Quangos and HIV

posted: 15/10/2010

The government promised a bonfire of the quangos, but it seems that beneath the surface not a lot will change for HIV. Two HIV advisory groups are scrapped, the Health Protection Agency will go, and the Equality and Human Rights Commission (EHRC) will be reformed, the Cabinet Office said.
 

Not a lot will change with the scrapping of the two HIV advisory groups. They don’t really disappear at all. One will be reincarnated as a Department of Health / Public Health Service committee of experts, and the other will be reborn as a stakeholder advisory group. Will anyone be able to tell the difference – we don’t think so.

The Health Protection Agency will be abolished and its work transferred to the proposed Public Health Service. Details have not been published.

The EHRC will be reformed but there are no details yet. An EHRC spokeswoman said that the situation was currently "largely speculative" and any proposed changes would be subject to wider consultation. The government is understood to be keen to "streamline" the commission and part of its work may be incorporated into the Government Equalities Office. A Government Equalities Office spokesman said the commission's work was currently being assessed with decisions to be made later in the year.
 

List of Quango changes

Policing Expert Patients

posted: 15/04/2010

The Expert Patients Programme (EPP) is to help people manage their own long term conditions better. A special version of the course is occasionally run by and for people living with HIV at BPNW in NW England.
 

There's an online version of the Department of Health Expert Patients Programme for the general public. Some of the people who joined that course decided to become course tutors and trainers for the EPP.

How well do those non-professional health staff – the online EPP tutors – engage, guide and attempt to manage people with long-term conditions to be ‘good’ self-health managers?

This study by Manchester University gives an insight into the good cop / bad cop roles some online EPP tutors take on. Some tutors attempt to ‘police’ people learning how to health self-management, and other tutors try to boost people’s mental state and skills. 

Moral tones and judgements

The moral tone that tutors sometimes use shows their ignorance of theories and methods used by adult educationalists (where the educator is to enable and support the pupil to learn for themselves, not tell them off), as well as the strong need they felt to stand up for the EPP. Being strong advocates meant they defended the course, even when it at times caused obvious upset, such as during the session on Living Wills.
 

Policing gave tutors permission to comment on participants' behaviour in ways which were not motivating or enabling, but which adopted a moral tone about expectations of normal good behaviour.
'I'm sure you are fully aware that comfort eating does exactly the opposite to what we would like to happen' (class 67)

There's a lot that is good about EPP, but online tutors can undermine some of the benefits by moralising and criticising behaviour that is judged to be less than perfectly healthy.

Full article free  BMC Health Services Research 2009, Volume 9, Issue 93