The alternative vote re-visited
Electoral reform re-emerged in the 1980s as a significant issue in British politics. After a long spell in which the established system was very widely accepted, warts and all, political developments in the last ten years have undermined satisfaction with the system. The 1983 and 1987 general elections produced a particularly disproportional relationship between the parties' votes and seats, and thereby highlighted the inherent unfairness of first-past-the-post. The Liberals and Social Democrats presented electoral reform as a central feature of their Alliance programme, and the Nationalists and Greens advocated systems other than first-past-the-post. Since 1987 growing concern over the Conservatives' electoral dominance has prompted renewed interest in electoral pacts between out-of-office parties, and thus in electoral systems which might facilitate such pacts. As well as doubts about the adequacy of the electoral system for the House of Commons, the proposals to create Assemblies for Scotland, Wales and the English regions, and Labour's recent proposals to establish an elected Upper House, involve the question of the electoral system that should be used. The 1990 Labour Conference recommended that the party consider the creation of a Speakers' Conference to examine the whole issue of electoral reform.
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Background: Self-expanding metal bile duct stents provide good palliation for inoperable malignant disease. However, problems may arise if metal stents are inserted before definitive histological diagnosis. The aim of this study was to evaluate the outcome of such patients. Methods: A retrospective case note review was conducted of patients referred to a tertiary pancreaticobiliary center between 1992 and 2004 in whom a metal bile duct stent was inserted for presumed unresectable malignant disease before definitive histological diagnosis. Results: There were 21 patients identified. Final diagnoses were: group 1, benign disease (n = 3); group 2, resectable malignancy (n = 2); group 3, unresectable malignancy (n = 12); and group 4, diagnosis remains uncertain (n = 4). During a follow-up of 22, 38 and 111 months, the patients in group 1 had one, eight and five episodes of stent occlusion. In group 2, both patients underwent pancreaticoduodenectomy for ampullary carcinoma, 2 and 6 months after presentation. In group 3, the median time to a confirmed malignant diagnosis was 2 months (range 1–27 months). In group 4, a median of two biopsies (range 1–4) were negative for malignancy, during a median follow up of 13 months (range 3–46). Overall in eight patients, the metal stents caused artifacts on computed tomography and/or were associated with tissue in-growth making the differentiation between benign and malignant disease difficult. Conclusion: These cases indicate that metal bile duct stent insertion before definitive histological diagnosis can be problematic. A proportion of cases will have benign strictures and in others the confirmation of malignancy may be made more difficult.
The British Constitution
Preface Part I. Government by the People: 1. We, the people 2. The people's choice Part II. Government by Party: 1. The polity of parties 2. A short history of the parties 3. The character of the parties 4. The party machines 5. The two-party system Part III. The House of Commons: 1. Political ambition and its rewards 2. The House and the government 3. The opposition part IV. The House of Lords: 1. A Conservative bulwark 2. The need for a second chamber Part V: The Monarchy Part VI. Administration: 1. Administrative bodies 2. The process of administration 3. Bureaucracy Part VII. Cabinet Government: 1. Ministerial responsibility 2. The Cabinet 3. The Prime Minister 4. Co-ordination 5. Instruments of co-ordination Part VIII. British Democracy: 1. Government and opinion 2. Democracy and liberty 3. Is it a democracy? Index.