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This document was developed by a group of over two dozen pain clinicians and investigators from Austria, Belgium, Denmark, France, Germany Ireland, Israel, Italy, The Netherlands, Norway, Poland, Portugal. Spain, Sweden, Switzerland and the United Kingdom and funded by an educational grant form Mundipharma International, Limited. The stated aim of the White Paper is to identify inequalities in government policies towards opioids that contribute to inadequate treatment of pain. It calls for their replacement with policies that will support doctors and patients in their efforts to relieve pain.
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The 1989 White Paper 'Caring for People' announced a radical shift in the way community care was to be delivered. The changes are now upon us and will affect all people with disabilities living in the community. They will also require nurses and social workers to work more closely together.
In a recently released White Paper on health, the Government of Zimbabwe details its plans to transform the colonial health care system it inherited at the time of independence to one consonant with its commitment to socialist development. The essence of the transformation can be described in terms of several key ideas. First, there is a commitment to develop an integrated non-racial health care system. Second, there is a concerted attempt to develop a primary health care system throughout Zimbabwe. Third, there is a deliberate attempt to 'redistribute' health care resources by making sure that additional or new resources are largely devoted to the rural populations. Fourth, the government is committed, and has acted on the commitment, to ensure equitable access to health services. Fifth, the government is taking a variety of measures to limit the size and influence of the private medical sector. Sixth, there is a serious intent to involve local populations in the health planning and programming. Seventh, human resource development must be consistent with the primary health care system the government wishes to establish throughout the country. It is suggested that while the White Paper is unclear and uncertain about some important aspects of the transformation, for example, with regard to the private sector and the financing of the National Health Service, most of its proposed changes are well within the realm of feasibility.
The nature of the plans for change detailed in the National Health Service review White Paper, Working for Patients, which was presented to the British Parliament on 1 February 1989, are examined in this paper. Seven key measures are identified and outlined. The author extrapolates from the nature of the plans contained within the White Paper, the types of problems within the NHS that are attracting government attention. Questions are raised as to the appropriateness and likelihood of success of the White Paper plans in view of the problems currently besetting the NHS.
BACKGROUND: The English Public Health White Paper proposes introducing smoke-free workplaces except in pubs and bars that do not prepare and serve food. The bar area will be non-smoking in exempted pubs. OBJECTIVE: To explore the likely impact of these proposals in UK pubs and bars. METHODS: A total of 59 pubs and bars within Greater Manchester in 2001 were chosen. Thirteen were mechanically ventilated, 12 were naturally ventilated and 34 had extractor fans; 23 provided non-smoking areas. We measured time-weighted average concentrations of respirable suspended particles (RSP), solanesol tobacco-specific particles and vapour-phase nicotine (VPN) over a 4-h sampling period on a Tuesday or Saturday night. RESULTS: Second-hand smoke (SHS) levels in smoking areas were high (mean RSP 114.5 microg/m3, VPN 88.2 microg/m3, solanesol 101.7 microg/m3). There were only small (5-13 per cent) reductions in bar areas. Mean levels were lower in non-smoking areas: by 33 per cent for RSPs, 52 per cent for solanesol particles and 69 per cent for VPN. Compared with other settings (homes and other workplaces) with unrestricted smoking, mean SHS levels were high throughout all areas of the pubs regardless of ventilation strategy. CONCLUSION: Partial measures, like those in the English Public Health White Paper, will leave bar staff in exempted pubs unprotected from the occupational hazard of SHS.
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A recent white paper entitled The New NHS describes the changes that the government aims to adopt in order to deliver a new truly national health service (NHS). Priority would be given to developing community services in partnership with hospital NHS trusts. This paper describes a model that could be adopted for delivering such a service in the field of ophthalmology.
The European Commission (EC) White Paper on a Strategy for a Future Chemicals Policy calls for the collection of adequate information about chemicals, in order to ensure their appropriate risk management. The White Paper proposes a stepwise and flexible approach to all chemicals produced in amounts above 1 tonne/year/manufacturer, including testing, if information cannot be provided by other means. The required information should be collected by the end of 2012. The EC services are currently preparing the drafts for the future chemicals legislation.
This commentary reports on the advances that have occurred over the 10-year period since the first National Workshop to Develop the Chiropractic Research Agenda was held and introduces the second set of white papers that were produced as a result of the 10th annual Research Agenda Conference. Four working groups were convened to update the original 5 white papers that represented the most significant results from the first workshop in 1996. Each group was to review the first report, examine the action steps and recommendations that were published in each report to see how much had been completed in the past decade, and develop new action steps and recommendations for the future. Four new articles were developed, each updating and adding significant amounts of new research to the original versions. New action steps and recommendations will help move the profession forward into the future. Chiropractic scientists have worked diligently over the past decade to address the recommendations noted in the first set of white papers. Despite significant advances in knowledge and scientific capacity, the chiropractic profession is still confronted with a large number of research challenges.
It has recently been pointed out that the 1989 White Paper Working for Patients, which provides the basis for the current reforms of the British National Health Service, has some common features with the 1944 White Paper A National Health Service, which was the unadopted model for the service produced by the Wartime Coalition Government. Moreover, it is likely that the Conservatives, if elected in the 1945 General Election, would have introduced a service based on a modified version of the 1944 document. We can compare these two blueprints to shed some light on Conservative thinking on health care over a period of nearly 50 years. There are some similarities in terms of the notions of purchaser and provider, contracts and pluralism. However, there are striking contrasts, notably in their attitude towards planning versus competition and local democracy versus patronage. It is claimed that the profound differences outweigh the apparent similarities and consequently the two blueprints show the discontinuity rather than the continuity of Conservative thinking on health care.
Overall, there is agreement from attendees at the Regional Seminars that the White Paper on the Establishment and Elaboration of Clinical Pharmacy Services is a document of major importance to the profession, that the principles and the skills stressed in the White Paper should be promoted continually through seminars and standards, and that it is appropriate in terms of meeting the needs of practitioners for the advancement of clinical pharmacy practice. There is a general sense that these "How To" efforts are the best mechanism for practitioners to increasingly adapt to the needs of becoming clinical practitioners. In addition, the idea is often expressed that this type of seminar needs to be offered repeatedly for different practice populations. There are implications expressed for political action by CSHP and for changes in our schools of pharmacy. Overall, the first efforts of CPAC have been met with broad satisfaction and a demand for further publications, educational seminars and research projects.
In February 1989 Prime Minister Margaret Thatcher presented her Proposals in a White Paper. These proposals imply essential changes in the National Health Service (NHS) in Great Britain. The changes will result in a more commercial way of managing both the hospitals and the offices of general practitioners. Among other things, they will imply buying and selling health services. Important objectives in the proposals are cost control, quality assurance and a greater choice for patients. During a visit to London this winter, the author studied the main topics of the proposals. This article discusses the content and aims of the White Paper, also with relevance to Norwegian health policy. Some aspects of the British health system today are also considered, with special reference to the development of the NHS during last 10 to 15 years.
As part of its National Affairs Plan, approved in 1991, CLMA committed to publishing periodic position, or "white," papers to explore contemporary public policy issues in laboratory services administration. As CLMA's first white paper, this article is an in-depth analysis of the historical and economic background to today's clinical laboratory industry in the United States. It provides the logic and rationale behind CLMA's position statement on Health-Care Reform and the Clinical Laboratory. The statement has been formally adopted by consensus and has been widely circulated to both Congress and our membership. It will help form the policy basis for the development of the Association's legislative agenda on health-care reform. The principles are intended to be universal and apply not only to U.S. reform efforts at the national level, but also to states and other nations.
The White Paper of the Health Professions of Catalonia (WPHPC) is a strategic document for the development of the health professions. It deals with the main components of the manpower development (education, management and planning) in relation to the health services development required to attain the objectives defined in the Catalan Health Plan. The WPHPC fosters the coherence between social needs and professional competencies required to respond to them, as well as to the quantitative aspects of service needs under adequate standards of quality, effectiveness and efficiency. The WPHPC has followed a methodological process with maximum stakeholder participation and transparency. Citizens, professionals and health organizations have contributed significantly. The conclusions and recommendations of the WPHPC are organized around four axis: the citizenship, the professionals, the health care organizations and the health care model. Key elements are: the requirement of a new social contract between the different stakeholders, the values of professionalism, the need for a new credentialism of professional competencies, innovation in the education process, innovation of governance and management for organization of knowledge, the redistribution of work inside teams requires deregulation and reregulation of the professions, the need for actualized data on workforce and job positions and the permanent requirement of sociological research.
OBJECTIVE: To determine the views of Avon's general practitioners about the general practice proposals within the government's white paper Working for Patients. DESIGN: Postal questionnaire survey. SETTING: A county in south west England. SUBJECTS: All general practitioner principals (n = 537) under contract with Avon Family Practitioner Committee. MEASUREMENTS AND MAIN RESULTS: 492 doctors (92%) responded to the survey. More than three quarters of the respondents were opposed to the government's proposals on budgets for specific surgical procedures, prescribing, and diagnostic tests; and between 63% and 93% felt negative about advantages that might accrue from the proposals. Over three quarters of general practitioners were in favour of family practitioner committees monitoring work load, prescribing, and referrals. General practitioners in large, potentially budget holding practices held similar views to doctors in smaller practices. CONCLUSIONS: Avon's general practitioners substantially reject most of the government's proposals about general practice in the white paper Working for Patients.