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This paper discusses the main ideas of the Diversity Based approach to culturally sensitive practices in health and social care services.This approach is important in emphasizing the fluid nature of culture, the diversity in cultural groups and the impact of inegalitarian and racist power relations on their life. Chinese people in the UK are used as an example to demonstrate how exploration of the diversity of ethnic minority groups could strengthen cultural sensitivity. Some methods for the realization of the Diversity Based approach, such as the culturagram and user involvement, have also been highlighted. [ABSTRACT FROM PUBLISHER]

This paper contrasts the views of two prominent politicians on the ways in which the distribution of hospital services should be organised, and relates them to the views of Hayek on the nature of planning. It is argued that, in relying on an independent regulator to supervise access to health care under the new 'foundation' hospitals regime in the English National Health Service (NHS), not only is the Labour government distancing itself clearly from old-style top-down planning, it also risks greater variability in the definition of fair access to health care. There are relevant historical parallels with the mixed economy of the pre-NHS era that policy-makers should make explicit. [ABSTRACT FROM AUTHOR]

Taking a social model of disability approach, this article explores how disabled people negotiate barriers in the large, modern hospital settings typically found in complex healthcare systems. While there is evidence of intractable barriers in the United Kingdom's National Health Service, little is known about the actions disabled people take in the face of barriers and the immediate effects of doing so. Analysis of data from a qualitative study of disabled people's healthcare encounters is presented. This draws on the concept of threats to embodied well-being to understand how disabled people perceive barriers and the influence this perception has on barrier negotiation. It demonstrates that some barriers are unique to healthcare and that these place disabled people in situations where their well-being is threatened. Despite these situations being inherently disempowering, disabled people are forced to take whatever action they can to protect the embodied self. We theorise that barriers are created inadvertently by the design, organisation and healthcare practices characteristics of modern hospital settings. Effective barrier removal requires understanding not only their impact on disabled people's embodied well-being, but also the political, policy and social relations implicated in their creation. [ABSTRACT FROM AUTHOR]

The Health and Social Care Bill proposes clinically led commissioning. The new Clinical Commissioning Groups will become statutory bodies and replace the old primary care trusts. This primary legislation will transfer accountability for health care spending to clinicians who will have a duty to meet the health needs of a population as well as balance a budget. This change gives rise to a number of ethical issues which are explored in this article. [ABSTRACT FROM AUTHOR]

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Calls for the treatment of chronic fatigue syndrome (CFS) in primary care have been based largely on considerations of the availability and accessibility of resources rather than with reference to a firm evidence base. Treatments such as cognitive–behavioural therapy and graded exercise therapy, which have proven effective for CFS in secondary and specialist care settings, have not been adequately tested in primary care. There are several factors that may affect the generalizability of such treatments. Patients seen in primary care may differ from those seen in secondary care, in terms of both illness beliefs and social characteristics, and these factors need to be taken into account when developing and adapting treatments for primary care. While some primary care physicians experience difficulties in the diagnosis of CFS, we argue that early and authoritative diagnosis and the provision of a tangible explanation for patients' symptoms are likely to be beneficial. Because of the scarcity of qualified specialist therapists, we need to train primary care practitioners to deliver treatments, and we need more research into the feasibility and effectiveness of doing this. Finally, the primary care setting offers opportunities for the guided development of patient self-help approaches. [ABSTRACT FROM AUTHOR]