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10 The economics of mental health services Brendan Kennelly Introduction Mental health services include a broad range of services, from home and ­community-based facilities such as day hospitals and out-patient facilities, to acute care units and residential care services. This chapter presents a broad overview of key economic issues facing the provision of such services in Ireland. The key issues that are addressed include: (a) the nature and extent of mental illnesses in Ireland; (b) the resources spent on care provided to people with mental illnesses; and (c

in The economics of disability

Chapter 8 The contributory schemes and the coming of the National Health Service Reflecting on the BHCSA’s efforts to influence the NHS policy debates, its first historian concluded that: ‘it can certainly never be said that … the Association failed for lack of trying’.1 This chapter reassesses this verdict, through an exploration of the responses of both the BHCSA and individual schemes to plans for the new health service. Its premise is that the shape of the NHS was the outcome of a process of discussion within a policy community of politicians, civil servants

in Mutualism and health care
From the Global to the Local

; all quotes from the circulars are taken verbatim from the documents on file with the author. In undertaking this close reading of the documents, I trace the nature and implications of a series of UNRWA’s more ‘private’ responses to the 2018 cuts, with a particular focus on shifts in educational and maternal and neonatal health services on the one hand and employment and pension rights on the other. I thus illustrate the extent to which UNRWA’s operational changes are invisible on the international stage and yet are having significant impacts

Journal of Humanitarian Affairs
Open Access (free)
Interpreting Violence on Healthcare in the Early Stage of the South Sudanese Civil War

This article seeks to document and analyse violence affecting the provision of healthcare by Médecins Sans Frontières (MSF) and its intended beneficiaries in the early stage of the current civil war in South Sudan. Most NGO accounts and quantitative studies of violent attacks on healthcare tend to limit interpretation of their prime motives to the violation of international norms and deprivation of access to health services. Instead, we provide a detailed narrative, which contextualises violent incidents affecting healthcare, with regard for the dynamics of conflict in South Sudan as well as MSF’s operational decisions, and which combines and contrasts institutional and academic sources with direct testimonies from local MSF personnel and other residents. This approach offers greater insight not only into the circumstances and logics of violence but also into the concrete ways in which healthcare practices adapt in the face of attacks and how these may reveal and put to the test the reciprocal expectations binding international and local health practitioners in crisis situations.

Journal of Humanitarian Affairs

This handbook is written for patients and members of the public who want to understand more about the approaches, methods and language used by health-services researchers. Patient and public involvement (PPI) in research is now a requirement of most major health-research programmes, and this book is designed to equip these individuals with the knowledge and skills necessary for meaningful participation. Edited by award-winning mental-health researchers, the book has been produced in partnership with mental-health-service users and carers with experience of research involvement. It includes personal reflections from these individuals alongside detailed information on quantitative, qualitative and health-economics research methods, and comprehensively covers all the basics needed for large-scale health research projects: systematic reviews; research design and analysis using both qualitative and quantitative approaches; health economics; research ethics; impact and dissemination. This book was developed during a five-year research programme funded by the UK’s National Institute for Health Research (NIHR) called Enhancing the Quality of User Involved Care Planning in Mental Health Services (EQUIP). The handbook clearly outlines research practices, and gives an insight into how public and patient representatives can be involved in them and shape decisions. Each chapter ends with a reflective exercise, and there are also some suggested sources of additional reading. People who get involved in health research as experts from experience now have a textbook to support their research involvement journey.

The impact of devolution and cross-border cooperation

This book examines how the conflict affects people's daily behaviour in reinforcing sectarian or ghettoised notions and norms. It also examines whether and to what extent everyday life became normalised in the decade after the 1998 Good Friday Agreement (GFA). Cross-border commerce has been the stuff of everyday life ever since the partition of Ireland back in 1921. The book outlines how sectarianism and segregation are sustained and extended through the routine and mundane decisions that people make in their everyday lives. It explores the role of integrated education in breaking down residual sectarianism in Northern Ireland. The book examines the potential of the non-statutory Shared Education Programme (SEP) for fostering greater and more meaningful contact between pupils across the ethno-religious divide. It then focuses on women's involvement or women's marginalisation in society and politics. In considering women's political participation post-devolution, mention should be made of activities in the women's sector which created momentum for women's participation prior to the GFA. The book deals with the roles of those outside formal politics who engage in peace-making and everyday politics. It explores the fate of the Northern Irish Civic Forum and the role of section 75 of the 1998 Northern Ireland Act in creating more inclusive policy-making. Finally, the book explains how cross-border trade, shopping and economic development more generally, also employment and access to health services, affect how people navigate ethno-national differences; and how people cope with and seek to move beyond working-class isolation and social segregation.

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Maternity and child welfare in Dublin 1922–60

Motherhood is a complex issue involving the mechanics of pregnancy and childbirth and the life experience of mothering and rearing children. This book provides a detailed account of the history of maternity and child welfare in Dublin between 1922 and 1960. It places maternity and child welfare in the context of twentieth-century Irish history. The book offers accounts of how women and children were viewed, treated and used by key lobby groups in Irish society and by the Irish state. It explores the development of female 'social rights of citizenship' during the first forty years of Independence. Maternity and child welfare often provided the pretext for debate on issues quite apart from mothers and children, which related to the deep-seated fears regarding the power lines in Irish society. In Britain, awareness on infant mortality led to a series of investigative committees, including the Inter-Departmental Committee on Physical Deterioration and the National Conference of Infant Mortality. A constant theme throughout the 1920s, 1930s and 1940s was how the standard of maternity and child welfare services varied throughout the country. The book discusses the Dublin experiment. In the early part of the twentieth century, the ignorance of Dublin mothers was blamed for the high rate of infant mortality in the city. The stringency of the Emergency period, the sustained atmosphere of deprivation throughout the 1940s and the British White Paper, A National Health Service stimulated a debate in Ireland regarding the public health services.

The state and hospital contribution, 1941–46

Chapter 7 The ‘impending cataclysm’: the state and hospital contribution, 1941–46 The National Health Service Acts of 1946 and 1947 were a watershed for the contributory schemes, as they were for the rest of the British health system.1 They appeared to signal the end of the mixed economy of health care in Britain, which had combined private, voluntary and public financing. In its place they instituted a health service funded by direct taxation and nominally universal, comprehensive and free at the point of use.2 The voluntary hospitals were nationalised and

in Mutualism and health care

A Research Handbook for Patient and Public Involvement Researchers Chapter 1: Patient and Public Involvement (PPI) and the research process Andrew C Grundy Chapter overview This chapter defines and introduces the different stages of the research process: from identifying a problem, to reviewing the literature; then developing a research question; designing a study; obtaining funding and ethical approval; recruiting participants; collecting and analysing data; and reporting and disseminating findings. This chapter will outline how users of health services, their

in A research handbook for patient and public involvement researchers
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Chapter 11 Concluding comments In the course of this project we had a range of reactions to the contributory schemes. One was admiration for the effort and commitment of the schemes and of key individuals within them. A second reaction, arising from the sheer heterogeneity of the schemes, was sympathy with the task facing those officials charged with reorganising the British health services in wartime: they faced the formidable challenge of trying to incorporate over 400 highly diverse schemes into a national structure and it is clear that they could find no

in Mutualism and health care