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Biomedical subjects

P L Bradshaw

Publications and source records attributed to P L Bradshaw.

12 recordsLinked to original sources
PubMed1997

Changing childbirth--the midwifery managers' tale.

This paper concerns Maternity Services. It begins by describing the development of the current policy in Britain which culminated in the report Changing Childbirth. It proceeds to describe a qualitative investigation in which a group of Heads of Midwifery Service in one health region were interviewed concerning their views about the basic recommendations of the report and their experiences concerning the feasibility of its implementation by 1998. On the basis of its evidence, the study concludes the policy is failing to be fully realized due to both a lack of earmarked resources and confused objectives which are not fully accepted by professionals and are not understood by service users. The findings demonstrate that the Heads of Midwifery believe that what was proposed as a bold and innovative policy has become no more than lukewarm advice. The conduct of the study is described in detail to illustrate how operational managers can research the ways in which policies are influencing service delivery in their field of practice.

Attitude of Health Personnel↗
PubMed1995

The recent health reforms in the United Kingdom: some tentative observations on their impact on nurses and nursing in hospitals.

The British National Health Service has recently undergone the most profound reforms since it was conceived some 50 years ago. In an attempt to contain the rising cost of spending the principles of market competition have been introduced. Similar developments are occurring internationally. This paper describes briefly the history of the reforms in the United Kingdom. It outlines the rationale for a market in health services which is largely publicly funded. The paper then provides an analysis of the serious impact of the new business culture on the control of nurses and nursing work in hospitals. In doing so, it identifies the threats which confront the future well-being of the nursing profession. It concludes with a brief resumé of opportunities which the profession must seize if it is to retain its identity.

Health Care Reform↗
PubMed1995

The equity debate within the British National Health Service.

This paper begins by identifying the principles of equity and fairness on which the British National Health Service (NHS) was founded in 1948. It then goes on to summarize the viewpoints of those who more recently have argued that equity is an out-moded, utopian and unachievable concept that should not be applied to the delivery of health care services. A brief review is conducted of the definitions of equity and inequity as these apply to health care. Brief attention is paid to the relationship between equitable distribution of health care and social class. The new contemporary significance of equity for all NHS managers is exposed through a debate concerning the impact of the recently introduced policies for the implementation of a quasi-market in health services in Britain. The inseparable relationship between equity and the rationing of resources is identified as central to the just distribution of health care. The paper presents evidence that the quasimarket solutions to improved economic efficiency and cost-containment are often in direct conflict with the equity doctrine on which the NHS was created. A brief conclusion how equity principles might be restored to health policy is proffered.

Health Care Rationing↗
PubMed1995

Audit in the British National Health Service.

This paper is about audit as it exists inside the broader framework of quality control within the National Health Service. It will define medical audit briefly and examine its antecedents in exploring why it was introduced. The paper will proceed to analyse the underlying economic and political reasons for the Government's strategy for audit, and assesses its contribution to the debate about quality in health care. The paper concludes by considering the future direction of audit arising out of the recent emphasis placed on multi-professional clinical audit.

Humans↗
PubMed1994

Competition and efficiency in health care--the case of the British National Health Service.

This paper examines the factors leading to the introduction of a competitive market in the British National Health Service (NHS). It can be seen that this most radical overhaul in the 45 years of the service was precipitated by economic but also ideological factors. Competition was seen as a means to producing the efficiency that would lead to better health care. The competitive market was introduced without public debate or reference to similar experiences in health care provision in the USA. Little consideration was given to the strengths and weaknesses of such a system. The purchaser-provider model chosen has been expensive to introduce. It has failed to stimulate competition amongst providers and the formal economic evaluation of its performance has so far been minimal. At first sight the separation of purchaser-provider functions has done little to disturb the traditional bureaucratic features of the NHS. The scope exists, however, to open up competition to a much greater extent. Depending on political feasibility, competition would be the necessary mechanism to prepare the NHS for sale into private ownership.

Economic Competition↗
PubMed1986

Testing times?

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Education, Nursing↗