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The focus of the paper is on the relationship between General Practitioners (GPs) and central government. This relationship dates from the introduction of national health insurance in the UK. From the outset it had an impact on GPs’ medical role, their professional status and income. The structure created in 1911 meant that GPs operated as franchisees and, notwithstanding Labour’s policy objective of creating a salaried service, this role continued, effectively unchanged, after the creation of the National Health Service (NHS) in 1948. General Practice was also the poor relation in contrast to hospital medicine, a feature intensified by the priorities of the NHS. These forces meant that GPs had a dual role: that of clinician and gatekeeper to specialist hospital services, a role in which they exercised substantial clinical freedom: and running a small business, a feature which was exaggerated by the absence of grant aid to improve premises prior to the Family Doctor Charter of 1965. This structural relationship has been progressively transformed by changes in the 1980s and 1990s. On the one hand the emphasis on cost control has seen central government attempting to combine a financial with a clinical gatekeeping role. The crucial change in this respect is the creation of GP fundholding which, in turn, could be seen to have implications for the subordinate status of GPs within the medical profession. However, this has been combined with trends to greater measures of control over GPs. Of central importance in this respect were the changes introduced by the 1990 GP contract. The contract involved an attempt to substantially reduce clinical autonomy by building in much more detailed contractual duties with respect for example, to health promotion activities. This was combined with the use of financial incentives to reach, for example, immunization targets. Control over clinical autonomy has also involved constraints over prescribing and the shift from Family Practitioner Committees to Family Health Service Authorities. The rationale for this shift is the move from an administrative to a managerial body, acting as the agent of central government in enforcing the contract and imposing financial norms. GPs are thus to be made managerially accountable. The paper analyses the place of general practitioners in central government’s approach to health strategy and examines the tensions generated by the combination of conferring new powers on GPs and increasing controls over them. These tensions are related to current disputes over out‐of‐hours working and attempts by GPs to redefine a “core of service” approach to their job. The ambiguities of reliance on professionals combined with the desire to exert greater controls is traced in the recent policy statement by the Secretary of State Primary Care: The Future (1996). The paper thus aims to contribute to the critical discussion of the impact of central government managerialist initiative on key professional groups in the welfare state.

In response to the challenge of the ageing of societies and concerns over recruitment and quality of service delivery, many nations have introduced new educational and training pathways, as well as national standards that set a minimum qualification level for residential care staff. In Ireland, national standards were introduced in July 2009 and, against this backdrop this study aimed to explore the level of qualification held or being pursued by non‐nursing care staff.

An email/postal survey was conducted.

This survey revealed that while vocational qualifications were most common, more than 50 per cent of care staff neither held nor were pursuing the minimum qualification set by the standards.

While the introduction of standards may address this situation, the workforce appears currently ill‐prepared for increasing professionalisation. Moreover, given Ireland's poor economic circumstances, training or supports are likely to be limited, with the burden of training liable to fall on staff, undermining morale and increasing already tense industrial relations. Limitations of this study include variations in the roles of non‐nursing care staff, with many staff classified as “multi‐task” staff that perform a range of duties from personal care through to more general domestic duties and, in the context of a mixed economy of provision, the abundance of responses from the public sector relative to the private sector.

Nonetheless, this study provides a timely snapshot and a reference point for further research around the impact of standards on quality of care or workforce professionalisation and it will be of particular interest to policymakers, regulators, employers and care staff.

Academic integrity in tertiary education is a global concern. This chapter describes academic integrity in Australian universities and proposes an “it takes a village” framework to guide universities toward a re-evaluation of academic integrity education. It takes a village to raise a child – a child needs role models and positive influences from multiple people for healthy growth and development. With regard to academic integrity, the parallel is that the entire university community needs to be involved to foster development of students of integrity. The institution and its community need to provide structures, multiple positive and effective learning experiences, and clear guidelines to support both staff and students. In this chapter, we argue that academic integrity needs to be seen as a complex system, one in which everyone involved has responsibility to develop and maintain a culture of integrity and one which supports a student throughout their academic journey.

The purpose of this paper is to discuss whether the use of outcome-focused homecare improves the subjective well-being of the familial carers of older people with dementia. It also discusses familial carers’ perception of whether this intervention has improved the well-being of their relative.

This qualitative study followed the familial carers of 20 service users suffering from dementia over a six-month period. Semi-structured interviews were undertaken at three intervals during the six months. The carers were asked to assess their subjective well-being at the start, middle and end of the study.

The key findings were that all 20 familial carers expressed an improvement in their subjective well-being and that of their older family member, who appeared more settled as a result of this model of care.

The need to consider the use of outcome-focused care as an intervention strategy for older people living alone in the community. The need to provide supportive environments for the carers of older people with dementia to limit their sense of isolation. The prioritising of outcome-focused care in the most complex and chaotic cases.

This study provides an insight into the effectiveness of outcome-focused homecare with older people experiencing dementia as perceived by their familial carers. Previously, research has established that outcome-focused care increased the subjective well-being of non-dementia sufferers. This study dovetails neatly with this in demonstrating the same effect on dementia sufferers as perceived by their familial carers. Additionally, this study also demonstrated that this model of outcome-focused care also improved the subjective well-being of the familial carers themselves. These finding will help practitioners consider the use of this model of homecare as a potential alternative or a delaying strategy to residential care.

This study investigated undergraduate preparation of English as a Second Language (ESL) students through English for Academic Purposes courses, in relation to recipient subject lecturers’ expectations. Qualitative data were gathered from 36 faculty teaching ESL undergraduates in nine countries. A two-phase approach included seeking discursive responses to questionnaires from faculty and information about curricula. Outcomes highlighted difficulties with material selection for EAP tutors. Tutors chose between ‘general interest’ or ‘discipline-specific’ material, but reported that the former could lead to oversimplification or discipline irrelevance, while the latter usually requires some specialized subject knowledge which may be beyond tutors’ remit. Addressing this, it is suggested that articles about EAP-related topics can form the subject matter of EAP courses with significant benefits. In particular, they can simultaneously provide students with models of academic writing, while the content reinforces skills needed for successful study.