Managed care has emerged as the dominant method of health care provision in the United States. Managed care systems, in assuming responsibility for both the financing and provision of health care, present new problems for health care practitioners. The primary care practitioner, has been put in the position of gatekeeper, whose responsibilities include cost containment as well as patient care. Our understanding of the impact of managed care on medical practice is evolving. Many physicians believe that managed care has significant negative effects on the physician-patient relationship, the ability to carry out ethical obligations, and on quality of patient care. These results have implications for health care system reform efforts.
Dwayne Brooks suggested an important area for progression was the “introduction of appropriately trained family liason officers in critical incident” (Parliament, 2009). The report highlights that this key improvement in police procedure surrounding appropriate training for family liason officers to deal with critical incidents has improved family liason officer’s ability to be able to ‘maintain relationships with families’, whilst obtaining necessary evidence and improving confidence in the police within the black community (Parliament, 2009). Thus, suggesting that this change in policing procedure and policy, due to the Macpherson report, has had a positive effect, especially within the ethnic community. The report also highlights that this change in policing procedure and policy has positively affected homicide detection rates which the report indicated at 90%, which is “the highest of any large city in the world” (Parliament,2009).
However, there are still issues surrounding police procedures especially within ethnic minority communities, in which the Macpherson report improvements may not have positively been actioned. This can be seen in the stop and search rates; policing statistics published by the government for the time period of 2016/2017 suggests that the ratio for white individuals stopped and searched was 4:1000 whereas the ratio for black individuals was 29:1000 (Gov, 2018). Thus, suggesting that police are stopping more black individuals that white, which may still suggest an element of institutional racism in the way police conduct this procedure.
The prison reform trust also highlights an over representation of Black minority ethnic groups (BMES) in prisons with the supporting evidence of the Lammy review, the reform trust suggests that there is a clear correlation between the ethnicity of an individual and custodial sentences being issued (Prison reform trust, 2019). Thus, suggesting discrimination in police procedures and the court system. Therefore, this may suggest that the Macpherson reports improvements have not positively been actioned in some elements of the criminal justice system.
In conclusion, where the recommendations have been put into place and are actively being worked upon, the Macpherson report has provided positive effects on police procedures and policy. However, evidence such as the stop and search statistics shows that there are still issues in policing procedures and
