917
AUDIT OF ACUTE INPATIENT PSYCHIATRIC SERVICE
government-supported documentation centre on alternative to provide scientific information and data on alternative and complementary medicine to the professions, to scientists, and to the general public.
medicine) aims
Whatever the area of medicine, Schoones’ view that more than source of information should be used is sensible. The application of information technology" to information services has many advantages but these do not include simplification of information retrieval. Effective searching is more complex than many suppose. one
Medical Information Service, British Library Document Supply Centre, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, UK
1. Pentelow GM. New
*Refers to admission under Mental Health Act sections.
homeless originate nationwide but tend to gather in specific areas." The logical solution would be to provide central funding for the homeless so that they can have full access to comprehensive psychiatric services in the inner cities. Clinicians and managers alike could then turn their attention to the needs of the homeless mentally ill without the fear that by so doing they will jeopardise the service they can provide to the resident
population. Department of Psychiatry, Middlesex Hospital, London W1 N 8AA, UK
NIGEL R. FISHER STUART W. TURNER ROBERT PUGH
M, Tobiansky RI, Hollander D, Ibrahami S. Psychosis and destitution at Christmas 1985-88. Lancet 1989; ii: 1509-11. Marshall M. Collected and neglected: are Oxford’s hostels for the homeless filling up with disabled psychiatric patients? Br Med J 1989; 299: 706-09. Whitehead T. Closure of psychiatric hospitals. Lancet 1990; i: 172-73. Lethem KR, Pugh CR. Psychiatric illness among the homeless. Br Med J 1989; 299: 1101. Department of Health. Working for patients: working party no 11 (annex 12). London: HM Stationery Office, 1989: 33-35.
1. Weller 2. 3. 4. 5.
Information data bases SiR,—Dr Schoones (Feb 24, p 481) comments on the retrieval of journal literature. The apparently not uncommon supposition that a search of ’Medline’ provides more or less a
medical
complete search of the medical literature is mistaken. About 3000 journals are indexed for Medline. The coverage is international, though there may be some bias towards US journals. Of the titles currently received by the British Library Document Supply Centre about 10 000 are relevant in some way to medicine. Acquisition policy in the UK means that all probably contain substantive material. The US National Library of Medicine takes about 22 000 periodicals but some will be of local interest or of a type with little or no substantive content. These figures suggest that Medline may include up to 40% of the world’s medical literature. This may be the most important 40% but significant material is likely to be excluded. ’Embase’ covers about 5000 journal titles but many are on Medline and a greater proportion are indexed selectively (ie, only items judged relevant by
indexers are taken). These considerations
not only reinforce Schoones’ recommendation about using more than one source but also imply that to create a single comprehensive database for medical journal literature would be a formidable task. Complementary medicine is neglected by both the above two data bases. The British Library’s medical information service has been trying to bridge this gap by compiling a database in these areas and producing a monthly index, listing journal publications many of which are not covered by other information services. This service is provided in cooperation with the Research Council for Complementary Medicine. In the Netherlands, IDAG (a
DAVID ROBERTS
technology in medical libraries. Br MedJ 1989; 298: 907-08.
Scottish health minister breaks the law SIR,-Dr Crawford (March 10, p 609) has been carefully "disinformed". I myself have encountered remarkable coyness on the part of officialdom with respect to the ultra vires position; to be told that "there’s nothing in the Act to say how often SHSPC [Scottish Health Service Planning Council] should meet" verges on the fatuous. I do not believe that there would be no objection to a statutory body charged with "keeping the NHS [National Health in Scotland under review" never meeting. There would be "no difficulty", SHSPC was advised, about it having its last meeting in June, 1989. After that meeting a circular letter signed by Mr Forsyth stated that he had abolished SHSPC. A Scottish Office news release on Oct 4, 1989, expressly indicated that SHSPC had been replaced by the Scottish Health Service Advisory Council. This new body, having been made subservient (in its remit) to the will of the Minister, is not a creation of Parliament but a mere "creature of the Department" that can be killed off at any moment suitable to the Minister and his officials. It has no statutory authority and certainly no statutory right "to advise on its own initiative". After consulting colleagues at the law faculty at Edinburgh University, I criticised these unlawful acts in the Scotsman newspaper and called for a judicial review. Since then (post hoc, ergo propter hoc) SHSPC and the national consultative committees have been "suspended"; but suspension sine die is simply constructive abolition. Unfortunately, there has been no Harry Keen in Scotland. With the connivance of officialdom (which had its own shabby reasons" for wanting to rid itself of SHSPC) a Minister of the Crown, now busy lecturing the Scottish people and some fellow MPs about the need to obey the law and pay their poll tax, has himself without any real opposition from those concerned driven a coach and horses through the British Constitution, in order to neutralise at a crucial moment professional opposition to policies for the NHS which are
Service]
as
half-baked as they are irresponsible?
Mr Forsyth knew only too well what he was about; but Scotland’s doctors, nurses, paramedical staff and others have all been hoodwinked into surrendering during those months when it most mattered their statutory right (won not without a heroic struggle 20 years ago) to advise on their own initiative. In these squalid times, no governmental manoeuvre is too disreputable to be ruled out; and sometimes discretion is the better part of valour. On this occasion, however, in view of opinion poll findings, valour migh have been the better part of discretion. Gogarburn Hospital Voluntary Association, Gogaburn Hospital, Edinburgh EH12 9BJ, UK
DRUMMOND HUNTER, Chairman
1. Hunter TD. Close encounters of the bureaucratic kind. Political
Quart 1987;
April-June. RB, von Otter C. Public competition 1989; 11: 43-55.
2. Saltman
versus
mixed markets. Health
Policy
AUDIT OF ACUTE INPATIENT PSYCHIATRIC SERVICE
government-supported documentation centre on alternative to provide scientific information and data on alternative and complementary medicine to the professions, to scientists, and to the general public.
medicine) aims
Whatever the area of medicine, Schoones’ view that more than source of information should be used is sensible. The application of information technology" to information services has many advantages but these do not include simplification of information retrieval. Effective searching is more complex than many suppose. one
Medical Information Service, British Library Document Supply Centre, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, UK
1. Pentelow GM. New
*Refers to admission under Mental Health Act sections.
homeless originate nationwide but tend to gather in specific areas." The logical solution would be to provide central funding for the homeless so that they can have full access to comprehensive psychiatric services in the inner cities. Clinicians and managers alike could then turn their attention to the needs of the homeless mentally ill without the fear that by so doing they will jeopardise the service they can provide to the resident
population. Department of Psychiatry, Middlesex Hospital, London W1 N 8AA, UK
NIGEL R. FISHER STUART W. TURNER ROBERT PUGH
M, Tobiansky RI, Hollander D, Ibrahami S. Psychosis and destitution at Christmas 1985-88. Lancet 1989; ii: 1509-11. Marshall M. Collected and neglected: are Oxford’s hostels for the homeless filling up with disabled psychiatric patients? Br Med J 1989; 299: 706-09. Whitehead T. Closure of psychiatric hospitals. Lancet 1990; i: 172-73. Lethem KR, Pugh CR. Psychiatric illness among the homeless. Br Med J 1989; 299: 1101. Department of Health. Working for patients: working party no 11 (annex 12). London: HM Stationery Office, 1989: 33-35.
1. Weller 2. 3. 4. 5.
Information data bases SiR,—Dr Schoones (Feb 24, p 481) comments on the retrieval of journal literature. The apparently not uncommon supposition that a search of ’Medline’ provides more or less a
medical
complete search of the medical literature is mistaken. About 3000 journals are indexed for Medline. The coverage is international, though there may be some bias towards US journals. Of the titles currently received by the British Library Document Supply Centre about 10 000 are relevant in some way to medicine. Acquisition policy in the UK means that all probably contain substantive material. The US National Library of Medicine takes about 22 000 periodicals but some will be of local interest or of a type with little or no substantive content. These figures suggest that Medline may include up to 40% of the world’s medical literature. This may be the most important 40% but significant material is likely to be excluded. ’Embase’ covers about 5000 journal titles but many are on Medline and a greater proportion are indexed selectively (ie, only items judged relevant by
indexers are taken). These considerations
not only reinforce Schoones’ recommendation about using more than one source but also imply that to create a single comprehensive database for medical journal literature would be a formidable task. Complementary medicine is neglected by both the above two data bases. The British Library’s medical information service has been trying to bridge this gap by compiling a database in these areas and producing a monthly index, listing journal publications many of which are not covered by other information services. This service is provided in cooperation with the Research Council for Complementary Medicine. In the Netherlands, IDAG (a
DAVID ROBERTS
technology in medical libraries. Br MedJ 1989; 298: 907-08.
Scottish health minister breaks the law SIR,-Dr Crawford (March 10, p 609) has been carefully "disinformed". I myself have encountered remarkable coyness on the part of officialdom with respect to the ultra vires position; to be told that "there’s nothing in the Act to say how often SHSPC [Scottish Health Service Planning Council] should meet" verges on the fatuous. I do not believe that there would be no objection to a statutory body charged with "keeping the NHS [National Health in Scotland under review" never meeting. There would be "no difficulty", SHSPC was advised, about it having its last meeting in June, 1989. After that meeting a circular letter signed by Mr Forsyth stated that he had abolished SHSPC. A Scottish Office news release on Oct 4, 1989, expressly indicated that SHSPC had been replaced by the Scottish Health Service Advisory Council. This new body, having been made subservient (in its remit) to the will of the Minister, is not a creation of Parliament but a mere "creature of the Department" that can be killed off at any moment suitable to the Minister and his officials. It has no statutory authority and certainly no statutory right "to advise on its own initiative". After consulting colleagues at the law faculty at Edinburgh University, I criticised these unlawful acts in the Scotsman newspaper and called for a judicial review. Since then (post hoc, ergo propter hoc) SHSPC and the national consultative committees have been "suspended"; but suspension sine die is simply constructive abolition. Unfortunately, there has been no Harry Keen in Scotland. With the connivance of officialdom (which had its own shabby reasons" for wanting to rid itself of SHSPC) a Minister of the Crown, now busy lecturing the Scottish people and some fellow MPs about the need to obey the law and pay their poll tax, has himself without any real opposition from those concerned driven a coach and horses through the British Constitution, in order to neutralise at a crucial moment professional opposition to policies for the NHS which are
Service]
as
half-baked as they are irresponsible?
Mr Forsyth knew only too well what he was about; but Scotland’s doctors, nurses, paramedical staff and others have all been hoodwinked into surrendering during those months when it most mattered their statutory right (won not without a heroic struggle 20 years ago) to advise on their own initiative. In these squalid times, no governmental manoeuvre is too disreputable to be ruled out; and sometimes discretion is the better part of valour. On this occasion, however, in view of opinion poll findings, valour migh have been the better part of discretion. Gogarburn Hospital Voluntary Association, Gogaburn Hospital, Edinburgh EH12 9BJ, UK
DRUMMOND HUNTER, Chairman
1. Hunter TD. Close encounters of the bureaucratic kind. Political
Quart 1987;
April-June. RB, von Otter C. Public competition 1989; 11: 43-55.
2. Saltman
versus
mixed markets. Health
Policy
