David Wainwright and Michael Calnan
- Published in print:
- 2011
- Published Online:
- May 2012
- ISBN:
- 9781847427588
- eISBN:
- 9781447305576
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781847427588.003.0011
- Subject:
- Sociology, Health, Illness, and Medicine
General Practitioner (GP) fundholding originated in the belief that a quasi-market mechanism would lead to the more efficient and effective use of health care resources. The model was implemented and ...
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General Practitioner (GP) fundholding originated in the belief that a quasi-market mechanism would lead to the more efficient and effective use of health care resources. The model was implemented and abandoned without formal recourse to evaluation or the evidence base. This chapter elucidates what can be learned from the past by taking the fundholding initiative of the 1990s as a case study. The Audit Commission's report emerged as the most extensive and systematic attempt to appraise the model. The authors have also broadened the case study to include evidence from other studies and consideration of the impact this evidence has had on policy.Less
General Practitioner (GP) fundholding originated in the belief that a quasi-market mechanism would lead to the more efficient and effective use of health care resources. The model was implemented and abandoned without formal recourse to evaluation or the evidence base. This chapter elucidates what can be learned from the past by taking the fundholding initiative of the 1990s as a case study. The Audit Commission's report emerged as the most extensive and systematic attempt to appraise the model. The authors have also broadened the case study to include evidence from other studies and consideration of the impact this evidence has had on policy.
Dan Zuberi
- Published in print:
- 2013
- Published Online:
- August 2016
- ISBN:
- 9780801450723
- eISBN:
- 9780801469824
- Item type:
- chapter
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9780801450723.003.0005
- Subject:
- Sociology, Health, Illness, and Medicine
This chapter argues that outsourcing has fundamentally compromised the teamwork required for effective infection control. Outsourced workers report to managers from their company, not doctors, ...
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This chapter argues that outsourcing has fundamentally compromised the teamwork required for effective infection control. Outsourced workers report to managers from their company, not doctors, nurses, or hospital administrators. The new model replaces cooperation and teamwork with a system of divided loyalties, a paradigm shift that seriously diminishes job quality and cleanliness. In such a system, hospital administrators have a single blunt tool to address any concerns about cleanliness—direct audits to check for compliance. Unfortunately, although auditing can identify problems, it cannot magically create the kinds of fundamental changes that will make a hospital any cleaner. Once jobs are outsourced, hospitals have almost no control over the who, what, when, why, and how of hygiene.Less
This chapter argues that outsourcing has fundamentally compromised the teamwork required for effective infection control. Outsourced workers report to managers from their company, not doctors, nurses, or hospital administrators. The new model replaces cooperation and teamwork with a system of divided loyalties, a paradigm shift that seriously diminishes job quality and cleanliness. In such a system, hospital administrators have a single blunt tool to address any concerns about cleanliness—direct audits to check for compliance. Unfortunately, although auditing can identify problems, it cannot magically create the kinds of fundamental changes that will make a hospital any cleaner. Once jobs are outsourced, hospitals have almost no control over the who, what, when, why, and how of hygiene.
Patrick Brown and Michael Calnan
- Published in print:
- 2012
- Published Online:
- January 2013
- ISBN:
- 9781847428899
- eISBN:
- 9781447307556
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781847428899.003.0006
- Subject:
- Sociology, Health, Illness, and Medicine
Chapter Five moves towards considering the organisational and policy dimensions of our study and especially explores the possibilities and difficulties for trusting relationships to develop within a ...
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Chapter Five moves towards considering the organisational and policy dimensions of our study and especially explores the possibilities and difficulties for trusting relationships to develop within a context dominated by frameworks of risk, calculability and accountability. In particular there is a focus upon the experiences of professionals and managers in the varying mental health contexts of our study and the manner by which a culture of audit and risk bears upon different relationship dimensions within the organisation. From here it becomes apparent that the nature of (mis)trust relations which exist within one level of the organisational context have implications for the development and character of relationships elsewhere – and therefore for trust.Less
Chapter Five moves towards considering the organisational and policy dimensions of our study and especially explores the possibilities and difficulties for trusting relationships to develop within a context dominated by frameworks of risk, calculability and accountability. In particular there is a focus upon the experiences of professionals and managers in the varying mental health contexts of our study and the manner by which a culture of audit and risk bears upon different relationship dimensions within the organisation. From here it becomes apparent that the nature of (mis)trust relations which exist within one level of the organisational context have implications for the development and character of relationships elsewhere – and therefore for trust.
