Health Services In London Research Articles

Mrs Bottomley announces changes to London's health services GPs report deterioration in community care services NHS dental care will be targeted on neediest patients GPs' current night visit fee structure will continue

# Mrs Bottomley announces changes to London's health services {#article-title-2} Last week the health secretary announced changes to the health services in London that resulted in her being castigated by many fellow Tories (p 962). Mrs Virginia Bottomley explained in a written parliamentary answer that the changes were the results of “four comprehensive consultation exercises carried out by the relevant district health authorities.” She had, she said, taken full account of the comments, particularly about the pace of change. For example, the accident and emergency departments at Guy's and Edgware General Hospitals would not close until alternative and related services were fully equipped. Alternative facilities for treating minor injuries would be provided at both sites. The short stay and specialist services at the Royal Hospitals Trust will be concentrated at the Royal London Hospital, in Whitechapel, and between now and the end of the century services will transfer from St Bartholomew's and the London Chest Hospitals. Emergency and specialist services at present split between the two sites of the Guy's and St Thomas's Trust will be concentrated at St Thomas's. Guy's Hospital will be developed as a major medical research and teaching campus. Accident and emergency services will continue to be improved at King's College and Lewisham Hospitals, with investments of pounds sterling8m and pounds sterling5m respectively. A major new neurosciences centre will be created at King's College Hospital, and the neurosurgery provided at the Brook Hospital will transfer to King's. A new district hospital will be established at Greenwich (currently the Queen Elizabeth Military Hospital) from August. Barnet General Hospital will be upgraded at a cost …

The Epidemic Streets: Infectious Disease and the Rise of Preventive Medicine 1865-1900

Epidemics still sweep the streets of London, taking their toll of its twentieth century inhabitants. Today's epidemic diseases are tackled with diverse drugs and policies: a clutch of childhood immunisations; antibiotics and hospital admission for pulmonary tuberculosis; for HIV, needle exchange, opiate substitution, and safe sex advice. The Victorian medical officers of health had few of these tools. They attempted to combat the epidemics of their day with surveillance, “stamping out,” and sanitary reform. Anne Hardy examines the impact of preventive health services in London after 1865, when 48 medical officers of health were first appointed to newly designated sanitary districts. She shows how surveillance often depended on …

Tomlinson on alcohol and drugs

Recognition of the problemSir Bernard Tomlinson's Report of the Enquiry into London's Health Service, Medical Education and Research (1992) starts with an excellent analysis of the particular problems associated with providing health care in the capital with its high density and turnover of population and disproportionate burden of severe deprivation. He emphasises the particular problems that arise because of the flow into London of vulnerable people with mental illness, drug addiction problems and alcoholism, many of whom are homeless. The consequent difficulties are compounded by the fact that primary health care and community services are poorly developed in comparison with elsewhere in the country and may not be easily accessible to those who need them most. Inadequacies in comprehensive service provision contribute to the high usage of accident and emergency departments as providers of primary health care, where community nursing services are expensive because of higher staff costs and where the characteristics of the patient population referred to above, make maintaining effective contact very difficult.

Tomlinson: a social policy perspective (Part 1).

This article is the first of two which explore the Report of the Inquiry into London's Health Service, Medical Education And Research (1) (the Tomlinson Report), and consider its origins and implications from a social policy perspective. In this article, the Tomlinson Report will be placed within its historical context and the key events leading up to its commissioning and publication examined. To facilitate the analysis, a 'policy as process model' will be adopted throughout to articulate and emphasise the relationships between the phenomena involved (2). Part two appears next week.

Improving London's health service.

Improving London's health service.

Mixed reaction to revised London hospital closure plan.

Nursing unions have given a mixed response to government plans for health services in London, which propose the closure of at least five hospitals in the capital and about 2,500 beds.

Tomlinson's tomfoolery?

The recent launch of the Report of the Inquiry into London's Health Service, Medical Education and Research (Department of Health, 1992) confirmed the predicted recommendations of hospital closures and mergers across the capital. Among the hospitals targeted by the Tomlinson report for merger are St Bartholomew's and the Royal London Hospitals, and St Thomas's and Guy's Hospitals. Middlesex Hospital is recommended for closure, with the services it currently provides being diverted to University College Hospital. In addition, the report suggests a similar fate for many other equally acclaimed institutions.

Advice to Government on London health services

In October 1991 the then Secretary of State for Health, William Waldegrave, appointed Sir Bernard Tomlinson to act as adviser on health services in London. Early on it was agreed that Sir Bernard would also take account of the role of these services in teaching and research. Previous reports have focused on one or other aspect, e.g. the Todd Report (1966) and Flowers Working Party Report (1979) primarily considered teaching and research while the report of the London Health Planning Consortium (1979) mainly addressed provision of services. While the former two reports have been followed by extensive change in the organisation of medical academic activities in London, there has been much less change in health care delivery. For instance, primary care and community care are still seriously deficient in parts of London while high technology hospital based medical practice, sometimes providing a nationwide service, has survived and sometimes continued to develop in an entrepreneurial way. The problem is riven by academic and professional concerns of nationwide relevance and importance.

Staffing: London's nursing workforce.

With health services in London under scrutiny, Ian Seccombe and James Buchan profile the capital’s nurses and speculate on future supply

London's health service.

London's health service.

Labour market study scheduled for June release.

The draft report from a major study into the labour market for health care staff in London is expected at the end of June, says the Institute of Manpower Studies. The report has been commissioned by the King's Fund and will provide the basis of a strategy for the future of acute health services in London.

Cutbacks

Elective surgery and orthopaedics have suffered most from the crisis in London's health service, where cuts have added to the country's longest waiting lists, a new report shows. The report by the Association of London Authorities and the Greater London Association of CHCs reveals that eight of the ten Inner London HAs have made cuts of more than £1 million this year.

The National Health Service in London: A Review of the Impact of NHS Policy since 1976

The National Health Service in London: A Review of the Impact of NHS Policy since 1976

PLANNING PROCESSES FOR MEDICAL EDUCATION AND THE HEALTH SERVICES IN LONDON

PLANNING PROCESSES FOR MEDICAL EDUCATION AND THE HEALTH SERVICES IN LONDON

A new look at London's health service

Governments faced with decisions that are not necessarily going to popular, and that also require general consent if they are to work, often take refuge behind an advisory body. This tells them what to do, normally what they want to told, and they then blame what is done?if it doesn't work?on those who told them. Faced with the Flowers Report and the report from the London Health Planning Consortium the health ministers have just done this?set up an advisory group, which they hope will report by the autumn. Dr Gerard Vaughan, the Health Minister, has assured the Commons Committee on the Health Services Bill that the advisory group will not cut across the consultations due to take place over the next three months on the Flowers Report. would take notice of the comments as they were received; look at the report and London University's views on it; study the report by the LHPC; and then come forward with recommendations, he said. Ministers see no reason, despite great pressure from Tory and Labour MPs, for the group to meet in public, since they believe that most of the evidence has already been taken. The group's task is rather to read the material available in abundance and come to a considered view. Mr Roland Moyle, shadow health spokesman, made it clear that he would prefer a public inquiry and argued that London had no need of an advisory group. But if it had to an advisory group then he wanted it to meet and take evidence in public and to report in public with the argu ments and evidence supporting its conclusions. Opposition to the plan was also voiced by Dr Brain Mawhinney, Conservative MP for Peterborough and a senior lecturer at the Royal Free Hospital School of Medicine. He complained that the Flowers Report bore the imprimatur of senior university officials. It seems unrealistic to suppose that those hospitals and medical schools, as part of the medical faculty that wishes to put a different view from the officiai line, will have an adequate opportunity to do so unless the advisory committee is prepared to take evidence directly, he said. Dr Vaughan emphasised that the two reports were discussion documents. They did not state final decisions on action. Their whole purpose was to point out the problems and start a dialogue on what should done. It would, he added, be a terrible mistake to jump to conclusions that the various recommenda tions will automatically carried out. As for the membership of the group?the names should announced shortly?it will drawn from the DHSS, the University Grants Committee, London University, the four Thames regional health authorities, the postgraduate board of governors, the Greater London Council, and the London Boroughs Association. If after all that lot anyone feels like adding Old Uncle Tom

Health Service in London: New advisory group

Health Service in London: New advisory group

Health Services in London

Health Services in London

Health services in London.

Health services in London.