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11 – 20 of over 61000The provision of services by private contractors in the National Health Service rather than by direct labour is not a recent phenomenon. Certain services, eg. the erection and…
Abstract
The provision of services by private contractors in the National Health Service rather than by direct labour is not a recent phenomenon. Certain services, eg. the erection and repair of buildings, have been performed by contractors in the majority of health authorities. In some instances, catering and domestic services have been performed by outside contractors for a number of years (although this has been the case only in a very small minority of hospitals). What is novel is a policy which says health authorities must invite companies to tender competitively against their own in‐house services, and choose the tender which is the least costly.
The Parliamentary Health Select Committee is currently holding an inquiry into public health. The Democratic Health Network (DHN) gave evidence to the inquiry, based on research…
Abstract
The Parliamentary Health Select Committee is currently holding an inquiry into public health. The Democratic Health Network (DHN) gave evidence to the inquiry, based on research among local authorities, on how new health structures are affecting partnership working between health and local government. This article summarises the DHN's evidence, which is based on a broad and inclusive understanding of public health, influenced by many of local government's traditional functions.
Carol Azungi Dralega, Pamela Amia, Gezahgn Berhie Kidanu, Kanu Bai Santigie, Daniel Kudakwashe Mpala and Wise Kwame Osei
As Africa’s internet penetration rates increase, and a significant portion of the continent’s population turns to social media as a source of news, platforms like Facebook are…
Abstract
As Africa’s internet penetration rates increase, and a significant portion of the continent’s population turns to social media as a source of news, platforms like Facebook are increasingly becoming crucial for political, public health, and risk communication. Thus, it is useful to gain insights into how state authorities are using these platforms to communicate with citizens especially in times of crisis. This study sought to examine how state authorities in Ethiopia, Ghana, Sierra Leone, and Zimbabwe framed public crisis communication on Facebook during the COVID-19 lockdowns in the respective countries. Qualitative content analysis of Facebook posts by the state authorities in the four countries over a six-week period before and after the COVID-19 lockdowns yielded several frames or strategies employed by authorities in the case countries. These included; education, caution, cooperation, government measures, hope, nationalism, and scaremongering. Other frames included impact, militarisation, politicisation, and religion. The analysis establishes, as in several other countries, Facebook as a current and strategic choice in state-spearheaded crisis communication. Whereas the main frames were globally and regionally driven, other frames encapsulated national contexts drawing on national histories, patriotism, hopes and fears that sometimes seemed contradictory and capricious.
The use of the balanced scorecard has been subject to increasing scrutiny and criticism in academic literature. The purpose of this paper is to explore the limitations of, and…
Abstract
Purpose
The use of the balanced scorecard has been subject to increasing scrutiny and criticism in academic literature. The purpose of this paper is to explore the limitations of, and implications for, the Performance Assessment Framework (PAF) as a balanced scorecard approach in the NHS. Although Kaplan and Norton suggested that the balanced scorecard can be adapted for strategic performance management purposes in the public sector, this study aims to argue that such claims fail to give sufficient weight to the political context in which a public sector organization operates.
Design/methodology/approach
Semi‐structured interviews were employed to investigate the perceptions about the PAF of local managers and whether and how they incorporated central government's performance targets into their local operations within two health authorities. Furthermore, in order to examine these two health authorities' performance measurement practices, documents relating to their internal performance reports and local delivery plans were analysed.
Findings
Empirical findings drawn from local health authorities indicate that the use of the PAF was primarily for legitimacy seeking purposes rather than for rational performance improvement. For central government, the PAF was used to make the performance of the NHS visible to the public so that the public would receive the signal that central government has attempted to deliver government mandates. For local health authority managers, in order to seek legitimacy from central government, imposed performance indicators were incorporated into their local performance measurement practice. However, the use of the PAF was symbolic and ceremonial and had little impact on improving performance valued by local managers in NHS.
Originality/value
This study agrees with institutional theorists' argument that the use of performance measurement systems should take into account politics and power faced by an organization. In the NHS, performance measurement might be used by local NHS organizations primarily as a ceremonial means of demonstrating their symbolic commitment for legitimacy seeking purposes.
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An Act to make further provision for securing the health, safety and welfare of persons at work, for protecting others against risks to health or safety in connection with the…
Abstract
An Act to make further provision for securing the health, safety and welfare of persons at work, for protecting others against risks to health or safety in connection with the activities of persons at work, for controlling the keeping and use and preventing the unlawful acquisition, possession and use of dangerous substances, and for controlling certain emissions into the atmosphere; to make further provision with respect to the employment medical advisory service; to amend the law relating to building regulations, and the Building (Scotland) Act 1959; and for connected purposes. [31st July 1974]
The Equal Pay Act 1970 (which came into operation on 29 December 1975) provides for an “equality clause” to be written into all contracts of employment. S.1(2) (a) of the 1970 Act…
Abstract
The Equal Pay Act 1970 (which came into operation on 29 December 1975) provides for an “equality clause” to be written into all contracts of employment. S.1(2) (a) of the 1970 Act (which has been amended by the Sex Discrimination Act 1975) provides:
Stephen Abbott, Sue Procter and Nicci Iacovou
The purpose of this paper is to explore the variety of mechanisms applied since 1991 to engage English and Welsh general practitioners (GPs) in local health services planning and…
Abstract
Purpose
The purpose of this paper is to explore the variety of mechanisms applied since 1991 to engage English and Welsh general practitioners (GPs) in local health services planning and implementation.
Design/methodology/approach
Three qualitative case studies.
Findings
The paper identifies three types of mechanism: separation, alliance and integration. “Separation” characterises the relationship between most GPs and health authorities during the 1990s; alliance refers to the cooperative arrangements between groups of GPs and health authorities such as GP commissioning pilots, total purchasing, primary care groups and local health groups; integration refers to the integration of most health authority functions with primary care organisations (primary care trusts – PCTs and local health boards). Alliance models appear to have been most successful in promoting GP engagement in local planning and implementation; the necessarily bureaucratic nature of PCTs an local health board has alienated many.
Practical implications
As yet, the National Health Service (NHS) lacks organisational arrangements which permit GPs a primarily clinical focus while ensuring that their knowledge and advice is available to those carrying out administrative functions. Practice‐based commissioning may provide a means of improving such arrangements.
Originality/value
The paper combines a number of features in health services and policy research. Few studies of primary health care organisations in the mid‐2000s have been undertaken; the Welsh NHS is very under‐researched; organisational analysis of the NHS is more often based on analysis from the outside rather than grounded in the felt experience of NHS personnel; and the historical perspective is often neglected.
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This article focuses on the legal issues arising from the Health Act 1999 and the Local Government Act 1999 (both in force from 1 April 2000), particularly in relation to the…
Abstract
This article focuses on the legal issues arising from the Health Act 1999 and the Local Government Act 1999 (both in force from 1 April 2000), particularly in relation to the governance of partnership arrangements and the commissioning of internal and external services under best value.
Considers the impact of the termination of the Grants for EducationSupport and Training for health education on the future support ofhealth education in schools. Discusses the…
Abstract
Considers the impact of the termination of the Grants for Education Support and Training for health education on the future support of health education in schools. Discusses the results of a national audit of healthy alliances between health promotion units and local education authority schools. The results of the survey showed that specialist health promotion units are enthusiastic about collaborative partnerships with education, but that the axing of the GEST‐funded advisory posts has militated against such initiatives. Demonstrates that relationships between local education authorities and health promotion units have been difficult since April 1993 and are now much more competitive. Concludes that alliances between health and education have an uncertain future.