Social welfare in a managerial society

Managerialism is a dominant ideology in the institution of social welfare and the profession of social work. Managerialism includes the tools and traditions of modern management. It is also a way of viewing the social world. Managerialism is a useful but limited ideology in social work and social welfare. The benefits of this perspective include the ordering and sanctioning of professional social workers and the application of sophisticated management tools in the institution of social welfare. Managerialism threatens the historic mission and identity of social work and social welfare. The field is challenged to find an institutional niche for those aspects that are outside the mainstream of the commercial culture.     

Out-of-hours care. Co-operative society

The last decade has seen a burgeoning of out-of-hours services in a movement characterized by experimentation and innovation that may have implications for all health services. The system needs to be more integrated to remove duplication and fill existing gaps in the service. But resistance from healthcare professionals is a major barrier. A shift from an out-of-hours emergency service towards 24-hour access for routine healthcare would be unsustainable and have limited health gain. NHS Direct should be the single point of access, with open access to A&E services restricted to people unable to telephone and who require urgent specialist care.     

Bioethics and health care in industrial society

Due to rapid development, industrial societies must now make a fresh start based on a new idea of society which will enable them to survive the fast approaching 21st century. In this situation, health problems must be dealt with not only by medical science but also by research in other areas such as economics and technology. In fact, we are now in a situation in which problems of health and health care can no longer be solved without cooperation from these other research areas. What is most necessary is a new ethical standard. This can be developed through ideas based on a system of bioethics in which Occidental humanism and Oriental humanism are combined to a substantial degree. I believe that the establishment of this type of bioethics can lead to the successful institutionalization of health, health care and welfare for the 21st century.