Health and Exclusion Policy and Practice in Health Provision

While practices and policies of exclusion have always characterized health care systems and the professional groups who work with them, wide global structural changes have increased the focus on exclusion as a key theme in health care. Bringing together contributors from a wide range of backgrounds, "Health and Exclusion" examines a sample of the policies and practices of exclusion currently experienced by health "customers" and by health professionals. It documents examples of exclusion and addresses a variety of related issues, including the implications of exclusion in health care for the work of health professionals and ways in which the experience of exclusion and its related structures might be challenged. Other topics include barriers to recruitment and career advancement in the health professions, processes of change which challenge the boundaries between health professionals and client groups, and resistance to exclusion through strategies of empowerment.

Health and Exclusion is a pioneering examination of those policies and practices of exclusion currently experienced by health 'customers' in the UK. Chapters document examples of exclusion in a number of controversial areas, including: *the impact of poverty on the health of children *exclusion in maternity care *exclusion of those with mental health problems *exclusion of the elderly in health care *the silenced voice of the patient *barriers to recruitment and advancement within the health professions. The authors challenge whether New Labour policies sufficiently address the inequalities in health experienced by some sectors of society. Moreover they suggest that health professionals at times actively contribute to exclusion and suggest strategies and practices to combat marginalisation and resist exclusion.

1. Tracing continuity and diversity in health and exclusion 2. Poor health, poor health care: the experiences of low- income households with children 3. Whose business? Social welfare and managerial calculation 4. The health of which nation? Health, social regulation and the new consensus 5. Exclusion in maternity care: midwives and mothers 6. Social exclusion and the mad: the complicity of psychiatric medicine and nursing 7. 'You can go home today, Mrs Jones'. Surgeons and patients' negotiations over discharge 8. Empowerment and health: a community development approach to health promotion 9. Older people and the health services: the challenge of empowerment 10. Informational health care networks: Health care organisations in the Information Age