Geographical Aspects of the Illinois Great Rivers Conference, The United Methodist Church

In relation to geography, the Illinois Great Rivers Conference (IGRC) is worthy of close scrutiny. Established in 1996, with a mission to form disciples of Jesus Christ (according to the conference website), the IGRC consists of 10 districts in downstate Illinois. The conference centers on United Methodist churches in the southern three-fourths of Illinois, as seen in Figure 1, and excludes all or part of 15 counties in the northern portion of the state. The other conference in Illinois, the Northern Illinois Conference, is, of course, much smaller in terms of geographical area covered. However, it is almost as big as the IGRC in terms of clergy and churches present because of the urban areas of Cook and surrounding counties. The IGRC is geographical raw material in several ways. First, I will focus on district boundaries, as shown in Figure 2. When looking at the map of the conference, the boundaries of the 10 districts do not seem to follow a consistent pattern. Boundaries sometimes run along county lines, roads, or waterways for a bit, but eventually they follow nothing notable. The boundaries will randomly curve and skew, sometimes multiple times depending on the district. Second, I will discuss the district names, comparing the old naming system to the new and reflecting on interviewee thoughts regarding the two systems. Third, I will examine pastoral migration from one church to another in the conference and talk about the process of assigning pastors. Finally, I will look at cultural geography across the conference and share some cultural facts and impressions that I learned when talking with interviewees

The long term importance of English primary care groups for integration in primary health care and deinstitutionalisation of hospital care

PURPOSE: This article reviews the impact of successive experiments in the development of primary care organisations in England and assesses the long-term importance of English primary care groups for the integration of health and community and health and social care and the deinstitutionalisation of hospital care. THEORY: Governments in a number of Western countries are attempting to improve the efficiency, appropriateness and equity of their health systems. One of the main ways of doing this is to devolve provision and commissioning responsibility from national and regional organisations to more local agencies based in primary care. Such primary care organisations are allocated budgets that span both primary and secondary (hospital) services and also, potentially, social care. METHOD: This article is based on a systematic review of the literature forthcoming from the UK Government's Department of Health-funded evaluations of successive primary care organisational developments. These include total purchasing pilots, GP commissioning group pilots, personal medical services pilots and primary care groups and trusts. RESULTS: Primary care organisations in England have proved to be a catalyst in facilitating the development of integrated care working between primary and community health services. Conversely, primary care organisations have proved less effective in promoting integration between health and social care agencies where most progress has been made at the strategic commissioning level. The development of primary care trusts in England is heralding an end to traditional community hospitals. CONCLUSIONS: The development of primary care groups in England are but an intermediate step of a policy progression towards future primary care-based organisations that will functionally integrate primary and community health services with local authority services under a single management umbrella

Creating an integrated public sector? Labour's plans for the modernisation of the English health care system

The current Labour Government has embarked on radical public sector reform in England. A so-called ‘Modernisation Agenda’ has been developed that is encapsulated in the NHS Plan—a document that details a long-term vision for health care. This plan involves a five-fold strategy: investment through greater public funding; quality assurance; improving access; service integration and inter-professional working; and providing a public health focus. The principles of Labour's vision have been broadly supported. However, achieving its aims appears reliant on two key factors. First, appropriate resources are required to create capacity, particularly management capacity, to enable new functions to develop. Second, promoting access and service integration requires the development of significant co-ordination, collaboration and networking between agencies and individuals. This is particularly important for health and social care professionals. Their historically separate professions suggest that a significant period of change management is required to allow new roles and partnerships to evolve. In an attempt to secure delivery of its goals, however, the Government has placed the emphasis on further organisational restructuring. In doing so, the Government may have missed the key challenges faced in delivering its NHS Plan. As this paper argues, cultural and behavioural change is probably a far more appropriate and important requirement for success than a centrally directed approach that emphasises the rearrangement of structural furniture