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Patients' charters have been incorporated in health services systems among various countries including the United Kingdom and Hong Kong. By means of a comparative case study, this research looked at the implementation of patients' charters in the National Health Service in England and the Hospital Authority in Hong Kong from the perspectives of staff at different levels as well as patients' groups and their representative bodies. Points of convergence and different approaches have been illustrated in both locations from their experiences in implementing the charter. Together with the positive and negative impacts learned, it is argued that current knowledge about 'Charterism' is limited to the UK context and this should be interpreted within the international arena as shown from a bundle of tenets and principles of the Hong Kong experience. By means of analyzing the case study, the utility of Pubic Choice Theory is demonstrated in understanding the self-interest behaviours among the actors involved in patient's charter in both locations. It is also argued that patients' charters can be effective Public Choice remedy tools to shift provider-led health services into consumer-led health services.

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The hypothesis underpinning this research study suggests that the integration of schools into the childcare framework could provide a key to re-balancing child protection work so as to prioritise the Children Act's family support provisions. It is the researcher's contention that an essential element in this re-balancing process would be the development of a more effective early detection system. In this respect, it is proposed that the educational establishment could fulfil this role given its unique position to gather information and to liaise with other agencies at a community level. Whilst this position has been recognised to a limited extent, the education service could be utilised to a far greater extent to reinforce the philosophy of the 'Framework for the Assessment of Children in Need and their Families' and as such Part III of the Children Act. A brief summary of the implications and considerations to arise from an analysis of the research data is as follows: Information concerning children in need is available within schools, though the utilisation of this information varied considerably between schools. Liaison can successfully take place between schools and other agencies at a community level. Greater clarification is required in terms of the scope a Child Protection Liaison Teacher's duties/responsibilities in order to address the variation in practice indicated by the sample. Consequently, formalisation in terms of guidance documentation, training and/or the personnel undertaking the role of CPLT is required. Greater support and training of teaching staff in general is also required if schools are to be integrated into the childcare framework. Whilst schools could undertake the early detection role proposed by the hypothesis a great deal will nevertheless depend upon how that information is subsequently utilised, i.e. in order to identify children in need or to pursue the current practice of risk assessment.