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The use of regulation to control behavior is a defining feature of modern government, penetrating a wide range of social and economic life. This book offers a detailed study of how regulation works in practice, its legal framework, and the arguments surrounding its economic and social impact.
Dated May 2007. On cover: Departmental report. The health and personal social services programmes
This review incorporates the views and visions of 2,000 clinicians and other health and social care professionals from every NHS region in England, and has been developed in discussion with patients, carers and the general public. The changes proposed are locally-led, patient-centred and clinically driven. Chapter 2 identifies the challenges facing the NHS in the 21st century: ever higher expectations; demand driven by demographics as people live longer; health in an age of information and connectivity; the changing nature of disease; advances in treatment; a changing health workplace. Chapter 3 outlines the proposals to deliver high quality care for patients and the public, with an emphasis on helping people to stay healthy, empowering patients, providing the most effective treatments, and keeping patients as safe as possible in healthcare environments. The importance of quality in all aspects of the NHS is reinforced in chapter 4, and must be understood from the perspective of the patient's safety, experience in care received and the effectiveness of that care. Best practice will be widely promoted, with a central role for the National Institute for Health and Clinical Excellence (NICE) in expanding national standards. This will bring clarity to the high standards expected and quality performance will be measured and published. The review outlines the need to put frontline staff in control of this drive for quality (chapter 5), with greater freedom to use their expertise and skill and decision-making to find innovative ways to improve care for patients. Clinical and managerial leadership skills at the local level need further development, and all levels of staff will receive support through education and training (chapter 6). The review recommends the introduction of an NHS Constitution (chapter 7). The final chapter sets out the means of implementation.
This is a memoir covering some 50 years' involvement with delivering public services in a wide range of roles: civil servant; local government; chairing inquiries and public bodies; special adviser; Minister; and Parliamentarian. The book's topic areas include the NHS, social services, social care, welfare benefits, human rights, criminal justice and constitutional issues like House of Lords reform. It starts with a government apprenticeship in the 1960s and ends with Brexit and Covid19. It covers successes and failures; and identifies the limitations of our institutions. The book ranges over 1970s political battles; Thatcher's efficiency drive; social services and community care reforms of the 1980s and 90s; and tackling child abuse. A diary kept for the 1997 Election year sets out what it was like taking over government after a long period in Opposition. A major reform of the youth justice system is described, along with developing the Blair government's family policy. Much of the book is concerned with the NHS and its shortcomings as well as its iconic status in the UK. There are chapters on life as the pharmaceuticals Minister; implementing NHS targets and cutting its bureaucracy; and trying to instal a mega NHS computer system. The chapters on implementing Tony Blair's NHS reforms with more patient choice and competition illustrate how difficult public service reform is. The book poses the possiblity that the NHS in its present form is unsustainable; and explains the failure to fix the funding of social care. Life in the House of Lords is described and why it needs major reform. The book concludes with some ideas on how the Government could build back better after Brexit and Covid with public sector reform.
These notes refer to the Health and Social Care Act 2008 (c. 14) (ISBN 9780105414087) which received Royal Assent on 21st July 2008