Doctors under the microscope: the birth of medical audit

In 1989 a UK government White Paper introduced medical audit as a comprehensive and statutory system of assessment and improvement in quality of care in hospitals. A considerable body of research has described the evolution of medical audit in terms of a struggle between doctors and National Health Service managers over control of quality assurance. In this paper we examine the emergence of medical audit from 1910 to the early 1950s, with a particular focus on the pioneering work of the American surgeons Codman, MacEachern and Ponton. It is contended that medical professionals initially created medical audit in order to articulate a suitable methodology for assessing individual and organisational performance. Rather than a means of protecting the medical profession from public scrutiny, medical auditing was conceived and operationalised as a managerial tool for fostering the active engagement of senior hospital managers and discharging public accountability. These early debates reveal how accounting was implicated in the development of a system for monitoring and improving the work of medical professionals, advancing the quality of hospital care, and was advocated in ways, which included rather than excluded managers

Current Issues In Comparative Psychology -- Recognition of Humans by Animals

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A New Revision of the EU Treaties After Lisbon?

This chapter assesses the need for a revision of the Treaty of Lisbon. I start out by arguing that a revision should address economic, institutional, and constitutional issues. I then analyse the different revision instruments introduced by the Lisbon Treaty. This will make it possible to understand what procedures may be required to amend the existing Treaties in crucial areas. Finally, I explore the possibility of revisions on a smaller scale, as a means of differential integration

Adaptation for autonomy? Candidates for EU membership and the CFSP

This paper looks at the specific situation of those European states currently candidates for accession to the European Union. These countries are expected to align their domestic laws and policies with the EU “acquis” to fulfil the admission criteria. Foreign policy is no exception. Indeed, the EU Common Foreign and Security Policy has become an increasingly significant part of the accession conditionality since the countries from south-east Europe embarked on the membership course. Arguably, the obligation to adapt to EU norms in the area of CFSP is stronger for candidates than for existing members of the EU. As a result, candidates might eventually enjoy more foreign policy autonomy once inside the EU than they did before accession. There is a risk that this discrepancy between the requirements of pre-accession adaptation and the relative post-accession autonomy may have a negative impact on integration in the field of foreign policy.The progression of EU law: Accommodating change and upholding value

The Court of Justice of the European Union as a self-made statesman

The Court of Justice of the European Union (CJEU) has some basic structural features similar to that of most judicial bodies. According to the treaties, the members of the Court are chosen from individuals whose independence is beyond doubt and who possess the ability required for appointment to higher judicial offices. The involvement of the Court and its president in the most important reforms of the European Union's judicial architecture in recent years is a striking feature which may be called judicial self-government. International courts have shifted away from being principally committed to dispute settlement towards pursuing other goals, such as advancing international norms and facilitating cooperative international arrangements. The reinforcement of the cooperation of the Court with national courts on the one hand, and with international courts and tribunals on the other, is one of the great current challenges facing the Court