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Article
Publication date: 1 June 1998

Sara Shaw and Timothy Milewa

The issue of “out of hours” provision of primary care services by family doctors has excited particularly marked debate in the UK. This article considers the implications for this…

304

Abstract

The issue of “out of hours” provision of primary care services by family doctors has excited particularly marked debate in the UK. This article considers the implications for this debate of results from a project designed to elicit the views of users of out of hours primary care provision. Focus groups were used to gauge definitions of “out of hours” services, factors governing the use of some services rather than others and influences on the evaluation of different options. The centrality accorded by patients to the social dimensions of a more “traditional” relationship with family doctors was central to the selection and evaluation of alternative provision. Any significant initiative in the reconfiguration of local health care services might thus be regarded as much a social enterprise as a technical challenge based on the most equitable and efficient application of resources.

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Journal of Management in Medicine, vol. 12 no. 3
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 1 August 1997

Timothy Milewa

It is often suggested that professional and managerial attitudes significantly delimit the impact of new structures for enhancing the role and influence of service users in health…

1286

Abstract

It is often suggested that professional and managerial attitudes significantly delimit the impact of new structures for enhancing the role and influence of service users in health and social care planning. Considers the existence and clarity of such managerial attitudes in the context of one attempt to involve users in mental health care planning. The existence of latent and explicit managerial parameters to the role played by users in the planning of services was confirmed by the research at a very general level. Perhaps inevitably though, even in relation to a very specific user participation project, these parameters became less uniform as more detailed issues were considered. This suggests that an investigative focus on the “process” oriented attitudes and assumptions of managers and professionals, although important, should not be allowed to detract from a concern with gauging the demonstrable outcomes of user participation.

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Journal of Management in Medicine, vol. 11 no. 4
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 1 December 1996

Timothy Milewa

Explains that Health for All is an international extra‐governmental movement that seeks to pursue equity in access to health‐related resources by broadening the scope of health…

2834

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Explains that Health for All is an international extra‐governmental movement that seeks to pursue equity in access to health‐related resources by broadening the scope of health policy. Notes that its major principles include social participation in state decision making, inter‐sectoral collaboration in policy formulation and the improvement of conditions for the disadvantaged. Points out that its local initiatives often encompass health‐service professionals and practitioners as well as the voluntary sector, social services and other local authority departments, and that the effect of this local activity on political understandings of health at a national level gives some indication of the extent to which this local time and effort have been justified. In this respect, notes two limits to the impact of the Health for All movement on the political debates about health in Britain. Suggests that these centre on a largely indifferent but powerful national government and an emphasis within the movement initiatives at the level of a politically marginalized local state.

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Journal of Management in Medicine, vol. 10 no. 6
Type: Research Article
ISSN: 0268-9235

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