Review of the Federal Department of Justice Investigation of California State Mental Hospitals

Today we are going to be talking about the investigations in our state hospital system by the United States Department of Justice. In both their reviews of the children\u27s and adult programs at Metropolitan State Hospital in Southern Califomia, as well as the more recent review in Napa State Hospital, the Department of Justice found significant and substantial deficiencies in virtually every aspect of patient care. Sadly, this is not the first time such concerns have been raised. And sadly and alarmingly, since the issuance of these reports, problems have continued, including suicides and homicide. Additionally, as noted in the report on Napa State Hospital, the Department of Justice has alleged that the state denied them access in conducting their review. This is an alarming accusation that needs to be addressed and is one of the purposes of today\u27s hearing. Our goal today is to understand the issues raised in the Department of Justice report, of the department\u27s response to them, what we must do to improve the quality of care in these facilities, and what the implications are if we don\u27t improve the care. I hope we can have a frank discussion about what it will take on all of our parts to create the kind of safe and positive environment I know we all strive for in our state hospitals. And in fact, I represent the right of patients to have that type of positive environment

Review of the Federal Department of Justice Investigation of California State Mental Hospitals

Today we are going to be talking about the investigations in our state hospital system by the United States Department of Justice. In both their reviews of the children\u27s and adult programs at Metropolitan State Hospital in Southern Califomia, as well as the more recent review in Napa State Hospital, the Department of Justice found significant and substantial deficiencies in virtually every aspect of patient care. Sadly, this is not the first time such concerns have been raised. And sadly and alarmingly, since the issuance of these reports, problems have continued, including suicides and homicide. Additionally, as noted in the report on Napa State Hospital, the Department of Justice has alleged that the state denied them access in conducting their review. This is an alarming accusation that needs to be addressed and is one of the purposes of today\u27s hearing. Our goal today is to understand the issues raised in the Department of Justice report, of the department\u27s response to them, what we must do to improve the quality of care in these facilities, and what the implications are if we don\u27t improve the care. I hope we can have a frank discussion about what it will take on all of our parts to create the kind of safe and positive environment I know we all strive for in our state hospitals. And in fact, I represent the right of patients to have that type of positive environment

Being there: Public health needs a public face

It seems that business knows a thing or two about reputation management. Social marketers – and the public health community -should pay heed, because when it comes to behaviour change, reputation matters. If you don’t believe this, just ask anyone working in infant immunisation. So how is it done? How can a corporation which is legally obliged to put its shareholder’s interests first trump a health service whose raison d’être is public welfare? How come, for instance, that for the best part of thirty years the UK Government listened to the weasel words of the tobacco industry and left advertising to an obviously failing self regulatory system? How come that it has been seduced into making the same mistake for alcohol

Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process