Article contents
Representing the Interests of the Public?: The Case of the Local Health Council in Scotland*
Published online by Cambridge University Press: 20 January 2009
Abstract
The statutory function of local health councils in Scotland (and of community health councils in England and Wales) is to represent the interests of the public in the health service. This article, based on data from a fouryear research project financed by the Scottish Office, examines official and participants' assumptions and claims about the legitimacy of health councils, as at present constituted, to carry out this function. Clarification of the basis of their legitimacy would assist, it is argued, in the resolution of a central dilemma: How are councils to represent the interests of the public? The conclusion is reached that inadequate thought was given to developing theoretically sustainable arrangements. Several interpretations of representation are admixed in the rationale for the present system and they cannot be aggregated to produce a coherent defence of it.
- Type
- Articles
- Information
- Copyright
- Copyright © Cambridge University Press 1979
References
1 See Scottish Home and Health Department (SHHD), National Health Service (Scotland) Act 1972 Local Health Councils, Preparation of Schemes, NHS Circular 1974 (GEN) 38, Edinburgh, 8 07 1974.Google Scholar
2 National Health Service (Scotland) Act 1972, S. 14(1).Google Scholar
3 874 questionnaires were sent out to local health council members, and 580 replies were received, a response rate of 66.4 per cent.
4 Klein, R. and Lewis, J., The Politics of Consumer Representation, Centre for Studies in Social Policy, London, 1976.Google Scholar
5 House of Lords Debates, Vol. 327, col. 1, 116.
6 The Hospital and Health Services Review, 71:9 (1975), 317.Google Scholar
7 Birch, A. H., Representation, Macmillan, London, 1971.CrossRefGoogle Scholar
8 Pitkin, H. F., The Concept of Representation, University of California Press, Berkeley, 1967.Google Scholar
9 Ibid.
10 Report of the Royal Commission on Local Government in Scotland 1966–69, Appendices, HMSO, London, 1969.Google Scholar
11 Report of the Committee on the Management of Local Government (Maud Report), Vol. 2Google Scholar, The Local Government Councillor, HMSO, London, 1967.Google Scholar
12 Ibid.
13 See for example Timms, D. W. G., ‘The Distribution of Social Defectiveness in Two British Cities: A Study in Human Ecology’, unpublished doctoral dissertation, University of Cambridge, 1963Google Scholar, quoted in Timms, D. W. G., The Urban Mosaic, Cambridge University Press, Cambridge, 1971CrossRefGoogle Scholar; Pyle, G. F., ‘Some Examples of Urban Medical Geography’, unpublished doctoral dissertation. University of Chicago, 1968Google Scholar, quoted in Herbert, D. T., Urban Geography, David and Charles, Newton Abbot, 1972Google Scholar; and Douglas, J. W. B., Children Under Five, Allen and Unwin, London, 1958.Google Scholar
14 See for example Cartwright, A. and O'Brien, M., ‘Social Class Variations in Health Care and in the Nature of General Practitioner Consultations’, in Stacey, M. (ed.), The Sociology of the NHS, University of Keele, 1976.Google Scholar
15 Klein and Lewis, op. cit.
16 General Register Office, Census 1971 Scotland: Housing Report, HMSO, Edinburgh, 1975.Google Scholar
17 Office of Population Censuses and Surveys, Social Survey Division, The General House hold Survey 1974, HMSO, London, 1977.Google Scholar
18 Birch, op. cit.
19 The Notional Health Service and the Community in Scotland, SHHD, HMSO, Edinburgh, 1974.Google Scholar
20 House of Lords Debates, Vol. 328, col. 697.
21 The National Health Service and the Community in Scotland.Google Scholar
22 See for example NHS Circular 1974 (GEN) 38; Reorganisation of the Scottish Health Services, SHHD, Cmnd 4734, HMSO, Edinburgh, 1971Google Scholar; and SHHD, Local Health Councils, NHS Circular 1974 (GEN) 90, Edinburgh, 1974.Google Scholar
23 Consumer Council, Consumer Consultative Machinery in the Nationalised Industries, HMSO, London, 1968.Google Scholar
24 House of Lords Debates, Vol. 328, col. 697.
25 Klein and Lewis, op. cit.
26 The generally low level of claims to represent specific interests must be appreciated in the light of official exhortation to put such interests aside (see p. 463 of the text).
27 National Health Service (Scotland) Act 1972, S. 14.Google Scholar
28 SHHD, The Constitution and Functions of Local Health Councilş: A Discussion Paper, Edinburgh, 1973.Google Scholar
29 STUC, Seventy-Seventh Annual Report, Glasgow, 1974.Google Scholar
30 DHSS Circular HC(7b) 25, 1976.
31 Community Councils, Scottish Development Department, HMSO, Edinburgh, 1974.Google Scholar
32 Smith, C. and Freedman, A., Voluntary Associations, Harvard University Press, Cambridge, Massachusetts, 1972Google Scholar; and Report of the Committee on Local Authority and Allied Personal Social Services (Seebohm Report), Cmnd 3703, HMSO, London, 1968.Google Scholar
33 The Future of Voluntary Organisations (Wolfenden Report), Croom Helm, London, 1978Google Scholar; and Smith and Freedman, op. cit.
34 Administrative Reorganisation of the Scottish Health Services, SHHD, HMSO, Edinburgh, 1968.Google Scholar
35 See NHS Circular 1974 (GEN) 38.Google Scholar
36 SHHD-DS (74) 148, 11 July 1974.Google Scholar
37 The Royal British Legion Scotland, Claymore, 26:6 (1975), 13.Google Scholar
38 See NHS Circular 1974 (GEN) 38.Google Scholar
39 Parliamentary Debates, First Scottish Standing Committee, 13 June 1972, col. 244.Google Scholar
40 Murray, G., Voluntary Organisations and Social Welfare: An Administrator's Impressions, Oliver and Boyd, Edinburgh, 1969.Google Scholar
41 Speech to the inaugural meeting of the Association of Scottish Local Health Councils, 30 September 1977.Google Scholar
42 NHS Circular 1974 (GEN) 90.Google Scholar
43 The Hospital and Health Services Review, 71:9 (1975), 318.Google Scholar
44 Scottish Council of Social Service, comments on SHHD, The Constitution and Functions of Local Health Councils: A Discussion Paper, 07 1973, Edinburgh, 11 1973.Google Scholar
45 The National Health Service and the Community in Scotland.Google Scholar
46 Scottish Council of Social Service, op. cit.
47 See NHS Circular 1974 (GEN) 38.Google Scholar
48 The Hospital and Health Services Review, 71:7 (1975), 241.Google Scholar
49 House of Lords Debates, Vol. 328, col. 697.
50 The Hospital and Health Services Review, 71:9 (1975), 318.Google Scholar
51 The National Health Service and the Community in Scotland.
52 Association of Scottish Local Health Councils, Local Health Council Factsheet, Edinburgh, 1978.Google Scholar
53 Klein and Lewis, op. cit.
54 Report of the Committee on the Management of Local Government, Vol. 2.Google Scholar
55 See for example Report of the Committee on the Management of Local Government, Vol. 3Google Scholar, The Local Government Elector, HMSO, London, 1967Google Scholar; Hausknecht, M., The Joiners, The Bedminster Press, New York, 1962Google Scholar; Bottomore, T. B., ‘Social Stratification in Voluntary Organisations’, in Glass, D. (ed.), Social Mobility in Britain, Routledge and Kegan Paul, London, 1954Google Scholar; and Aves, G., The Voluntary Worker in the Social Services, Allen and Unwin, London, 1969.Google Scholar
56 Klein and Lewis, op. cit.
57 Hampton, W., Democracy and Community, Oxford University Press, Oxford, 1970.Google Scholar
58 Eulau, H. and Prewitt, K., Labyrinths of Democracy, The Bobbs-Merrill Company, Indianapolis, 1973.Google Scholar
59 Newton, K., ‘Links between Leaders and Citizens in a Local Political System’, Policy and Politics, 1:4 (1973), 287–305.CrossRefGoogle Scholar
60 Community Councils.
61 Lindblom, C. E., ‘The Science of “Muddling Through”’, Public Administration Review, 19:2 (1959), 79–88.CrossRefGoogle Scholar
62 May, D. and Smith, G., ‘Policy Interpretation and the Children's Panels: A Case Study in Social Administration’, Applied Social Studies, 2 (1970), 91–8.Google Scholar
- 4
- Cited by