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Welfare Reform on the Web (May 2010): National Health Service - primary and community care

Abortions to be offered at GP surgeries

K. Devlin

Daily Telegraph, Apr. 16th 2010, p. 12

Some 15% of primary care trusts in England have either applied for, or are considering an application for, a licence to perform early abortions in GP surgeries. Some applications have been made in conjunction with the British Pregnancy Advisory Service which already offers medical terminations at GP surgeries in Wolverhampton and Newcastle upon Tyne. Each surgery has to gain approval from the Care Quality Commission and the Health Secretary before abortions can be carried out.

Health visitor drive faces barriers

R. Watson

Children and Young People Now, Mar. 9th-15th 2010, p. 11

The Conservatives have pledged to increase the number of health visitors by 4,200. They propose to do this by enticing qualified professionals back to practise and by simplifying the career path from midwifery to health visiting. This article points out the problems with this approach. Experts are sceptical that trained midwives would want to become health visitors, and spiralling workloads make it unlikely that professionals who have left would be eager to return to practise.

More of the same? Conflicting perspectives of obesity causation and intervention among overweight people, health professionals and policy makers

J. Greener, F. Douglas and E. Van Teijlingen

Social Science and Medicine, vol. 70, 2010, p. 1042-1049

This research explored the different understandings of the causes, effects and effective interventions needed to reduce obesity among overweight individuals, health professionals and policy makers. Overweight and obese individuals viewed their weight problems as a result of their own motivational and physical shortcomings or as a response to specific challenges in their lives. They blamed themselves rather than environmental determinants of weight gain. Health professionals recognised the socio-environmental causes of obesity and viewed it as a biological reaction to adverse social conditions. As regards interventions, they were more inclined towards individually-oriented behaviour change strategies than structural remedies. Policy makers considered environmental and social policy changes to be most likely to make a substantial difference to current obesity trends, but considered it unlikely that such policies would be implemented due to lack of political will and popular support.

Public policy, 'men's time' and power: the work of community midwives in the British National Health Service

V. Bryson and R. Deery

Women's Studies International Forum, vol. 33, 2010, p. 91-98

This case study shows that community midwives in the NHS are chronically short of time to talk to mothers, engage in genuine relationships and reflect on their work. This is illustrative of a more general problem that develops when considerations of cost effectiveness are applied too rigidly to care work, squeezing out the relational time that this properly involves. Despite some recent women-friendly changes in maternity care at the level of rhetoric, market-driven reforms have consolidated an inappropriate 'time is money' approach.

Young people's sexual health: the National Chlamydia Screening programme

Committee of Public Accounts

London: TSO, 2010 (House of Commons papers, session 2009/10; HC 283)

Chlamydia is the most commonly diagnosed bacterial sexually transmitted infection and the prevalence of this infection is increasing, especially in young people under the age of 25. The infection is often symptomless but if left untreated can lead to serious health problems including infertility in women. In 2003 the Department of Health (the Department) launched the National Chlamydia Screening Programme (the Programme) which is overseen by the Health Protection Agency (the Agency) and delivered locally by the 152 Primary Care Trusts (PCTs) in England. The Programme aims to identify, treat and control the infection in young people aged under 25. Since the Programme's launch an estimated 100 million has been spent but the Department does not yet know what effect, if any, this has had on reducing the prevalence of the infection. During the financial year 2007-08, five years after the Programme was launched, only 5% of 15 to 24 year-olds were tested, against a target of 15%. When it became clear that very little was happening the Department introduced a new requirement for PCTs to test 17% of their 15-24 year-old population, which drove the testing rate up to around 16% in 2008-09. When PCTs increased their activity to meet the 17% target, a fragmented and inefficient Programme became even more wasteful of taxpayers' money. The Department should identify the most cost-effective local delivery strategies, establish regional or national commissioning arrangements, increase testing numbers and measure the Programme's impact on the prevalence of chlamydia. By improving efficiency, economies estimated at 40 million per year could be made by 2010-11.

Young people's sexual health: the National Chlamydia Screening programme

Committee of Public Accounts

London: TSO, 2010 (House of Commons papers, session 2009/10; HC 283)

Chlamydia is the most commonly diagnosed bacterial sexually transmitted infection and the prevalence of this infection is increasing, especially in young people under the age of 25. The infection is often symptomless but if left untreated can lead to serious health problems including infertility in women. In 2003 the Department of Health (the Department) launched the National Chlamydia Screening Programme (the Programme) which is overseen by the Health Protection Agency (the Agency) and delivered locally by the 152 Primary Care Trusts (PCTs) in England. The Programme aims to identify, treat and control the infection in young people aged under 25. Since the Programme's launch an estimated 100 million has been spent but the Department does not yet know what effect, if any, this has had on reducing the prevalence of the infection. During the financial year 2007-08, five years after the Programme was launched, only 5% of 15 to 24 year-olds were tested, against a target of 15%. When it became clear that very little was happening the Department introduced a new requirement for PCTs to test 17% of their 15-24 year-old population, which drove the testing rate up to around 16% in 2008-09. When PCTs increased their activity to meet the 17% target, a fragmented and inefficient Programme became even more wasteful of taxpayers' money. The Department should identify the most cost-effective local delivery strategies, establish regional or national commissioning arrangements, increase testing numbers and measure the Programme's impact on the prevalence of chlamydia. By improving efficiency, economies estimated at 40 million per year could be made by 2010-11.

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