Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study

Objective: To explore general practitioners' perceptions of the effects of their profession and training on their attitudes to illness in themselves and colleagues. Design: Qualitative study using focus groups and indepth interviews. Setting: Primary care in Northern Ireland. Participants: 27 general practitioners, including six recently appointed principals and six who also practised occupational medicine part time. Main outcome measures: Participants' views about their own and colleagues' health. Results: Participants were concerned about the current level of illness within the profession. They described their need to portray a healthy image to both patients and colleagues. This hindered acknowledgement of personal illness and engaging in health screening. Embarrassment in adopting the role of a patient and concerns about confidentiality also influenced their reactions to personal illness. Doctors' attitudes can impede their access to appropriate health care for themselves, their families, and their colleagues. A sense of conscience towards patients and colleagues and the working arrangements of the practice were cited as reasons for working through illness and expecting colleagues to do likewise. Conclusions: General practitioners perceive that their professional position and training adversely influence their attitudes to illness in themselves and their colleagues. Organisational changes within general practice, including revalidation, must take account of barriers experienced by general practitioners in accessing health care. Medical education and culture should strive to promote appropriate self care among doctors.

Politicians, elections and catastrophe: the general election of 1847

Over the last decade, much new research has appeared on the subject of the Great Irish Famine but, remarkably, a major political event during the famine - the 1847 general election - has received virtually no mention. Recent work on politics in this period has tended to concentrate on political reaction in Britain rather than Ireland. The aim of this article is to examine the response of Irish politicians to the famine during the general election of 1847. The main source has been the political addresses and nomination speeches of most of the 140 candidates. The evidence from this material shows that, although the famine was an important matter in many constituencies, it was not the dominant issue countrywide. Various proposals to deal with the famine emerged, but there was an absence of agreed, practical measures to deal with immediate problems. The parties in Ireland failed to create a common platform to challenge the government over its efforts. Ideological constraints played an important part in these failures. The general election of 1847 represents a lost opportunity to tackle some of the effects of the famine.

After Housing Policy: Housing and the UK General Election 2001

This paper describes the results of a review of the housing content of UK General Election 2001 manifestos. Housing policy was of little importance during the election campaign. The main British political parties had, essentially, a shared housing agenda - to promote and facilitate home ownership, support area and community regeneration, tackle homelessness, improve the private rented sector, and prevent building on greenfield sites. Many issues of importance to housing specialists received little or no attention, most notably that of low demand. Some policy variations within the UK were evident, for example in attitudes towards greenfield development, home ownership and stock transfer. The paper concludes that differences in housing policy are emerging within the UK as part of a new politics of devolution and that the days of a single housing policy approach for the UK are over.