STRUCTURAL CHANGE IN THE NHS AND GP UTILIZATION IN ENGLAND UNDER NEW LABOUR, 1997–2003

In this article we compare the pattern of service utilization in the period preceding the health‐care reforms introduced by New Labour with service utilization following the refoms. Data from the 1997 and 2003 waves of the British Household Panel Survey are used to estimate a series of utilization functions. These show that GP utilization overall fell, for women more than men and for the sick more than others. The results suggest that GPs responded to the changing context the reforms created but there are different interpretations of that response. They support the contention that GPs devoted greater attention to preventative services post‐reform than had previously been the case. They are also consistent with the contention that GPs responded less directly to the needs of their patients, either because they became more sophisticated in interpreting those needs or conscious of the increased opportunity costs of responding to them.     

The Use of Citizen Review Boards with Juvenile Offender Cases: An Evaluation of the Effectiveness of a Pilot Program

This study evaluates a Citizen Review Board (CRB) program designed to review juvenile offender cases. The sample includes 157 juvenile offenders that were first‐time adjudicated offenders. The youth were randomly assigned by the juvenile judge either to receive review by the CRB or go through the regular court process. Sixty‐eight of the youth were reviewed by the CRB and 89 made up the control group. Data were collected on both groups for more than three years. Program outcomes examined for the study included court processing time, placement and treatment facility changes, and re‐offense rates. Findings suggest that the youth served by the CRB program had statistically fewer out‐of‐home placements in treatment programs during the course of the study and more time had elapsed between the date of the original offense and the re‐offense for youth reviewed by the CRB. The rise in the number of juvenile offenders going through the nation's court systems, as well as a rise in the number of citizen review boards, indicate a need for further examination about how CRBs can best serve the juvenile court system and the youth served by that system.