Andy Alaszewski

Rehabilitation, the remedial therapy professions and social policy.

Abstract This article focuses on the position, development and role within the National Health Service of a cluster of paramedical practitioners—the remedial therapy professions, and provides a conceptual analysis of ideological issues. The first section provides a conceptual analysis of the alternative modes of organising medical work, especially the preventative, curative and alleviative approach. The second section develops the analysis by examining the concept of rehabilitation as embodied in official policy statements. It shows that the concept has curative and alleviative elements, and examines the problems of creating a correct conceptual balance between these elements and reproducing this balance in the pattern of services. The third section develops these arguments with special reference to the remedial therapy professions. It shows how the two major groups, physiotherapy and occupational therapy, have different histories and examines the way in which this affects their current practice.

Managing risk in the city: the role of welfare professionals in managing risks arising from vulnerable individuals in cities.

Modern cities depend on individualism and the process of contracting. Contracts between individuals contribute to stability and order in cities. However, this is challenged by risks and uncertainties especially those relating to vulnerable individuals who are unable or unwilling to enter into contractual relations. This paper focuses on the role of caring professions and the impact of new strategies for managing risks related to vulnerable adults and children, especially the shift from managing risk in institutions to managing risk in the community. This paper is based on research funded through the ESRC Risk and Human Behaviour Programme.

Restructuring Community Care: Risk, Decision‐Making and Control

This article takes a fresh look at the concept of risk in the light of the Governments plans to modernise health and social care.

The rise of risk assessment and risk management in the United Kingdom

This article examines the reform of the health care system in England in terms of the risk assessment and risk management. Three major health policies are examined, the Health of the Nation strategy, community care and the Patients Charter. The article demonstrates that effective risk assessment and risk management is an important component of each initiative. The Health of the Nation strategy is based on epidemiological evidence on the nature of health risks and is linked to specific targets for the reduction of harm that require effective management of risks. Community care is a well established policy designed to provide long term and continuing support for vulnerable individuals in the community. With high profile incidents in the 1980s, there has been a greater emphasis on effective risk assessment and risk management, especially to protect the public. The Patients Charter is designed to empower users of service. Central to this strategy is informed consent. Effective empowerment depends of the pro...

The situation of nursing administrators in hospitals for the mentally handicapped: problems in measuring and evaluating the quality of care.

Abstract This article is concerned with social policy, especially with measuring and improving the performance of hospitals for the mentally handicapped. The first part of the article focuses on the tension between senior personnel and care staff and outlines the key role of senior personnel in maintaining and monitoring standards. The second part of the article looks at the problems of monitoring standards, especially the current shortage of suitable criteria of evaluation. Following a historical analysis of official evaluation techniques a new approach is suggested based on a redefinition of care.

Another dose of managerialism? Commentary on the consultative paper “patients first”

Abstract On 1 April 1974 the NHS was reorganised. In July 1979 a Royal Commission Report recommended a simplification of the structure. In December 1979 the Secretary of State issued a consultative paper on the restructuring of the Service. This article critically examines the proposals and suggests that they will do little to change the pattern of NHS decision-making.