Cochrane, D. A
(1991)
The AEGIS campaign to improve standards of care in mental hospitals: A case study of the process of social policy change.
PhD thesis, London School of Economics and Political Science.
Abstract
This study explores the process of decision-making in central government health policy. It also documents the history of the pressure group Aid for the Elderly in Government Institutions (AEGIS) and thus the career of its Chairman Mrs Barbara Robb as a social reformer. There are two major arguments in the thesis. Firstly, the study demonstrates that AEGIS played the key role in initiating and sustaining the extraordinary succession of scandals in the mental hospital service between 1965 and 1975 and that these were one of the major determinants of policy between 1970 and 1980. There are two broad areas of policy. The establishment of mental illness and mental handicap as priority services. Empirical evidence is presented to support the argument that the policy has achieved a considerable measure of success. The second area is the redress of grievances in the NHS through the development of formal complaints procedures, special inquiries and the Health Commissioner, where the conclusions are that reforms have been largely cosmetic and largely unaffected the established autonomy of the medical profession to investigate allegations of performance failure brought against its members. Secondly, none of the major competing models of state activity gives a complete understanding of the process of change in the study. The policy process in mental health thus emerges as an example of the professionalised state thesis in neo-pluralism, set within an ideological framework which establishes medicine as the dominant profession.
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