By Paul Henderson, Sylvia Summer, Contin You and Thara Raj.This is an introductory on-line training course for workers from a variety of backgrounds including health, local authority and the voluntary sector. It aims to improve knowledge and skills in the different approaches to community development and engagement in order to improve health and reduce health inequalities in local communities. The course book includes a full learner’s guide, background reading materials and tutor’s notes.

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A website has been launched to allow outpatient appointments to be booked online. Initially the service will only be available to GPs, but by the end of 2005 patients will be able to book appointments through the Internet. Patients will be able to choose a convenient place, date and time for their initial hospital appointment. By the end of 2005 they will have the choice of four or five hospitals. It is also planned to introduce a telephone booking service.Some healthcare communities in London and the North East will introduce the service in the summer of 2004. Others will adopt the Choose and Book service throughout the rest of 2004 and 2005.

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Bureaucrats who make up the ‘non-essential’ frontline want a better employment deal. They recognize that compared to a doctor or a teacher, the tax collector and benefit administrator is undervalued by the public. Nobody likes the taxman, but without efficient tax collection there would be less money for health and education.The ‘non-essential’ frontline is bearing the brunt of the drive towards efficiency. The three landmark reviews, Lyons, Gershon and O’Donnell represent the most widescale changes to the civil service for 150 years. Under the Lyon’s review 20,000 civil servants will be moved out of the South East with savings of 2 billion pounds over 15 years from cheaper accommodation and lower salary costs. The Gershon review recommended a move to smaller strategic centers, a focus on professional and technical skills and more emphasis on performance management. The result from adopting this approach could be staff cuts of 80,000. The Inland Revenue and Customs and Excise are being merged into a single department as a result of the O’Donnell review. Significant staff cuts are predicted.

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