Ann Cartwright

In the early 1970s, the consumption of both prescribed and non-prescribed medicines in Britain was increasing. Originally published in 1972, this book takes a look at the medicine takers and the types of medicine they take. It examines the relationship between self-medication and prescription, and describes the frequency and nature of repeat prescribing. The medicines kept in a random sample of households were counted and analysed, and data about the length of time people hoarded medicines is used as a basis for estimating the proportion of prescribed medicines that are wasted.By putting the views and habits of people as patients alongside information from their general practitioners the study illuminates the relationship between patients and doctors. In addition, variations between people in different social classes direct light on the distribution of care and the equity of services at the time

‘This study of general practice and the attitudes of patients and general practitioners to it is the most significant book yet written about the NHS.’ This was how the reviewer in the ‘British Medical Journal’ reviewed Ann Cartwright’s earlier book Patients and their Doctors. In General Practice Revisited, originally published in 1981, Ann Cartwright and Robert Anderson compare the experiences and views described in the first study, carried out in 1964, with those revealed by a second survey in 1977.In the intervening period there were a great many changes in the organization of general practice. For example appointment systems and nurses working in the surgery became the rule rather than the exception, and the number of doctors working in health centres or using deputizing services rose dramatically. This study shows how the basic patient-doctor relationship has been affected by these changes. A fundamental feature of the survey is the demonstration that the attitudes and practices of patients and doctors are linked, and that it is possible to relate the experiences and degree of satisfaction of patients to the doctor’s age, sex, size of practice, equipment, ancillary help, and indeed to the doctor’s views and habits.By bringing the picture of general practice up-to-date Ann Cartwright and Robert Anderson provided the basic data for any discussion of primary health care in this country at the time.

Originally published in 1979, this study looks at the experience of childbearing from three viewpoints: first and foremost from that of the childbearing women; but in addition it considers the views and experiences of midwives and consultant obstetricians.It examines the proportion of induced labours and questions who is induced, when, where and why and how. Comparisons are then made between induced and non-induced labours of mothers’ experiences of labour and delivery and then of the babies conditions and the early relationships between the mothers and babies. Women’s views of their experiences, their attitudes to the information they were given, and their choice for treatment at further pregnancies are then examined.In the final chapter induction policies and practices are reviewed in the light of women’s reactions to their experiences. The implications of the findings are discussed in relation to other innovatory and interventionist procedures and in the context of the women’s movement.

Ann Cartwright’s book Parents and Family Planning Services (1970) had become a classic in its field.Originally published in 1976, How Many Children? Dr Cartwright’s study of family size and spacing in England and Wales in 1973 is again based on detailed research and analysis, and upon interviews with the mothers and fathers of a random sample of legitimate births in England and Wales.Ann Cartwright discusses the extent to which people have firm intentions about their family structure and the factors which may affect these intentions – work, housing, economic situation, marital relationships and family roles. She describes the part played by contraception, abortion and birth control services in people’s achievement of their intentions.A major interest of the study is in changes over time. It attempts to throw some light on the falling birth rate and the relative contributions to this decline of desires for smaller families, different spacing patterns and the use of more effective methods of birth control. Comparisons are made with the earlier study, Parents and Family Planning Services, and a fascinating conundrum emerges: in the later study, parents were using more effective methods of birth control but the proportion of unintended pregnancies had not declined. Possible explanations for this are discussed.

Since death is an experience which will inevitably be common to us all, we are often surprisingly uninterested in what services are provided for those people, often the elderly and infirm, who are at risk or who are on the point of death. Originally published in 1973, this study describes the last twelve months in the lives of 785 adults. Based mainly on the reports of close relatives, it is concerned with the needs of the dying and the care they receive. This includes the more emotional aspects such as ‘awareness’ of dying and the effects of the death on relatives. The book looks at the part played by hospitals, general practitioners, local authority health and welfare services, and by relatives, friends and neighbours. The views of those who provide these services are also considered. The picture that emerges shows up the gaps in the care that was given to people in the final year of their lives at the time.

In the late 1980s, an increasing proportion of all prescribed medicines went to people over 65 years of age, not only because they constituted a growing sector of the population but also because their consumption rate, unlike that of younger people was increasing. This increase was therefore a matter for widespread concern which had until now been largely speculative, as no recent national survey had focused on this issue.Originally published in 1988, Ann Cartwright and Christopher Smith looked at the medicines prescribed for, and taken by, a nationally representative sample of elderly people. The experiences and views of both patients (elderly people) and professionals (general practitioners) are examined and related. What is revealed is how much, and how little GPs knew about the social circumstances and medicine taking of their elderly patients. Evaluation of all the prescribed medicines taken shows the extent of elderly people’s knowledge of their medication and identifies duplications, potentially harmful interactions, contraindications, and inappropriate dosages. Recommendations for action to be taken by doctors, pharmacists, medical educators, and elderly people themselves made this book essential reading for all those concerned with the health and welfare of elderly people at the time.

The recently widowed experience many complex problems, and an understanding of their needs and the kinds of difficulties they encounter is essential if appropriate services and help are to be mobilized. It is the old who are most likely to be widowed, and they may face this crisis at a time when they may also be adjusting to ill health and increasing infirmity, and to retirement, with its problems of role identification and adaptation to an increase in leisure and a decrease in wealth. Most will have to learn to live alone, or to uproot themselves from their home and adjust to life with relatives. Often, the elderly person will have been involved in caring for their spouse during his or her terminal illness; widowhood will mean that they have lost their main occupation. For some, who are themselves disabled, widowhood may mean that they have lost the person who cared for them, so that there is an immediate crisis as alternative sources of care need to be found. These problems have to be faced in a situation often complicated by the anxiety, loneliness, apathy, and bewilderment of bereavement.Originally published in 1982, Life After A Death presents the results of a study of the experiences and attitudes of over 350 elderly widowed men and women, their general practitioners, and their relatives, friends, and neighbours, and considers the implications of the help the widowed received, or failed to receive, from those to whom it was most likely that they would turn for support. The authors’ identification and description of the emotional and practical day-to-day needs of the widowed, and their recommendations about the potential role of the general practitioner and voluntary and social services, should be considered by all those concerned to alleviate the difficulties of the widowed, and to help them to live a better ‘life after a death’.

Originally published in 1964, this book describes the hospital service as it is seen by patients. It is based mainly on interviews with a random sample of patients and discusses the relationships between patients and between them and hospital doctors, nurses, and general practitioners. The best available medical care should not only be given, but the patient and his relatives should feel that this has been given. Explanations need to be seen not as a lavish appendage, but as an integral part of medical care. Recognition and acceptance of this responsibility could stimulate interest in patients' social lives, so that hospital staff become more aware of the difficulties patients may encounter when they leave hospital. This in turn could lead to greater integration between the hospital and welfare services and between the hospital and the general practitioners. Still relevant today this study can now be read in its historical context.

In the late 1980s, an increasing proportion of all prescribed medicines went to people over 65 years of age, not only because they constituted a growing sector of the population but also because their consumption rate, unlike that of younger people was increasing. This increase was therefore a matter for widespread concern which had until now been largely speculative, as no recent national survey had focused on this issue.Originally published in 1988, Ann Cartwright and Christopher Smith looked at the medicines prescribed for, and taken by, a nationally representative sample of elderly people. The experiences and views of both patients (elderly people) and professionals (general practitioners) are examined and related. What is revealed is how much, and how little GPs knew about the social circumstances and medicine taking of their elderly patients. Evaluation of all the prescribed medicines taken shows the extent of elderly people’s knowledge of their medication and identifies duplications, potentially harmful interactions, contraindications, and inappropriate dosages. Recommendations for action to be taken by doctors, pharmacists, medical educators, and elderly people themselves made this book essential reading for all those concerned with the health and welfare of elderly people at the time.

Since death is an experience which will inevitably be common to us all, we are often surprisingly uninterested in what services are provided for those people, often the elderly and infirm, who are at risk or who are on the point of death. Originally published in 1973, this study describes the last twelve months in the lives of 785 adults. Based mainly on the reports of close relatives, it is concerned with the needs of the dying and the care they receive. This includes the more emotional aspects such as ‘awareness’ of dying and the effects of the death on relatives. The book looks at the part played by hospitals, general practitioners, local authority health and welfare services, and by relatives, friends and neighbours. The views of those who provide these services are also considered. The picture that emerges shows up the gaps in the care that was given to people in the final year of their lives at the time.

The recently widowed experience many complex problems, and an understanding of their needs and the kinds of difficulties they encounter is essential if appropriate services and help are to be mobilized. It is the old who are most likely to be widowed, and they may face this crisis at a time when they may also be adjusting to ill health and increasing infirmity, and to retirement, with its problems of role identification and adaptation to an increase in leisure and a decrease in wealth. Most will have to learn to live alone, or to uproot themselves from their home and adjust to life with relatives. Often, the elderly person will have been involved in caring for their spouse during his or her terminal illness; widowhood will mean that they have lost their main occupation. For some, who are themselves disabled, widowhood may mean that they have lost the person who cared for them, so that there is an immediate crisis as alternative sources of care need to be found. These problems have to be faced in a situation often complicated by the anxiety, loneliness, apathy, and bewilderment of bereavement.Originally published in 1982, Life After A Death presents the results of a study of the experiences and attitudes of over 350 elderly widowed men and women, their general practitioners, and their relatives, friends, and neighbours, and considers the implications of the help the widowed received, or failed to receive, from those to whom it was most likely that they would turn for support. The authors’ identification and description of the emotional and practical day-to-day needs of the widowed, and their recommendations about the potential role of the general practitioner and voluntary and social services, should be considered by all those concerned to alleviate the difficulties of the widowed, and to help them to live a better ‘life after a death’.

In the early 1970s, the consumption of both prescribed and non-prescribed medicines in Britain was increasing. Originally published in 1972, this book takes a look at the medicine takers and the types of medicine they take. It examines the relationship between self-medication and prescription, and describes the frequency and nature of repeat prescribing. The medicines kept in a random sample of households were counted and analysed, and data about the length of time people hoarded medicines is used as a basis for estimating the proportion of prescribed medicines that are wasted.By putting the views and habits of people as patients alongside information from their general practitioners the study illuminates the relationship between patients and doctors. In addition, variations between people in different social classes direct light on the distribution of care and the equity of services at the time

‘This study of general practice and the attitudes of patients and general practitioners to it is the most significant book yet written about the NHS.’ This was how the reviewer in the ‘British Medical Journal’ reviewed Ann Cartwright’s earlier book Patients and their Doctors. In General Practice Revisited, originally published in 1981, Ann Cartwright and Robert Anderson compare the experiences and views described in the first study, carried out in 1964, with those revealed by a second survey in 1977.In the intervening period there were a great many changes in the organization of general practice. For example appointment systems and nurses working in the surgery became the rule rather than the exception, and the number of doctors working in health centres or using deputizing services rose dramatically. This study shows how the basic patient-doctor relationship has been affected by these changes. A fundamental feature of the survey is the demonstration that the attitudes and practices of patients and doctors are linked, and that it is possible to relate the experiences and degree of satisfaction of patients to the doctor’s age, sex, size of practice, equipment, ancillary help, and indeed to the doctor’s views and habits.By bringing the picture of general practice up-to-date Ann Cartwright and Robert Anderson provided the basic data for any discussion of primary health care in this country at the time.

Originally published in 1979, this study looks at the experience of childbearing from three viewpoints: first and foremost from that of the childbearing women; but in addition it considers the views and experiences of midwives and consultant obstetricians.It examines the proportion of induced labours and questions who is induced, when, where and why and how. Comparisons are then made between induced and non-induced labours of mothers’ experiences of labour and delivery and then of the babies conditions and the early relationships between the mothers and babies. Women’s views of their experiences, their attitudes to the information they were given, and their choice for treatment at further pregnancies are then examined.In the final chapter induction policies and practices are reviewed in the light of women’s reactions to their experiences. The implications of the findings are discussed in relation to other innovatory and interventionist procedures and in the context of the women’s movement.

Ann Cartwright’s book Parents and Family Planning Services (1970) had become a classic in its field.Originally published in 1976, How Many Children? Dr Cartwright’s study of family size and spacing in England and Wales in 1973 is again based on detailed research and analysis, and upon interviews with the mothers and fathers of a random sample of legitimate births in England and Wales.Ann Cartwright discusses the extent to which people have firm intentions about their family structure and the factors which may affect these intentions – work, housing, economic situation, marital relationships and family roles. She describes the part played by contraception, abortion and birth control services in people’s achievement of their intentions.A major interest of the study is in changes over time. It attempts to throw some light on the falling birth rate and the relative contributions to this decline of desires for smaller families, different spacing patterns and the use of more effective methods of birth control. Comparisons are made with the earlier study, Parents and Family Planning Services, and a fascinating conundrum emerges: in the later study, parents were using more effective methods of birth control but the proportion of unintended pregnancies had not declined. Possible explanations for this are discussed.

Originally published in 1964, this book describes the hospital service as it is seen by patients. It is based mainly on interviews with a random sample of patients and discusses the relationships between patients and between them and hospital doctors, nurses, and general practitioners. The best available medical care should not only be given, but the patient and his relatives should feel that this has been given. Explanations need to be seen not as a lavish appendage, but as an integral part of medical care. Recognition and acceptance of this responsibility could stimulate interest in patients' social lives, so that hospital staff become more aware of the difficulties patients may encounter when they leave hospital. This in turn could lead to greater integration between the hospital and welfare services and between the hospital and the general practitioners. Still relevant today this study can now be read in its historical context.

Parents and Family Planning Services focuses on parents of a sample of newborns in twelve areas of England and Wales during the 1970s. The parents were asked about their contraceptive practices, attitudes toward different methods of birth control, and opinions of-and experience with-different types of services. General practitioners, health visitors, and doctors at family planning clinics were interviewed about their views and practices. This juxtaposition of the attitudes of parents and professionals highlights the reasons why people do not use effective methods of birth control, and leads to suggestions as to how they could be helped to do so. Several chapters discuss fathers' attitudes and actions, the views of parents and professionals, and the influence of religion, social class, education, and geographic location. The final chapter is concerned with possible changes in contraceptive habits, and the ways in which services can develop to help more women avoid unwanted pregnancies. The work has ongoing policy implications, and also indicates how attitudes and change evolve over time. Parents and Family Planning Services is predicated on the assumption that unwanted fertility is to be avoided. It underscores the need for a proliferation of different sorts of services: more clinics, an increase in the help and advice given at hospitals, the development of a supportive and integrated home service. This volume is a significant contribution to the literature in this vital field. It remains essential reading for both professionals and concerned policy personnel, particularly those interested in the evolution of policy and practice.

Building rapport, communicating and establishing trust with people, as a line manager, as part of a department or a temporary project team, involves a fundamental set of human and business skills. And yet this set of skills is also the area where the majority of managers feel least equipped to cope. Emotional intelligence is, at its heart, all about self-awareness; an understanding of how people relate and respond to you. This collection of training activities provides managers and employees with a series of proven exercises for raising personal and social awareness, skills for managing self and relationships with others. Each activity includes detailed instructions for the user or facilitator as well as copies of any handout materials. The collection is available as a looseleaf manual or on CD ROM.

Parents and Family Planning Services focuses on parents of a sample of newborns in twelve areas of England and Wales during the 1970s. The parents were asked about their contraceptive practices, attitudes toward different methods of birth control, and opinions of-and experience with-different types of services. General practitioners, health visitors, and doctors at family planning clinics were interviewed about their views and practices. This juxtaposition of the attitudes of parents and professionals highlights the reasons why people do not use effective methods of birth control, and leads to suggestions as to how they could be helped to do so. Several chapters discuss fathers' attitudes and actions, the views of parents and professionals, and the influence of religion, social class, education, and geographic location. The final chapter is concerned with possible changes in contraceptive habits, and the ways in which services can develop to help more women avoid unwanted pregnancies. The work has ongoing policy implications, and also indicates how attitudes and change evolve over time. Parents and Family Planning Services is predicated on the assumption that unwanted fertility is to be avoided. It underscores the need for a proliferation of different sorts of services: more clinics, an increase in the help and advice given at hospitals, the development of a supportive and integrated home service. This volume is a significant contribution to the literature in this vital field. It remains essential reading for both professionals and concerned policy personnel, particularly those interested in the evolution of policy and practice.

Building rapport, communicating and establishing trust with people, as a line manager, as part of a department or a temporary project team, involves a fundamental set of human and business skills. And yet this set of skills is also the area where the majority of managers feel least equipped to cope. Emotional intelligence is, at its heart, all about self-awareness; an understanding of how people relate and respond to you. This collection of training activities provides managers and employees with a series of proven exercises for raising personal and social awareness, skills for managing self and relationships with others. Each activity includes detailed instructions for the user or facilitator as well as copies of any handout materials. The collection is available as a looseleaf manual or on CD ROM.