Patients First — Reality or Rhetoric?

This paper will argue that the NHS, despite its aspirations to provide a universal service of excellence, has not been historically very responsive to the consumers it serves. Under the present Government this attitude has ostensibly changed. “Patients First” has become a catch phrase both nationally and at the local level in Brighton Health District. A recent CHC survey of consumers' rections to service revealed however that many elderly patients were not consulted in any meaningful way about their needs on discharge from hospital. Why does the reality of consumerism not match the rhetoric? A number of potentially explanatory factors are identified and their relevance evaluated in the context of Brighton CHC's research. It is suggested that the currently fashionable consumerism represents a different concept from active participation which would necessarily involve a fundamental realignment of the NHS.     

Family Therapy Process in a Family Therapy Seminar

The interaction between leaders and members in a year-long family therapy seminar is systematically compared to the process that unfolds between therapist and family during the course of family therapy. A five stage developmental process common to both is postulated and described: (1) Battle for Structure, (2) Naive Enthusiasm, (3) Conflictual Frustration, (4) Task Orientation, and (5) Mutuality. The dynamic elements of each stage are analyzed and factors affecting their development are identified. It is concluded that this five stage process occurs in all similar groups, but that the content of each stage may vary widely from group to group.     

Effects Of The Number And Spacing Of Children On Marital And Parental Satisfaction

Analyzing data from a fifteen-year follow-up study of high school students originally surveyed in 1957–58 and resurveyed in 1973–74, this paper examines the effects of the number and spacing of children on marital and parental satisfaction. The results suggest that the number of children in the family has no direct effect on marital satisfaction but has a direct negative effect on parental satisfaction. Childspacing, as measured by the length of the average birth interval, is found to have no significant effect on either marital or parental satisfaction. Premarital pregnancy has a negative effect on both the marital and parental satisfaction of women.