Category Archives: Service entry

Challenging micro-aggressions against people living homeless through acts of acceptance

In my present project I began with research showing that homeless and other very disadvantaged people have poorer health and use fewer health services. I considered this in the context of the Social Determinants of Health (Marmot & Wilkinson), that … Continue reading

Posted in Homeless health, Research, Service entry, Social Determinants of Health, Vulnerable populations

Health system entry change required

I’ve been exploring system change at the local level in health service entry and delivery. For example there is an issue with the algorithms used in call centres. They use a bio-medical triage logic that puts the most acute people … Continue reading

Posted in Service entry, Uncategorized, Vulnerable populations

A victory of rule rigidity and risk management over compassion and common sense

Last week there was  a 92 year lady on the ward who was unable to stand but wanted to go home where she lived alone. I was requested to do a Guardianship application even though she was cognitively sound. I … Continue reading

Posted in Empowerment, Ethical issues, Service entry

‘System participants’ inform local action on hard to reach services

Equity of access to health services is a key goal for primary health care internationally and in Australia (WHO, 1978). The systems used to gain entry to health services can impede or facilitate access, engagement and health outcomes. Equity of … Continue reading

Posted in Research, Service entry, Social Determinants of Health, Vulnerable populations

Inadvertently locking out the most needy from health services

In 1971 Tudor Hart believed that the people who most needed health services were the least likely to receive them, and that turns out to be true. His ‘Inverse Care Law’ is valid today. Since then Marmot and Wilkinson have … Continue reading

Posted in Service entry, Social Determinants of Health, Vulnerable populations

‘Desire trails’ and Health Service entry systems

In town planning the ‘desire trail’ is the track across the park made by people making their own way in the absence of, or in spite of, made pathways. After a point we tend simply to use the most obviously … Continue reading

Posted in Service entry