Suchergebnisse

In a recent review of the mental health policies of its 42 member states in the European Region, the World Health Organization highlighted the need for further analysis of service user involvement in the policy making process. In the UK, a plethora of recent government policies and initiatives have stressed the importance of service user involvement in the design and delivery of health and social services. Their input is described as a fundamental requirement of a modern, flexible, responsive healthcare system. This paper reviews mental health policy in Northern Ireland, which has undergone a period of unprecedented activity and explores the extent to which service users have influenced the process of policy design and development. It raises questions about the extent to which a genuine commitment to and investment in user involvement has been achieved and comments on the prospects for the future.

Intro -- Contents -- List of Boxes, Figures and ­Tables -- Abbreviations -- Acknowledgements -- 1 Introduction and Content -- Introduction -- The wider context and challenge -- The implementation of integration -- Structure of book -- Sources -- Terminology -- 2 Development of Policies and Strategies in England -- Policies and strategies pre-1999 -- Promoting partnerships and the Flexibilities agenda -- Transforming care and integration policies under New Labour -- NHS reforms and impact on integration -- Social care reform and integration -- Support for integration from non-statutory bodies -- Operation of integrated care in England -- Partnerships and use of Flexibilities -- Major themes in integrated partnerships -- Conclusions -- 3 Reshaping Integration in England -- Introduction -- Clinical Commissioning Groups -- Health and Wellbeing Boards -- Partnership NHS trusts -- Integrated Care Pioneers Programme -- Government encouragement of integration -- Better Care Fund -- NICE: Standards for integration -- Vanguard sites, new care models -- City/region devolution and integration -- Integrated personal commissioning -- Conclusions -- 4 Integration in Scotland -- Introduction -- Policy development and Joint Future -- Establishment of health and social care partnerships -- Support for integration -- Vision for integration -- Integrated Authorities -- Assessment of progress -- Integration activities -- Self-directed support -- Conclusions -- 5 Integration in Wales -- Introduction -- The Welsh experience of integration -- Other promotional factors -- Assessments of integrated care -- Conclusions -- 6 Integration in Northern Ireland -- Introduction -- Historical context -- Development of integrated structure -- Reorganisation of health and social care -- Transforming your care and its impact -- Integrated Care Partnerships.

The system of devolution set up in Northern Ireland in 1999 has proved volatile and unstable. In 2017, the Northern Ireland Executive collapsed, following the resignation of the Sinn Féin, deputy First Minister. For a three-year period, Executive and legislative devolution ceased to operate. The UK Government opted not to impose Direct Rule from Westminster, as happened previously. This article examines the consequences of the absence of a devolved government in the context of the existing system of multi-level governance (MLG). It is contended that mitigating action taken or considered to address the gap in governance can be best understood using an analytical framework drawn from the lens of MLG. A range of interventions, adjustments and interactions occurred involving the remaining levels of MLG. Despite the fall of the Executive and Assembly an amended form of governance continued to function in Northern Ireland.

This article assesses the implications of the 2017 Confidence and Supply Agreement between the Conservative Party and the Democratic Unionist Party (DUP) in the context of the Barnett Formula and intergovernmental relations post the devolution settlement and the Good Friday Agreement. In light of the parties' shared objectives to strengthen and enhance the UK, the Confidence and Supply Agreement, sets out how the DUP would support the minority Conservative government in specific areas, including finance Bills and matters pertaining to the exit from the European Union. This article examines the nature and operation of this Agreement and assesses the extent to which it may be seen to have breached established conventions, rules and principles around devolved funding and the principle of political impartiality enshrined in the Good Friday Agreement. It is argued that the Confidence and Supply Agreement has contributed to the perceived shortcomings of the Barnett Formula as a robust, fair, financial methodology. The distribution of money to the devolved administrations should be modernised and based on need, accountability and transparency. It is also concluded that being locked into a parliamentary deal undermines the UK Government's ability to be impartial between the competing interests in Northern Ireland.

AbstractIt is over a year since the collapse of the devolved administration at Stormont, which left one region of the United Kingdom without a functioning executive. Reluctance to introduce direct rule from Westminster reduced Northern Ireland to a desiccated form of governance. This article examines the nature and form of government in this political vacuum. The consequences of this system are examined in terms of the absence of legislation, mechanisms for scrutiny, and participation in intergovernmental relations. In the absence of devolution and direct rule, the potential for greater involvement of the Irish government in the affairs of Northern Ireland is also considered.

AbstractSince the establishment of devolution in 1999, Northern Ireland's power‐sharing governments have been fragile and prone to crisis. However, following a decade of relative stability and cooperation between Nationalists and Unionists at Stormont, hopes were high that the devolved arrangements had finally become embedded and more resistant to collapse. This optimism was dashed when Sinn Féin brought down the devolved institutions in January 2017. A snap election once again returned the Democratic Unionist Party (DUP) and Sinn Féin as the largest parties and their inability to form a government resulted in yet another political stalemate. This article begins by outlining the pattern of political crises in Northern Ireland and assesses both the trigger factors and the responses. It then goes beyond the most obvious explanation for this continuing instability—that of the deep sectarian based divisions—and points to a number of other reasons for the volatility. These include issues such as the incomplete implementation of previous agreements, the impact of broader UK policies and the shadow of Direct Rule.