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This comparative study gathers together new research by local historians into aspects of welfare in Hertfordshire spanning four centuries and focusing on towns and villages across the county, including Ashwell, Cheshunt, Hertford, Pirton, and Royston, amongst many others. In so doing it makes a valuable contribution to the current debate about the spatial and chronological variation in the character of welfare regimes within single counties, let alone more widely. As well as viewing poor relief geographically and chronologically, the book also considers the treatment of particular groups such as the aged, the mad, children, and the unemployed, and shows how, within the constraints of the relevant welfare laws, each group was dealt with differently, giving a more nuanced picture than has perhaps been the case before. The overarching question that the book attempts to answer is how effectively Hertfordshire cared for those in need. With chapters on madhouses, workhouses, certified industrial schools, the Foundling Hospital, pensions, and medical care, the book covers a very broad range of topics through which a complex picture emerges. While some officials seem to have been driven by a relatively narrow sense of their obligations to the poor and vulnerable, others appear to have tailored welfare packages to their precise needs. Naturally, self-interest played a part: if the weakest citizens were well managed, vagrancy might be lessened, the spread of disease contained, and control maintained over the cost of looking after the poor and sick. It seems that Hertfordshire was relatively nimble and sensitive in discovering and treating its people's needs. Evidence is beginning to emerge, in other words, that Hertfordshire was in essence a caring county.
The demographic trends and financial constraints in the Nordic countries, and all over Europe, are posing challenges, especially in the health care sectors. The rising number of elderly with 'new' diseases, as well as new technology and inventions, create a growing demand for health care services and health care personnel. The aim of this report is to establish a clearer picture of the challenges in the future health care sectors in the Nordic countries, especially in terms of lack of health care personnel, and the strategies and initiatives implemented for recruitment and retention of personnel.
The Government has not fully thought through the implications of its social care reforms and may leave local authorities open to a deluge of disputes and legal challenges. MPs and Peers warn that without greater integration with health and housing, and a focus on prevention and early intervention, the care and support system will be unsustainable. The Committee also calls for a nationwide campaign to educate people about the need to pay for their own care, saying that adult care and support are poorly understood. Key recommendations include: a new power to mandate joint budgets and commissioning across health, care and housing, such as support for the frail elderly, making it simpler for NHS and local Councils to pool budgets; fast-tracking of care and support assessments for terminally-ill people; new legal rights for young carers to protect them from inappropriate caring responsibilities and ensure they get the support they need; an obligation on the Secretary of State to take into account the draft Bill's well-being principle when designing and setting a national eligibility threshold; independent resolution of disputes over decisions about care and support - and costs that count towards the cap - through a Care and Support Tribunal. In addition, the Committee makes a number of recommendations to improve health research and the education and training of NHS workers. The Committee also warns that restricting support and care to those with the highest levels of need will simply shunt costs into acute NHS care and undermines interventions to prevent and postpone the need for formal care and support.