Suchergebnisse

AbstractThis article considers the impact of the recent reform of the National Health Service (NHS) on specialist regional health services. A case study of medical genetic services is presented to highlight some problems arising from the implementation of the 1990 NHS and Community Care Act. New financial arrangements introduced by the Act have led many regional health authorities to devolve the finance and organization of specialist health services to districts. The introduction of competition and devolved budgets may pose especial problems for some specialist health services. In the case of genetic services these difficulties are exacerbated by new pricing rules. The paper explores these issues and suggests that the imposition of the market model on health care overlooks some vital, human elements which do not fit neatly into such a model.

ABSTRACTRoom management has been developed and researched in an attempt to improve aspects of the quality of life of children and adults with mental handicaps. The effect of this procedure was evaluated in a classroom for pupils with severe mental handicaps. Following a baseline, the system was implemented with eight pupils and monitored for five weeks. Subsequently, the additional component of interest, weekly target‐setting, was included for half the group for a further five weeks. The progress of each of the eight pupils on target skills and "control" target skills was assessed, and the results were compared. The rate of skill acquisition by pupils for whom targets were set did not differ significantly from that of the control pupils. The target‐setting procedure did not have an adverse effect on pupil or staff behaviour within the room management procedure. The implications of including a teaching element within the room manager role are discussed.