentary, the recent article by Mezey and Evans (Journal, June 1971, 118, p. 609) is a much needed contribution towards evaluating these different facilities of the psychiatric services.


2003 ◽  
Vol 33 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Richard Lewis ◽  
Stephen Gillam

Yet more reform of the National Health Service in England has been announced by the Department of Health. In opposition, the Labour Party criticized the creation of an “internal market” for health care by the Conservative government, but five years into the Blair administration, market incentives are to be reinvigorated and the private sector is to be embraced in ways not seen hitherto. New guidance signals the introduction of competitive contracting using cost-per-case currencies, more choice for patients in where they will receive hospital treatment, and the freeing of NHS care providers from the direct political control of ministers. It is intended that the monopolistic features of the NHS in England should give way to greater pluralism, in particular through contracts with privately owned health care organizations. However, there is little evidence to suggest that these policies will be effective, and a number of practical problems may obstruct implementation.


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.


2005 ◽  
Vol 29 (10) ◽  
pp. 365-368 ◽  
Author(s):  
Kingsley Norton ◽  
Julian Lousada ◽  
Kevin Healy

Following the publication by the National Institute for Mental Health in England (NIMHE) of Personality Disorder: No Longer A Diagnosis of Exclusion (National Institute for Mental Health in England, 2003), it is perhaps surprising that so soon after there have been threats to the survival of some of the small number of existing specialist personality disorder services to which it refers. Indeed, one of the few in-patient units specialising in such disorders (Webb House in Crewe) closed in July 2004. Such closures or threats argue for closer collaboration in planning between the relevant secondary and tertiary services and also between the Department of Health, the NIMHE and local National Health Service commissioners. Not safeguarding existing tertiary specialist services, at a time of increasing awareness of the needs of patients with personality disorders, may be short-sighted.


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