Exploring distributive justice in health care.

The allocation of resources to providers and the way in which the resources are then prioritised to specific service areas and patients remain the critical ethical decisions which determine the type of health system a community receives. Health care providers will never be given enough resources to satisfy all the demands placed upon them by a community that is becoming increasingly informed and demanding. This paper discusses the matter of justice as it relates to the distribution of health resources. It translates the theoretical constructs of distribution into a practical situation that arose at The Geelong Hospital. It is important to emphasise that the aim of giving the example is not necessarily to provide the right answer but rather to assist in determining what ought to be the questions.

Alzheimer patients' ability to read words with irregular stress.

The TIB, an Italian version of the National Adult Reading Test (NART), requires the subject to read out a list of Italian words with a dominant (regular) and a less frequent (irregular) stress pattern. It was given to a group of 45 patients with a diagnosis of dementia of Alzheimer type (DAT) and to a matched control group. Both the NART and the TIB are based on the assumption that the ability to translate orthography into phonology is relatively unimpaired in DAT patients. Despite the different language characteristics on which the two tests are based, the present results largely replicate those found for the NART. Patients with mild and moderate DAT did not perform differently from matched controls on the TIB, while they were impaired on the NART. Patients with severe dementia, however, also failed in the TIB test.

Assessing staff morale through a staff opinion survey.

This paper reports the results of a staff opinion survey conducted at a 309-bed Victorian public hospital. The reasons for the survey were to measure staff morale and attitudes across all the departments of the hospital. Staff members were able to participate in the survey, by completing a questionnaire which was distributed to all staff. The overall results indicate that staff members of Frankston Hospital consider they operate in a healthy working environment. Staff from some departments within the hospital responded to several questions in a manner that required further investigation. These have since been actively discussed and decisions taken to overcome them.

The Victorian Management Residency Programme.

This paper describes an innovative approach to the development of health managers in the Victorian health system. Under what is known as the Management Residency Programme, young graduates are recruited to undertake a rigorous two year programme which blends the academic specialisation necessary for health managers, with the techniques of action learning available through exposure to a range of management situations in various field placements. The proponents of action research are seriously challenging the traditional approach to management education and the Management Residency Programme provides a unique opportunity to maximise the benefits of each philosophy.

Economics, dollars and nursing practice.

Primary production and overseas debt seem a far cry from nursing practice but its import on the Australian economy has far reaching effects on how our health and hospital system is funded. This article covers a good deal of territory from a broad consideration of health economics and the relevance of traditional market theory to health, to the fiscal problems of State administration and how these are placing pressures on individual hospitals. The article concludes with some of the strategies open to the nursing profession and concludes that a participative model of joint decision-making is an integral element in meeting a changing environment.