Review by Appropriate Minister

The 2018 Act introduces a strictly controlled ministerial review mechanism. The Act prevents designated persons from immediately challenging section 1 regulations before the courts, by way of judicial review. Rather, they must first request either variation or revocation of the designation from the appropriate Minister (at the Treasury or Secretary of State level). Only after that initial stage may a designated person seek judicial review of a sanctions-related decision; see Chapter 9 of this Guide. Thus, those who are subject to financial sanctions can challenge their listing, but financial sanctions will remain in place while the challenge or request is being considered.

Issues in pharmacological management of behavioural and psychological symptoms of dementia: English ministerial review of the use of antipsychotic drugs for people with dementia

IntroductionIn response to increasing concerns about the use of anti-psychotic drugs in dementia, the Department of Health in England commissioned an independent ministerial review.Aims and methodsThe report was based upon an expert review of policy and publications; systematic review of the benefits and harms; and new pharmacoepidemiology.ResultsThis review finds that these drugs are used too often in dementia and potential benefits are outweighed by their risks overall. It estimates 180,000 people with dementia receive antipsychotic medication in the UK per year. Of these, 20% (36,000) will derive some benefit. Negative effects directly attributable to antipsychotics equates to an additional 1,620 cerebrovascular adverse events (around half severe), and an additional 1,800 deaths per year. The report's analysis is that this overuse is a specific symptom of a general cumulative failure over the years in health and social care systems to develop an effective response to dementia.ConclusionsThe report contains 11 recommendations to reduce the use of these drugs to the level where benefit will outweigh risk. These include: making reduction a clinical governance priority; audit to drive down the level and up the quality of use of these drugs; specialist services to support primary care in its work in care homes and the community; research on alternatives to antipsychotic medication. The report estimates that, if this is implemented then we can reduce the rate of use of antipsychotic medication to a third of its current level safely over a 36 months.

New Directions-a Ministerial Review in Review

The Ministerial review, "Building on a Strong Foundation for the 21st Century: New Directions" attempts to solidify certain recommendations from the December 1997 "Not Just Numbers" report of the Legislative Review Advisory Group. The present review does not qualify as a "white paper" as its guidelines are suggestive and incomplete, rather than being convertible into an integrated set of legislative proposals in a parliamentary bill. Its guidelines stress the need for greater and more transparent accountability of immigration regulations and administration. This emphasis is evident both for immigration and refu- gee policy, the latter to be distinguished by creation of a special Protection Agency. Protection, a term undefined in the document, is twinned with control of abuse as administrative preoccupations. Overall, the guidelines stress administrative vigilance over humanitarian objectives to which Canada is committed as signatory to many international instruments.

A Note on Teachers as Obstacles to the Implementation of Integration

The Ministerial Review of Educational Services for the Disabled came out strongly in support of the right of disabled children to pursue their education in the ordinary classrooms of regular schools.