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Government White Paper (government + white_paper)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

Regulation of Government: Has it Increased, is it Increasing, Should it be Diminished?

PUBLIC ADMINISTRATION, Issue 2 2000
Christopher Hood
This article examines arms-length ,regulation' of UK government , the public-sector analogy to regulation of business firms , and assesses the precepts for public-sector regulation embodied in the Blair Labour government's official vision of public-man-agement reform, its Modernising Government White Paper of 1999. As a background to assessing the recipes for public-sector regulation in Modernising Government, the article shows that such regulation grew markedly both in the two decades up to 1997 and in the plans and activities of the Blair government from 1997 to 1999. Against that background, the design principles for public-sector regulation contained in Modernising Government are assessed. The White Paper was notable for embracing a doctrine of ,enforced self-regulation' for the public sector that involved aspirations to both more and less public-sector regulation in the future. It put its faith in a mixture of oversight and mutuality for ,regulating regulation'. But in spite of the radical-sounding tone of Modernising Government, the measures proposed appeared limited and half-hearted, and two well-known institutional design principles for regulation seemed to be missing altogether from the Blair government's view of administrative ,modernity'. [source]

The Continuing Value of Relief for Directors' Breach of Duty

THE MODERN LAW REVIEW, Issue 2 2003
Rod Edmunds
The nature and scope of relief for directors in breach of their duties did not figure prominently in the Steering Group's fundamental review of company law. Little is proposed beyond removing one of the two pre-conditions for relief laid down in section 727 of the Companies Act 1985; the requirement of reasonableness. This article seeks to subject the relieving discretion to a more radical re-appraisal. Drawing upon the views expressed by its architects together with the current judicial approach adopted towards the provision, it is argued that its underlying rationale would be better met if the test for relief was based solely upon the court's determination of fairness. It will be demonstrated that such a model would better serve to bolster the fundamental tenets of transparency, simplicity and accessibility that underpin the approach of the Government's White Paper towards company law reform while also reinforcing the continuing value of relief. [source]

Dermatology outpatient case-mix survey for all Welsh Trusts, 2007

BRITISH JOURNAL OF DERMATOLOGY, Issue 1 2010
G.M. Hill
Summary Background, In 2006 a U.K. government White Paper recommended making NHS care in England more accessible by shifting services from secondary care into community settings. There is a shortage of contemporary activity data for U.K. dermatology units to allow benchmarking for service development. This study will not only provide useful comparative data for the future in Wales, but will also serve to highlight the impact of changes made in England. Objective, To provide an overview of 1 week's dermatology outpatient activity for the whole of Wales. Methods, All dermatology units in Wales collected data for 1 week in early 2007. The case mix, appropriateness of referral, requirement for surgery or second-line therapies and follow-up requirements were all determined. Results, A total of 2142 patients were seen. Of new patients, 21% had skin cancer. Seventeen per cent of skin cancers had no diagnosis suggested by the general practitioner (GP) and 10% of basal cell carcinomas, 33% of squamous cell carcinomas and 17% of malignant melanomas were inappropriately diagnosed. In all, 26% of new patients had benign lesions, and this group caused the greatest diagnostic difficulty for GPs. Seventy-one per cent of these patients were diagnosed, reassured and discharged at their first visit without the need for biopsy or surgery. Thirty-seven per cent of new patients required surgery, of which 21% required complex intervention. Twenty-six per cent of follow-up patients were receiving second-line therapies. The new to follow-up ratio varied considerably according to diagnosis, the mean ratio being 1 : 0·21 for benign lesions through to 1 : 5·53 for psoriasis. This highlights the inappropriate nature of a ,one fits all' ratio. The majority of follow-up patients in secondary care required this level of input for monitoring of cancer, complex second-line therapies or surgery. Conclusions, This study provides evidence to support logical planning of dermatological services and to assess the impact of proposed changes on different healthcare systems in the U.K. [source]

Clinical governance in practice: closing the loop with integrated audit systems

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2006
L. TAYLOR ba hons rmn
Clinical governance has been acknowledged as the driving force behind National Health Service (NHS) reform since the government white paper outlined a new style of NHS in the UK in 1997. The framework of clinical governance ensures that NHS organizations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will develop. A major component of a clinical governance framework requires utilizing audit procedures, which assess the effectiveness of current systems and ultimately direct continual quality improvement. This paper describes the audit component of a local clinical governance framework designed for a unit based within an NHS trust, which has utilized a multidisciplinary approach to assess the effectiveness of a newly commissioned service and its impact on the residents and staff. The unit is a 12-bedded, low-secure-intensive rehabilitation unit for clients with severe and enduring mental illness. Using recognized and standardized psychometric outcome measures, information was collected on clinical symptoms, social functioning, social behaviour, quality of life, relationship quality with named nurses and medication side-effects. Additionally, confidential staff measures were included to assess levels of burnout, identify expressed emotion and assess staff perception of models of illness. The paper includes a comprehensive account of how managerial commitment, teaching processes and application of technology ensured prompt data collection and maintained the momentum through the audit timescale. Data analysis and presentation of data in both clinical reviews and in senior management meetings within the unit are discussed. Findings highlight the full integration of the audit system into the processes of the unit. Clinically, the paper highlights the enhancement of the knowledge base of the client group and the influence on clinical decision-making processes and care delivery as a result of the audit. Brief clinical examples are given. In conclusion, the impact of the audit on unit strategy and organizational efficiency are discussed to highlight the importance of closing the audit loop and completing the cycle of clinical governance. The audit system has positive implications for replication in other services. [source]