MEMBERSHIP OF THE ‘NEW STYLE’ HEALTH AUTHORITIES: CONTINUITY OR CHANGE?

The 1989 White Paper 'Working for Patients' continued the process begun by Griffiths of managerial reform and the introduction of private sector concepts into the NHS. One of the new proposals was to change the composition and constitution of health authorities, both to avoid the assumed weaknesses of the existing format and to emulate the pattern found in the private sector.
The essence of the change was the removal of the representational elements on authorities, both of medical professionals and nominees from the local authority. The health authorities were reduced in size to just eleven members and for the first time executives were included. Previous attempts at reform within the NHS have been judged to have resulted in more continuity than change. This article examines in detail who the new members are and assesses the balance between continuity and change.
Despite a high level of continuity of membership, there are signs of more fundamental change. There is a significant increase in the proportion of non-executive members from the private sector and with the inclusion of executives, a stronger managerial role is emerging. The article concludes by assessing what the implications of these changes maybe.     

政府机构改革的宪法性思考

我国政府机构改革的深层原因是计划经济体制下所形成的高度集权的宪政秩序和权力结构特征与社会主义市场经济体制所要求的不相融 ,因此 ,重新界定行政权范围 ,设计出能够保障行政权规范有效运行的权力结构 ,优化宪政秩序是当前政府机构改革的实质所在。行政权的正确定位需要来自立法权、司法权、公民权以及其他社会权利的支持与配合 ,所以应把政府机构改革纳入整个权力结构调整的大系统之中。在推进政府机构改革的过程中要从宪政角度出发 ,加强三个方面的制度建设。     

Emerging Liabilities from Pharmaceuticals and Personal Care Products

There is growing awareness and concern regarding the presence of chemical constituents of pharmaceuticals and personal care products (“PPCPs”) in the environment. A recent USGS study indicated that PPCPs are present at low levels in surface water throughout the U.S. Concern is based in part on the fact that certain PPCPs: (1) are designed to have biological effects (particularly pharmaceuticals), (2) are persistent in or continually added to the environment, (3) have negative environmental effects (specifically on aquatic life) even at low levels, and (4) potentially have cumulative and synergistic effects when combined with other PPCPs. The primary route of PPCPs into the environment is sewage discharges, septic systems, and large stock yards and feedlots where the unmetabolized PPCPs are excreted by humans and animals and end up in surface water and ground-water. Given these circumstances, manufacturers of PPCPs may face a risk of increased regulation and possibly litigation similar to that faced by oxygenate manufacturers and petroleum refiners over the use of Methyl Tertiary Butyl Ether (“MTBE”). Companies can take steps now and in the future that may minimize the impact of these risks.     

Chapter 2: Pay Now So You Won't Pay Later: The Effectiveness of Prevention Programming in the Fight to Reduce Delinquency

Community-based delinquency prevention programs, designed to work with youth and families before they become involved with the official court process, are relatively rare. Likewise, few studies have been published concerninge valuative research on such programs. This article reviews some background on program concepts, describes the operations of the Oakland County Probate Court Youth Assistance casework services program, and reports the results of a comprehensive program evaluation project. The findings suggest that prevention programming is one effective strategy to aid in reducing the likelihood of more costly court interventions. Recommendations for program development are offered.     

Acute myoglobinuria as a fatal complication of heroin addiction

A fatal case of myoglobinuria complicating heroin addiction is described. Clinically the patient had no overt symptoms of rhabdomyolysis. Pathologists should be alerted to this rare complication in heroin addicts who die of no apparent cause. The antimyoglobin immunoperoxidase technique is useful in confirming the diagnosis.