Creating and recreating the NHS: the importance of ensuring nurse involvement.

AIM: The aim of this paper was to examine the consequences of the lack of a formal role for nurses within the administrative structure of the NHS between 1948 and 1966. BACKGROUND: UK health policy since 1997 has emphasized the need to re-create the NHS as a modern, dependable service, with clinicians leading the changes. Over the same period, restructuring of the bodies that determine the planning and provision of NHS services has resulted in fewer places for nurses on key decision-making bodies. EVALUATION: Exclusion from formal decision-making roles in the health committees of the NHS during its first two decades considerably limited the influence that nurses could exert over their own work and the circumstances in which they performed their duties. KEY ISSUES: Nurses should recognize the importance of involving themselves in the politics of health and of health service delivery. CONCLUSIONS: Nurses are unlikely to be able to deliver the changes in healthcare that current Department of Health policy anticipates without access to political and economic, as well as clinical, influence in the NHS. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing leaders should continually press the Department of Health to guarantee places for nurses at all levels of decision-making in the NHS and seek assurances that further restructuring will not result in further losses.

Community participation in health care: the Turkish case.

World Health Organization's global goal of Health for All by the Year 2000 (HFA) and achievement of this laudable goal through the Primary Health Care (PHC) approach has been accepted unanimously by participant countries of the Alma-Ata Conference in 1978. Turkey is also among the countries that showed their approval to the concept. However, that approval of the policy did not generate particular attention among the policy-makers until the 1990s. The year 1990 can be regarded as a watershed in the Turkish health policy-making environment as attempts at producing a National Health Policy document that centred around the global goal of HFA and PHC commenced. This paper aims at discussing the commitment of Turkey to one of the prerequisites of the approach, or heart of the PHC as regarded by some: community participation. After a brief presentation of community participation the Turkish commitment to the concept is analyzed based on a research carried out among Turkish health policy-makers. It is concluded that the prospect for community participation in Turkey does not look good mainly because of the medical approach adopted by the policy-makers. The need for more discussion of the topic among the academic circles has been emphasized.

Historia de la Sanidad Militar en el Paraguay: su creación

Resumen historico de la creación y de la organización de la Sanidad Militar, que en este trabajo comprende desde su creación, 20 de mayo de 1819, hasta la gran epopeya heroíca de 1864-1870. (AU)