Joining it up? Health and Wellbeing Boards in English Local Governance: Evidence from Clinical Commissioning Groups and Shadow Health and Wellbeing Boards

Statutory responsibility for health care and social care has long been separated between National Health Service (NHS) bodies and local government authorities. Repeated policy attempts to promote service integration through collaboration between such authorities have achieved little. The latest of such policy interventions are the Health and Wellbeing Boards (HWBs) established by the 2012 Health and Social Care Act (HSCA) alongside a range of other organisational innovations, including Clinical Commissioning Groups (CCGs). These organisations await full legal and operational status but have begun to develop structures and processes. HWBs are intended to lead the integrated assessment of local needs to inform both NHS health and local authority social care commissioners. We undertook detailed qualitative case studies in eight CCGs during 2011–2012 and here report observational and interview data related to CCGs’ perspectives and observations of early HWB developments. We found that developing HWBs vary greatly in their structure and approach, but we also identified a number of significant issues that are familiar from earlier research into health and social care integration. These include heavy dependence on voluntary agreements to align the strategic plans of the many different new statutory bodies; a significant role for mundane organisational processes in determining the extent of effective co-operation; and problems arising from factors such as size and the arrangements of local boundaries.     

Protect Our Children: Vaccination Exemptions Can Establish Child Abuse and Neglect

The need to protect public health has increased as the anti‐vaccine movement is on the rise. Exemptions to vaccination requirements have become more lax, and parents find ways to avoid vaccinating their children, thereby exposing not only their children to the dangers of serious diseases, but other children as well. This Note proposes a federal statute mandating that parents subject their children between the ages of infancy and 6 to acquire vaccinations for all diseases recommended by the Centers for Disease Control and Prevention unless a licensed physician recommends otherwise.     

The nearest relative in the Mental Health Act 2007: still an illusionary and inconsistent safeguard?

Abstract

The role of nearest relative (NR) is intended as a safeguard in the Mental Health Act 1983 (as amended in 2007) to curb the excesses of professional discretion and protect patients from unwarranted compulsory hospitalisation. It is unique to the mental health compulsory detention process in England and Wales. There are, however, evident tensions in the role and a lack of clarity surrounding the precise functions of the NR. There is also some uncertainty and confusion among practitioners about the scope of the NR involvement, and government plans announced recently to review mental health legislation will include a focus on the role of family and carers in the care of detained patients. Despite long-standing concerns about the role, there is remarkably little published research available to date on its use and effectiveness, in so far as evaluating the extent to which it provides an adequate safeguard for patients, as intended by the legislation. This article will briefly explore the background to the role, highlight some of the difficulties and tensions within it and conclude with some observations about where further research and reform may be needed to provide greater protection and clarity for patients, relatives and health and social care practitioners.     

On Zen and Ecology Health Dimenshon

There are three levels in the Interaction between Zen and ecology. First, Zen and ecology focus on illness caused by ecological problems,Disease pain is the basic point between Zen and ecology. Secondly, although Zen can improve health conditions, but this is just one of the results. The most important of Zen is “prajna”. The real world which “prajna” regard is same with ecology. The two emphasis on“ Ecological cycle”concept.Finally,because the philosophy of Zen focus on liberation, so the heath quality of Zen is better than general health.     

Towards universal health coverage in Zambia: impediments and opportunities

Universal health coverage has been given a prominent place in the post-2015 global development agenda, but there are concerns over its feasibility in low- and middle-income countries. This article assesses successive Zambian governments’ efforts to achieve this agenda. We discuss the recent restructuring of health governance to support policies that re-emphasise the social determinants of health and health equity. This includes a new Ministry of Community Development and Mother and Child Health alongside the Ministry of Health. We argue that recent innovations in policy and practice need to be extended to include ministries which focus on economic development.     

突发公共卫生事件中谣言的产生机理和因应策略——基于一个历史比较和社会心理分析的视角

突发公共卫生事件期间,谣言的蔓延既容易引发社会性恐慌,又有损于政府公信力,极大地影响了疫情的整体性治理。阻遏谣言不能简单依靠多元主体参与辟谣,而需要洞察谣言作为群体性无意识活动背后的社会心理诉求和意识形态表达。整理汇集2020新冠肺炎2003非典型肺炎1910东北鼠疫和1894粤港澳鼠疫期间流行的谣言,通过建立一个历史比较的框架,分析和解释重大疫情谣言规律性重现的原因,即谣言的产生是公众世界观秩序被扰乱后的慌忙重构、公众意识形态的集体具象化和公众渴望深度介入公共事务的表达。鉴于此,谣言的治理必须建立在对谣言随疫情变化规律的掌握上,设置预防性前置性的工作机制,综合运用多渠道多机制进行防治。     

新加坡医疗保障体系运行机制及现状评述

新加坡政府创造性的建立了储蓄型医疗保险制度,取得了较好的效果。本文通过对新加坡保健储蓄计划、健保双全计划、乐龄保健计划和保健基金运行机制分析,发现新加坡医疗保障体系具有以个人负责作为制度设计总理念,精细化管理,体现公平正义理念,具有服务型社会治理内涵,进行积极调节,具有激励约束机制的特点。     

Gender equality needs critical consideration in conflict-affected settings

The World Bank's 2012 World Development Report calls for gender equality on a global level but falls short on its analysis of conflict-affected contexts. It is critical that we understand the needs of vulnerable populations in these settings. This viewpoint draws on findings from research in health reform in conflict-affected contexts to highlight some opportunities and challenges for addressing gender equality in these settings, using the policy priorities outlined in the World Bank report. Drawing on this analysis we argue that more attention and action should be focused on addressing gender inequalities and inequities in neglected conflict-affected states.     

Customary and contemporary resources for women's empowerment in Bangladesh

In Bangladesh, dramatic social and economic changes are transforming historical forms of patriarchy with various impacts on pathways to women's empowerment. We hypothesised contemporary resources would be more strongly associated with women's empowerment, as reflected in their influence in family decisions. In cross-sectional analysis, we found the contemporary resources of employment and membership in NGOs were most strongly and consistently associated with women's influence in family decisions. Education was only modestly associated, as were customary resources, including age and fertility. Programmatic efforts to enhance women's empowerment should consider the rapidly changing environment and the importance of women's economic participation.