Mental health and legal landscapes

When it was established early in the twentieth century, Tokanui became part of a network of mental hospitals that were responsible for the care and confinement of the insane and the mentally deficient. At the time of its construction Tokanui was the first new mental hospital commissioned in over 20 years and the first to be built in the central North Island. Of those mental hospitals operating in 1912 all, except Ashburn Hall (the country's only private institution), were government controlled and funded. State dominance in the management of mental abnormality was the result of an unofficial policy which followed English precedent, favouring government intervention in the belief that it produced beneficial results and which endorsed the conviction that government responsibility for such matters could not be divested to a third party. This position was strengthened by the paucity of a prosperous philanthropic class who would otherwise have bridged the gulf between demand and supply under the auspices of charity. The essence of this philosophy was reflected in the early nineteenth and twentieth-century legislation which governed the development and management of New Zealand's mental hospitals

Patient choice in the NHS: How critical are facilities services in influencing patient choice?

Purpose – From December 2005, patients in the UK needing an operation will be offered a choice of four or five. These could be NHS trusts, foundation trusts, treatment centres, private hospitals or practitioners with a special interest operating within primary care. This is called “Choose and Book”. The purpose of this research is to discover how critical facilities management service factors are in influencing a choice of hospital. The aim is to find out what the most important influencing factors are to people when making a choice of which hospital to have their operation. If facilities services and the patient environment are influencing factors in the patient experience, which are considered critical. Design/methodology/approach – Focus groups were used as the primary method of data collection. Findings – The study finds that all three focus groups placed more importance on clinical factors than facilities factors. High standards of cleanliness and good hospital food were the two facilities factors that participants in all groups placed most importance on. Cleanliness was highlighted by all three groups as a top facilities priority for the NHS at the moment and there was a general perception that private hospitals have better standards of cleanliness. Practical implications – By understanding how important facilities factors are in influencing patient choice and which ones have a critical impact, it will help NHS trusts focus on where they channel their resources.</p

Does hospital competition save lives? Evidence from the English NHS patient choice reforms

This paper examines whether or not hospital competition in a market with fixed reimbursement prices can prompt improvements in clinical quality. In January 2006, the British Government introduced a major extension of their market-based reforms to the English National Health Service. From January 2006 onwards, every patient in England could choose their hospital for secondary care and hospitals had to compete with each other to attract patients to secure their revenue. One of the central aims of this policy was to create financial incentives for providers to improve their clinical performance. This paper assesses whether this aim has been achieved and competition led to improvements in quality. For our estimation, we exploit the fact that choice-based reforms will create sharper financial incentives for hospitals in markets where choice is geographically feasible and that prior to 2006, in the absence of patient choice, hospitals had no direct financial incentive to improve performance in order to attract more patients. We use a modified difference-in-difference estimator to analyze whether quality improved more quickly in more competitive markets after the government introduced its new wave of market-based reforms. Using AMI mortality as a quality indicator, we find that mortality fell more quickly (i.e. quality improved) for patients living in more competitive markets after the introduction of hospital competition in January 2006. Our results suggest that hospital competition in markets with fixed prices can lead to improvements in clinical quality

Spartan Daily, September 24, 1974

Volume 63, Issue 8https://scholarworks.sjsu.edu/spartandaily/5893/thumbnail.jp