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Biomedical subjects

C Ham

Publications and source records attributed to C Ham.

At least 73 records · Page 4Linked to original sources
PubMed1993

The primary healthcare/hospital interface.

In this paper, the author attempts to review the changing relationship between primary care and hospital care. In doing so, he draws on recent experience in the UK which has sought to strengthen the role of primary care services. This has centred on a new employment contract for general practitioners (GPs) and the introduction of the GP fundholding scheme. Both reforms represent a radical change from past practice and illustrate both the opportunities and the risks involved in introducing new financial arrangements in the primary care sector. Not only does he comment on UK experience, but he also make brief references to broader trends in health services reform in various other countries, giving the speech a truly international dimension.

Economic Competition↗
PubMed1992

Local heroes.

Explore the source record for details and available documents.

Decision Making, Organizational↗
PubMed1992

Contract culture.

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Continuity of Patient Care↗
PubMed1992

Reforming the Swedish health services: the international context.

This article reviews the performance of Swedish health services in the international context. It notes that Sweden stands out as a country which has made a major commitment to the welfare state. Nowhere is this more evident than in the health services. Expenditure on health care is high by international standards and over 90% of expenditure derives from public sources. Despite Sweden's achievement in providing comprehensive health care to its population, a number of problems have emerged in recent years. In response to these problems, there has been a debate about options for reform. It is suggested that management reforms may offer the best way forward in improving the performance of health services. Policy makers should take advantage of the decentralised nature of the Swedish system to initiate and evaluate different reforms in different county councils.

Canada↗
PubMed1992

Future directions.

In this final paper, we summarise briefly the principal conclusions to emerge from the conference. We also review possible future directions in the light of the contributions of different authors and discussions at the conference. The paper argues that changes in the Swedish health services are both inevitable and desirable. The challenge is to maintain the strengths of the existing system while tackling widely acknowledged weaknesses. It is not yet clear what will emerge from the process of reform but the probable outcome is a period of innovation and experimentation leading to greater diversity in service provision. We argue that diversity is most likely to develop within the context of a continuing commitment to equity and comprehensiveness in the delivery of health care.

Economic Competition↗
PubMed1991

Happy ever after?

Health authorities are responding to the NHS reforms with a variety of approaches to joint purchasing, some in collaboration with FHSAs. Chris Ham and Chris Heginbotham explore the future of these relationships.

Purchasing, Hospital↗
PubMed1991

How to make a future champion.

Conflict between GP fundholders and health authorities could blow the health reforms apart--but co-operation could help improve the nation's health, argue Chris Ham and Chris Heginbotham.

Community-Institutional Relations↗
PubMed1991

So far, so good?

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Contract Services↗
PubMed1991

Analysis of health policy--principles and practice.

Health policy analysis covers a wide range of activities: from university-based research to practical activities carried out by bureaucrats and professionals working within the health system with independent unit or think tanks for health policy analysis as a third alternative. A key distinction is between analysis of policy and analysis for policy, which has eight key features: problem-centered; bias to facts and data; multidisciplinary; emphasis on feasibility; uses techniques and political awareness; quantitative and qualitative analysis; role of values; and timing of analysis. Decision-making is not a rational, logical process in which information and research determine policy outcomes, but a highly political process in which power and interest are the main driving forces. Health policy analyses can make a small contribution. Communication and salesmanship must go hand in hand with good academic techniques if research is to influence policy.

Bias↗