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Management for Child Health Services
  1. R J Jefferson

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Children's services have increasing priority with the present government in the UK. If we are to use available resources wisely and provide the “seamless service” that children and their parents deserve, then we need good managers to oversee its delivery. Who are these people and where are they found? The editors of this book believe that “all involved in child health are, by definition, involved in its management”—so that none of us is excluded—and that “they should have the benefit of material drawn together specifically for this purpose”—material which they have sought to provide.

For me, much of this book was virgin territory, and I found it a good, readable introduction, and an information resource upon which I will draw in the future. Those with more experience would also find it useful. It is in no way a reference text book, but contributors from child health, legal, and management fields bring their experience together to cover the many different aspects involved in managing a service. Useful references are supplied at the end of each chapter for those who wish to delve further. The first chapter comprises a brief historical review of child health services during the twentieth century, and one realizes the degree of expansion from small and inauspicious beginnings. Later chapters are devoted to such topics as management skills, models of service quality, audit, finance, risk control, and management. Issues around the partnership of care with parents and carers are explored, and interagency working—never easy to carry out in practice—forms the basis of another chapter. A particularly interesting and informative chapter was written as a case study of the establishment and running of an integrated secondary level child health service. Another chapter, which was perhaps a little easier reading, discussed legal and ethical principles relevant to child health using a hypothetical, if perhaps slightly artificial, family case history of a baby born with significant disability to a single mother who is also facing adolescent health issues in her teenage daughter. The final section is devoted to the services in the four countries comprising the UK, each with unique values and approaches, although built upon a common base.

As child health services and service plans continue to evolve, there is much we can learn from the experience of those who have been involved in establishing our present services—we must avoid their pitfalls and follow their successes. The book was written before the most recent service changes involving the establishment of Primary Care Trusts, and one can only conjecture what a revised version will contain after “the next 10 years”. Will we, the present day paediatricians, leave a similar legacy for our successors?

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