International Marketing Essay

Executive Summary The main purpose of the report will be to analyze Hong Kong and Shanghai Banking Corporation’s (HSBC) Premier proposition (PP). The author will be analyzing the product proposition using a SWOT analysis frame work on HSBC Premier. Based on the result of the analysis the author will highlight as to why HSBC has chosen to cater the high end society. The report also showcase as to why the PP is focused on this particular market segment. Followed by the author conducting a study on the requirements and expectations of Premier Customer (PC). Based on the identified factors the author will illustrate how the PP has being designed to address the client’s requirements by using the concept of relationship banking through their specialized employees. The report will also emphasis on the importance of HSBC being customer centric. Supported through changes done to the marketing mix in order to achieve the goal of customer care. In conclusion the author has conducted a research to track the total customer experience. Introduction HSBC is a leading multi-national organization which has been operating in the financial industry in Sri Lanka for over 120 years (Refer Appendix A.1). Being an organization which has both local and international expertize, HSBC has a competitive advantage in positioning their products and services in the market. HSBC caters both corporate and Retail Banking segments with a wide range of product propositions. As the newly appointed marketing consultant for HSBC Premier (Refer Appendix A.3), the author will be conducting a market research to find out the factors as to how HSBC PP can be improved. During the market study the author will be conducting a research on areas like working business culture and marketing concept, segmentation of the product in line with its customers, analyzing the customer’s needs wants and  value expectations of the proposition, creation of customer-based value propositions for each of the segments, developments through relationship marketing and customer care, the organizations branding strategies, research studies related to customer experience and the outcome of been an organization which is more customer centric. The working business culture and marketing concept Considering the business culture, HSBC is an organization exposed to many international trends and working environments. From retaining years of experiences in the financial industry HSBC has identified how the organization should adopt itself according to the local culture and trends. In order to localize the organization has invested in the areas such as product development, pricing, branding, market research and relationship marketing. Which eventually covers the marketing concepts of HSBC. These concepts are used by the top level management as strategic concepts in order to make decisions and processes to cater to customer requirements and expectations. Through these concepts HSBC has being able to align the Premier Proposition (PP) according to the current market conditions. Product development and Pricing In order to sustain their market share HSBC PP is been reviewed and developed annually by the marketing department. Product development has being focused based on the following market conditions. The emergence of local and international competition: In the recent past there have being many number of financial institutes starting to introduce similar product propositions as HSBC Premier. Eg :Nations Trust Bank : Private Banking Standard Chartered Bank: Priority Banking Fragmented markets and sophisticated customer needs, wants and demands: The emergence of sophisticated customers such as investors, directors of multinational companies, businessmen who each have diverse needs wants and demand expectations from the bank. Technological advances in the financial sector: HSBC has being successfully  been able to achieve this by offering the best consumer internet. The organization has being offered the award by Global Finance. HSBC uses a price premium strategy in the PP which has made the product to be exclusive and appealing to the high end society of Sri Lanka. By using this strategy HSBC has been able to acquire over 6000 Premier Customers (PCs) who each maintain over Rs 7,500,000 in a portfolio. This in return has given them to generate Rs 45 Billion in deposits. Branding Every product requires a strong branding technique. HSBC uses the following branding methods to showcase the benefits of PP. Online marketing Billboards Electronic Direct Mails New paper and magazine advertising Corporate sponsorships Consumer sales promotions As per the methods mentioned above HSBC has focus in showcasing the lifestyle of a PC and the benefits that could be achieved by being part of the growing PP. The next goal by branding would be to acquire potential customers through displaying benefits compared to the competitors. Market Research and Relationship Marketing HSBC invests a large proportion of resources on market research and development. Which eventually result HSBC a cutting edge among competitors. This market research and development is conducted through HSBC head office in Hong Kong at regular intervals. By doing so HSBC has being able to identify new global trends and investment opportunities which they have being able to include within the PP. In order to customize and align the global trends and investments according to the Sri Lankan market, the local marketing department conduct research. These researches are conducted through client survey calls, mystery shopper programs and customer feedback forms. This has provided the opportunity for the management to gain a descriptive insight of the service pros and cons offered to the PC. Customer being treated as king in today’s business world HSBC believes customer centric relationship marketing is the critical selling factor of the PP. In  order to complement this factor Relationship Managers (RMs) have being groomed to be customer oriented, which will enable to provide a personalized service package. Based on the study carried on HSBC Premier the author will explain the current position of the organization and explain the desired position to be in through his suggestions. Understanding customers and segmentation A PC is an individual who banks at HSBC for the purpose of receiving exclusive customized service, global recognition, safety of their funds and investment advice. By performing a SWOT analysis on HSBC Premier the author has being able to highlight why HSBC has selected the particular segment of high income earner both locally and internationally. Strengths HSBC is a brand which provides their clients a global recognition through HSBC Premier. Expertise in the financial industry both locally and internationally. Including modern technology into their services. Priority services for all international banking services through Global Premier Centre’s. Customizing the products and services according to the local culture. Dedicated RMs who would manage the clients financial requirements 24 hour Premier Call Centre (PCC) Emergency credit facilities. Exclusive promotions for PCs both locally and internationally. Weaknesses Limited bank branches around Sri Lanka. Offering low interest rates on fixed deposits and savings accounts. Being an International brand the organization is vulnerable for strict government rules policies. Having only 2 Premier Centre’s in Sri Lanka to cater to over 6000 PCs. Unavailability in developing new wealth management products for clients with high investment appetites. Having a low workforce to attend to each PC’s requests. Limiting the eligibility criteria for HSBC Premier. Having only one PCC to attend to over 6000 PC calls. Opportunities By growing the premier portfolio the organization will be able grow the HSBC brand Value. Developing newer technological advances in line with the Central Bank of Sri Lanka would assist in making the product more attractive. HSBCs Global recognition which would attract clients. Constant R&D provides new dimensions to a growth. Individuals who aspire to become a PC. Global international support through the HSBC group. Threats Competitor banks starting to offer similar propositions. Central Bank regulations which limits cross border transactions. Losing customers who are rate sensitive Reputational risks from miss selling HSBC Premier. Vulnerability to attract money launderers who would tarnish the HSBC Premier brand name. Global recession impacts on HSBC High priorities given to local banks. Table -SWOT Analysis Different PC individuals have diverse expectations from HSBC. In order to meet these high client expectation levels HSBC conduct thorough staff trainings, workshops and knowledge sharing sessions. Based on the product exclusivity it shows that HSBC has segmented in clients who seek global recognition and quality service even though they do not offer competitive return on investments. Further the client base can also be segment according to the below listed eligibility PC criteria. 1. Clients maintaining a portfolio balance of Rs7,500,000 In Sri Lanka 2. Overseas PCs maintaining the required balance in their home country All though this protects the products exclusivity it has limited the organization expanding their market share. In order to overcome this limitation the author suggests that HSBC to introduce new entry criteria to become a PC. Market research shows competitors also offering similar products under the following entry criteria. Nations Trust Bank (Private Banking eligibility) -Rs 5 million or  equivalent in foreign currency, in deposits Total relationship of Rs 10 million in both deposits and loans Repurchase Agreements (REPO’s) and/or investments of Rs 20 million. Standard Chartered Bank (Priority banking eligibility)-Total relationship in Fixed deposits Rs5, 000,000/- Commercial Bank (Elite Banking eligibility)-Total deposit relationship in excess of Rs 7.5 Million in a savings or fixed deposit account. In order to gain the completive advantage and grow the profit margins for the business sustainability the author’s suggestion is to remake entry criteria’s to become a PC. This will also open doors for potential customer segments and new business opportunities where competitors have still not approached on. Authors entry criteria suggestions: Maintaining Rs5,000,000/- in a non-interest bearing current account and granting of an interest free overdraft facility of Rs2,500,000/- which would attract Islamic Banking clients. Maintaining Rs5, 000,000/- in a fixed deposit and granting an overdraft facility against in which will attract clients who like to invest in the Stock market and other instruments. Offering Premier for top Directors of Companies such as MAS, Nestles, Fonterra, MIT so that they would be brand ambassadors for the Product. Introducing Premier for clients with large credit facilities which are more than Rs10, 000,000/- these clients would give a high income to grow the premier portfolio. Analyzing needs, wants, values and Expectations of Customers As indicated above a HSBC PC contains diverse set of expectations and requirement through this package. This requirements and expectations vary from individual to individual. HSBC has being able to identify these client expectations based on the research performed by their research and development team. Analyzing needs and wants The success of HSBC PP is based on how the organization meets the customers’ expectations. Based on the market studies performed on the client base the author has being able to identify what are the needs and wants of the clients. Needs Wants Easy access to their funds. Ability to withdraw funds at any given time. Reliability on the invested money at HSBC. To have the assurance that the invested money is secured at HSBC. Return on investment. Preferential interest rate for savings accounts and fixed deposits. 24 hour assistance in financial needs. 24X7 customer support. Commendable customer relationship. To receive a tailor made service from HSBC. Ability to obtain credit facilities. Ability to request for credit cards, loan facilities and overdraft facilities on demand. Priority services in transferring funds globally and assistance in opening accounts overseas. Global assistance. Hassle free money transfers with global accounts Table – Analyzing needs and wants Values and Expectations of a HSBC Premier customer The relationship between a HSBC PC and the bank is built around the values presented by the organization. In order to achieve clients expectations HSBC works hard along with their set values. The below list contains the relationship between the PC’s values and expectations. Values Expectations Fairness Offering a fair Interest rate on the Fixed deposits within the bank. Honesty and integrity. To create transparency on the fees and rates of the bank. Ability to understand and address the client’s requirements. Excellent two way communication with the RM and client for a better service. Assurance Assurance for the client’s financial safety. Service. Customized clients service package. Dependability High dependability on their personal and official financial matters. Recognition. To be recognized as a valued Premier client. Table -Value and Expectations of a HSBC Premier Customer Creating Customer-based Value Propositions for Customer segments Creating customer-based value propositions is a widely used strategy to create awareness on different customer segments. Having looked at the researchers conducted from inception of HSBC Premier the author believes the most significant factor is to address PCs expectations. Also the author believes, through catering these requirements will influence the client’s decision making ability. This will result to grow the market share and generate business incomes. Relationship Marketing & Customer Care Relationship marketing has become one of the current important concepts of today’s business environment. Relationship marketing is mainly dependent on organization policies employee skill and capabilities. Each employee plays a vital role in the process of delivering an exceptional customer service. Starting from the front level customer support to the back office support the same service level should be maintained. Factors that influence Relationship Marketing for HSBC Premier: Convenience in accessing the Premier Centre’s. Efficiency of the RMs. Strong bond between the client and the RMs. Consistent service delivery. The luxurious Premier Centre facilities. Extensive Friendly support provided by the employees. Understanding the customer requirements. Playing honestly and winning customer trust. Assurance of investments. Management of customer care Knowledge : The employees should always maintain high knowledge level regarding customer portfolios, requirements and up to date with organizations processes. Service Level : All staff engaged directly or indirectly with clients should always provide same service standards. Operations : Maintaining consistent operations according to the set guidelines in order avoid any service lapses. Customer Care : Providing the best customer experience through exceptional customer care. At HSBC the management believes in building strong relationships between the business and its clients is vital. In order to full fill the above influences HSBC has built the PP around customer relationship marketing and exceptional customer care. A PC of HSBC is entitled to a RM who caters to their every financial requirement. The RMs are often closely engaged with their clients, this allows them to win the trust and understand the client. It enables the RMs to provide a better service to their clients. A satisfied customer will always improve their portfolios and recommend the product and service to others. However during the research conducted it is evident the concept of relationship banking is blossomed from the point a client becomes a PC. Although the author strongly believes regardless weather the customer is Premier or not the bank should provide customer relationship banking. HSBC should extend their focus towards all segments and expand their exceptional customer relationship. Through conducting the above mentioned new concept the organization will be able to identify the potential clients and grow them to become aspiring qualitative PCs. Reinforcing the organization’s Identity through changes to the Marketing Mix Variables What is a Marketing Mix? A marketing mix is traditionally referred to as the 4P’s, which consists of Product, Price, Place and Promotion. With market evolution 4Ps has grown itself towards adding 3 more concepts like People, Process, and Physical Environment. The combination of these elements will contribute towards providing successful of the products and services. Figure -7 P’s Concept The Product It can be a tangible good or an intangible service. The successfulness of a  product or service is based on how it is developed and how it will cater the customer needs. HSBC has developed HSBC Premier to cater to the high end niche market. The product offers exclusivity, recognition and a wide range of benefits to its clients. Although the PP appeals to the specific pricing category it restricts HSBC in acquiring new clients. The author belief is to create a sub category under HSBC Premier to grab the clients who cannot meet the HSBC Premier requirement and not allowing them to move towards other competitors. Price The price is the amount a customer is willing to pay for the product or service. It will also determine the organizations profit or loss as a product or service is only worth for the price that the chosen segment of customers is willing to pay. The price should be competitive when compared with competitors. In the end customers would choose the service which offers the best value for their money. HSBC uses a price premium strategy for the eligibility of becoming a PC. The product offers exclusivity for clients who seek global recognition and quality service. The eligibility in becoming a PC has being set at Rs7, 500,000.00. This will restrict majority of new clients in enrolling for HSBC Premier. The reason being for the author to state that HSBC uses a price premium strategy is because HSBC historically has not offered high return on interest rates on their fixed deposits or investments, but compensates it with a superior service which retains the client from moving to competitors. However in order to grow the Premier portfolio held at HSBC the author suggests that HSBC increases the interest rates paid on the fixed deposits in order to retain the existing client base and also be able to attract the rate conscious clients from competitors. Place Place is the physical location where a product or service will be offered or distributed to the customer. It should be easily accessible by the customers. HSBC Premier is offered to the clients through the HSBC Premier Centre’s, HSBC PCC’s, the HSBC retail branch network and also through HSBC Internet Banking. Since HSBC has only 2 Premier Centre’s and 15 retail branches it has limited the accessibility to the public. The authors suggestion is introduce new retail branches in new locations where HSBC will  be able acquire new PCs and grow their market share. Promotion Promotion is the method used by marketers to communicate information on products or services. It includes elements such as advertising, sales campaigns and awareness programs. HSBC uses the following modes to do their promotions. Branding Advertising Special Offers Electronic direct mailers Brochures Most of the promotional methods used at HSBC are prepared based on the market studies performed by research teams. However at times the in accuracy of the market study and poor promotional communication methods would fail to meet the customer needs. Based on the authors experience he advises that HSBC use a two way communication method when setting up their promotions. This will enable to get the clients feedback on the promotion as well as to answer any of the queries that the client has regarding the promotion. People People play a vital role in the service industry. They create a positive or negative impression toward the client which will eventually impact the organization. It is always important that the staffs are well groomed and motivated when they deliver their service to client. HSBC Premier is built around addressing the client’s requirements through relationship banking. Therefore it is important that HSBC recruits the right people with right skills and attitude to carry out their processes. The level of support and service granted by the RMs will determine whether the clients will retain at HSBC or weather the will move to other financial institutes. Process The processes set within the organization contribute to the end result of customer satisfaction. A PC is not interested on how the set systems work at HSBC, but what they are interested is only to get their job done. It is important that HSBC evolves their system up to date with high efficiency and  productivity. This will lead toward satisfied customers. This is the ultimate goal of HSBC Premier. Physical Evidence The physical evidence is what a Premier client would experience from the moment they step in to a Premier Centre. During the stay at the Premier centre the customers would experience luxurious facilities. These comforts and benefits will capture potential customers through branding and through word mouth. The combination of each of the above elements will contribute to the success of the HSBC PP. Research Requirements for the organization to track the total customer experience What is Marketing Research? It is a systematic module which is used to collect data for analysis and reporting purpose on a specific marketing situation faced in an organization. Companies use these research results in various situations. This helps the organization to measure the customer experience. The research results will enable the marketers to improve their products or services. Commonly organizations have their own in house R&D team and however some companies tend to conduct this market research through 3rd party specialized organizations. Importance of Marketing Research for HSBC As the time past banks have gradually evolved themselves to introduce new products and services. This has increased the competition amongst financial institutes who are striving to be the best. While each bank offers similar products and service packages. The differentiation is dependent on the services and after sales. While HSBC understands the importance of marketing research they have sub contracted high level research studies for specialist such as AC Nielsen Corporation. At the inception of HSBC Premier the organization used research studies from the Primary data acquired through Surveys, data collections, focus groups and interview. Based on these research studies carried out HSBC was able to develop the global proposition. For further development and changes to HSBC Premier the organization carries out secondary data research studies by purchasing research studies done by specialists, collecting data of customer courtesy calls, mystery shopper programs, branch observations, suggestion boxes and  testimonials left by other PCs. Once the information is collected HSBC uses it to understand the lapses that they have in terms of service, competitor interest rates, product features and benefits which affect the total customer experience. Based on the experience at HSBC the author suggests that the research should be carried out by using the Primary research studies in order to track the total customer experience. Although collecting of data can be costly through primary research methods it is accurate and easy to understand the customer as listed below. Primary research can be obtained by research performed on existing PCs. The research can be tailored according to the requirement of the organization. It helps you understand the type of client which does business with you. Since it is an in-depth research done the data would not be available for competitors. The organization has the freedom the set the parameters of the areas they wish to perform the research studies on. Collected data would be qualitative and quantitative. Figure – Research frame work Defining Objectives: The objective of the research is to identify the total customer experience that a HSBC PC under go. Research Design: At the research design stage, the marketer or the organization would follow a set of guidelines carried out the research. The different stages of a research are as followed. Figure -Research Design Data Collection: Data collection to be done according to the above research design using the existing client based and the potential client base. Data Analysis: Data analysis is a process of transforming acquired data in to qualitative and quantitative information for the use of the marketers. Research Report: The research report will be the end result of the research process. The report would highlight the areas which require development and the areas which have service lapses. This will enable HSBC to develop them self as an organization. The author believes it is vital that HSBC continues and  improves their research methods in order to be on top of the financial industry. Through performing and tracking the total customer experience which a PC goes through HSBC will be able to adjust and make changes to the processes which are in use. The outcomes of becoming more customer centric In every organization the customer is treated as the king or queen. Therefore each organization wishes to be customer centric. They build their businesses around the expectations of the targeted customer segments. At HSBC the working business culture and marketing concepts are aimed and designed according to its target market. The process of choosing the segment of high end customer and to cater them with the product HSBC Premier was done under the customer segmentation process. Once the segmentation was done HSBC choose to analyze the needs, wants, values and expectations of a PC. This enable the organization to tailor make the benefits for a PC at HSBC. This in return creates a global value proposition for each PC. A key area in being a customer centric organization is the capability of building strong relationships with the clients. At HSBC Premier the concept of using a RM has enable the organization to identify in-depth information regarding their base of PCs. It has also enabled HSBC to discover the clients hidden needs and also create needs within them in order to grow the Premier portfolio. By addressing these requirements HSBC has being able to enhance the customer experience derived through HSBC Premier. The author suggests that HSBC continues to conduct primary research which gives the organization in-depth information regarding how and where the organization is heading towards. The conducted research would stand as an indicator to identify on the changes that the organization could do to its marketing mix variables to achieve customer satisfaction. Becoming an organization which is customer centric would contribute to the sustainability of the company. It will act as a guide in the company’s long term vision to enable them to align the business and its processes accordingly. By doing so the organization would be able to increase the customer experience levels and values. Conclusion The overall report is a critical analysis on HSBC’s PP. The author has identified the working business culture and marketing concepts used at HSBC.  Based on the study the report illustrates the importance of designing HSBC’s PP in line with the chosen customer segments expectations. Having being a customer centric organization, HSBC has being able to identify its customer requirements through market researches and adaptation of relationship banking. Having identifying a PC’s necessities the organization has being able to make changes to its marketing mix variables in order to increase the total customer experience. The PP in general, can be measured as one of the most consistent propositions which offer exclusive financial services. In order to sustain HSBC’s PP the author recommends that the organization develops its strategies and reduces the service lapses based on the suggestions made. References Acrwebsite.org. 2013. Applications of Marketing Concepts to Candidate Marketing by Avraham Shama. [online] Available at: http://www.acrwebsite.org/search/view-conference-proceedings.aspx?Id=5803 [Accessed: 11 Nov 2013]. Antarcticglaciers.org. 2013. Untitled. [online] Available at: http://www.antarcticglaciers.org/wp-content/uploads/2012/09/10-steps-to-research-design.png [Accessed: 15 Nov 2013]. Chennaiconsultants.in. 2013. Chennai Consulting Group. [online] Available at: http://www.chennaiconsultants.in/marketing_research.html [Accessed: 14 Nov 2013]. Combank.net. 2013. Savings Sri Lanka | Internet Banking | Commercial Bank Sri Lanka. [online] Available at: http://www.combank.net/newweb/info?id=196&menu_type=mainmenu&selected=About%20Us&subitem=Social%20Responsibility&oid=230 [Accessed: 17 Nov 2013]. Google Books. 2013. Product Development Performance. [online] Available at: http://books.google.lk/books?hl=en&lr=&id=7cCAASTW6IQC&oi=fnd&pg=PA1&dq=product+development+concept&ots=vuYX2 TiVnH&sig=ARVFe8GFf7- [Accessed: 11 Nov 2013]. Jstor.org. 2013. JSTOR: An Error Occurred Setting Your User Cookie. [online] Available at: http://www.jstor.org/discover/10.2307/1248740?uid=3738456&uid=2&uid=4&sid=21102819894071 [Accessed: 10 Nov 2013]. Kotler, P. 2005. Principles of marketing. Lbr.lk. 2013. Lanka Business Report. [online] Available at: http://www.lbr.lk/fullstory.php?nid=201101052013018515 [Accessed: 12 Nov 2013]. Nationstrust.com. 2013. Nations Trust Bank, Sri Lanka – Personal Banking, Corporate Banking, American Express, SME Banking. [online] Available at: http://www.nationstrust.com/personal_banking/private_banking [Accessed: 13 Nov 2013]. Unknown. 2013. [online] Available at: http://www.amsreview.org/articles/wiedmann07-2007.pdf?q=are-consumer-perceptions-of-brand-affected-by-materialism [Accessed: 13 Nov 2013]. Unknown. 2013. [online] Available at: http://www.cim.co.uk/files/7ps.pdf [Accessed: 15 Nov 2013]. APPENDICES A.1 About HSBC HSBC is a financial organization which opened in Sri Lanka on the 1st of July in 1892. The bank initially opened for business under the name of â€Å"Hongkongbank† thereafter was named as the â€Å"The Hong Kong and Shanghai Banking Corporation† and in the more recent years operates under the name â€Å"HSBC†. HSBC currently has over 6,600 offices in over 80 countries and territories and assets of US$2,692 billion as at 30 June 2012 according to (HSBC, 2013) This Makes HSBC one of the largest Financial Organizations in the world. Since 1892 HSBC has supported and contributed to the Sri Lankan Economy and is currently one of the most Profitable Banks in Sri Lanka. A.2 Products and Services offered by HSBC HSBC uses the influences of their international expertise, their local knowledge and experience in order to build the Products and Services they offer. This puts HSBC in a good position to compete with the local financial organizations. HSBC offers propositions to its clients. They have come up with 2 main propositions which are called â€Å"HSBC Premier† and â€Å"HSBC Advance†. A.3 About HSBC Premier This product is offered to HSBCs top end clients who are the high income earning segment of society. It would be clients who are well established in life and lives a lavish lifestyle. HSBC Premier comes with a bundle of value additions and exceptional service standards. Such as a Relationship Manager who will look in to the clients every financial need, preferential rates,  fee waivers and preferential promotions positioned only for Premier Clients. HSBC has set the minimum eligibility of becoming a Premier Client at maintaining Rs7, 500,000/- in a client’s portfolio.

Thought and Hi Rachel

Rachel: Good evening Tom. It's nice to meet you. Please call me Rachel. Tom: Hi Rachel†¦ It is good to meet you too. Rachel: To start off why don't you tell me a little bit about why you think you are here today and what has been going on for you in your life. Tom: I think I am here because my friend thinks I am a drunk. Maybe I am, but I have a good reason. Rachel: What is your reason? Tom: Because my wife left me. We were married for 25 years, and she cheated. Rachel: I am very sorry to hear that Tom. I can understand how that would be hard to deal with. Tom: it is horrible!When I am up, I am thinking of her, thinking of her with someone else, and then drinking to make it go away. I am alone! Rachel: So would you say your drinking has increased since this relationship ended? Tom: ummm†¦. I guess it has†¦ probably more than a little. I mean the guys and I always had a few on sunday for football, you know. But sometimes I drink and I don't know why? Rachel: Would you s ay your alcohol use has affected your job at all, or other family or social commitments? Tom: Well I know I am sick and tired of being hungover in the morning and operating the crane.My family was my wife†¦. we ran from family and our love was all we had. It made us strong†¦ but not strong enough apparently. Rachel: Well we definately need to find you some better ways to cope with this. How would you describe your mood and how you have been feeling since this has happened? Tom: My mood has been getting worse. It's like the worst has happened but I have this nagging feeling that something unbelievably horrible will follow it. My body also has these pains and aches and I have no idea where they came from†¦Rachel: Well it is definately normal to feel this way after such a stressful occurence in your life. Although it is hard to remain postive, it is important. Do you have any other support in your life besides your wife? Anyone that you could talk to? Tom: Well Jim. He i s the one who said I needed to see a counsellor. He said I looked dissheveled. I trust him but I feeling like I am letting him down. Rachel: Well that is good that you took Jim's advice to come in and talk to someone. It can be very difficult to deal with something like this on your own.It is good to have social support in your life and someone who can be honest with you. Do you see yourself getting into a new relationship in the future? Tom: I can see that maybe I can move on but I am hurting. I have been too drunk to grieve! Rachel: Why do you think your wife cheated on you? Do you blame this on yourself? Tom: I never could give her brains and a body. I didn't have brains and my body is getting too old. She took off to the carribean with this lawyer. I wasn't good enough. Rachel: Im sure there are plenty of great things about yourself. This is not something you should blame on yourself.I think once you put yourself out there you will see that many people will find you attractive i nside and out. Challenging your negative thoughts in ways such as this is the first step to feeling better. You will prove your own negative thoughts wrong and will begin to build a new more positive self-concept. I know right now it may be too early to start dating but you should focus on other things you are good at or that you once enjoyed. Rachel: I wanted to ask you a little about your family history. Is there anyone in your family that has suffered from depression or alcohol abuse? Tom: My father drank alot.He was an angry drunk. His mother was sad alot of the time. She killed herself when my dad was 11 Rachel: Im sorry to hear about that Tom. I want to make sure you know that it is normal to feel the way you do right now. I would however suggest talking to your family doctor about taking an antidepressant to help you get back on your feet. It is not something you have to take forever but it can really help to get your life back in perspective. Unfortunately we are out of time for today but I would really like to continue talking to you about this another time. Tom: ok, thank you Rachel

Autism and Rain Man

Autism and Rain Man In the movies things are portrayed in ways that are supposed to make the movie sell, which means that movies are not always accurate. The movie Rain Man was about a man and his brother, who happened to be an autistic savant. In Rain Man Dustin Hoffman played Raymond, who was a high-functioning autistic savant. In the movie Raymond had routines and rituals that he did; and when his routines were interrupted or he was afraid of something he had a temper tantrum where he would hit his head. He tended to babble and repeat himself, and when he was stressed he would recite â€Å"Who’s on First? by Abbott and Costello. Raymond had trouble interacting with people and had problems understanding certain concepts. Raymond doesn’t like people touching him or his stuff. He also doesn’t understand the concept of money. The question is, â€Å"Is this a realistic portrayal of an autistic savant? † The answer is that at least part of it is realistic. T he character Dustin Hoffman played was based on a real life savant. The name of the savant that inspired the movie, and got the title of â€Å"real life Rain Man† was Kim Peek. Dustin Hoffman actually spent time with Kim Peek so he could more accurately play the character.While he may have gotten the savant part of his role correct, Dustin Hoffman may not have necessarily gotten the autistic part of his role correct, since he didn’t actually meet with an autistic like he did with Kim Peek. That means that to find out how accurate the movie was in portraying autism, you must first look into and get a better understanding of autism. People with autism usually experience onset prior to age three. It has been estimated that there are approximately two to five cases of autism per ten thousand individuals.Males are four to five times more likely to have autism, but girls with autism are more likely to be more severely mentally retarded. Also, you are more likely to have auti sm if one of your siblings has autism. Autism has been shown to take a continuous course. It has been reported that some children with autism act abnormal from the time of birth. Their parents report being worried since the time they were born. With these kids, their parents notice a lack of interest in social interaction. In infancy, symptoms are harder to notice and define than those found after age two.On the other hand, it has also been reported that other children with autism were developmentally normal for the first year or two of their life. Children with autism tend to have problems with pretend play, verbal and nonverbal communication, and social interactions. In school-aged children developmental gains are common in some areas. Behaviorally, some individuals deteriorate around adolescence while others improve. Only a small amount of autistic people are capable of living and working individually when they reach adulthood.It is estimated that only about one-third of autistic people are capable of achieving any amount of partial independence. Even the highest-functioning adults with autism still have problems with social interactions and communication. The highest-functioning adults with autism will also still have a small range of hobbies and interests. People with autism may have unusual distress when routines are changed. They also may perform repeated body movements, show unusual attachments to objects, and be overly sensitive in sight, hearing, touch, smell, or taste.People with autism will also have communicational issues, which may include the inability to start or maintain a social conversation, using gestures to communicate instead of words, having slow language development or no language development, not adjusting their gaze to focus on what others are looking at, not referring to themselves correctly (like by saying you instead of I when talking about themselves), not pointing to direct others' attention to objects, repeating memorized words, phrases, dialogs, and passages (like from books or movies), and using nonsense rhyming.Autistic people are withdrawn. They do not make friends or participate in interactive games. When autistic people play, they don’t imitate the actions of others. They prefer solitary or ritualistic play instead of group games. They engage in little or no pretend or imaginative play. Autistic people may not respond to eye contact or smiles, and may even avoid eye contact. They may treat others as objects instead of people and show a lack of empathy towards others. Autistic would rather spend time alone than with others. Autistic people may also have unusual responses to sensory information. For xample, they may have heightened or low senses of sight, hearing, touch, smell, or taste. An autistic person would not jump when they heard a loud noise, although they may find normal noises painful and hold hands over ears. They may withdraw from physical contact because it is over stimulating or ov erwhelming. They may have heightened or lowered responses to pain. They may also rub surfaces and lick objects. Autistic people tend to â€Å"Act up† with intense tantrums when something they do not like happens (like not getting what they want). Autistic people may get stuck on a single topic or task.They may also have a short attention span. Autistic people tend to have very narrow interests and may show a strong need for sameness. An autistic person may be either very overactive or very passive. They may also show aggression towards themselves or others. People with autism have specific neuropsychological deficits that produce many of the symptoms associated with autism. It has been identified that prefrontal impairments are present in autistic people that affect things like spatial working memory, attention shifting, and response inhibition.Also, there have been impairments detected in the medial temporal lobe and in facial processing. It has also been shown that very you ng children with autism have abnormal ERP responses to faces, emotions, and speech. It has also been shown that people with autism have auditory processing abnormalities. There is no cure for autism, but the symptoms can be managed through therapy. Also, it has been shown that early, intensive behavioral programs can significantly improve learning and communication skills and reduce disturbed behaviors.It has been proven that children that are better functioning at the start of treatment are more likely to gain more from the treatment. Biomedical treatments are limited to using medications to manage the disruptive behavior, self-injuring, and stereotyped behavior. According to Abnormal Psychology In A Changing World (Seventh Edition) â€Å"Autistic traits generally continue on into adulthood to some degree or another† (Nevid, Rathus & Green, 2008, p. 485). Even so, some autistic children go on to get college degrees and function independently.Others need constant treatment th roughout the duration of their lives and some even need institutionalized care. Now that we have enough information on autism we can make a judgment on how realistic the movie was in portraying Raymond Babbitt as an autistic savant. Because the actor met with Kim Peek, a real life savant, and studied his mannerisms and abilities, we can conclude that his depiction of savants is realistic. He did not though; meet with an autistic to learn what they are like, so we must look at his actions as Raymond Babbitt and judge their authenticity as the behaviors an autistic person would experience.It has been pointed out that in the movie Raymond Babbitt had routines and rituals that he did; and when his routines were interrupted or he was afraid of something he had a temper tantrum where he would hit his head. He tended to babble and repeat himself, and when he was stressed he would recite â€Å"Who’s on First? † by Abbott and Costello. Raymond had trouble interacting with peopl e and had problems understanding certain concepts. Raymond doesn’t like people touching him or his stuff. He also doesn’t understand the concept of money.Apart from Raymond’s inability to understand the concept of money, all of the oddities about Raymond that are not accounted for by his savant nature are accounted for by autism. The only thing unaccounted for is his inability to understand the concept of money which played a fairly big part in the storyline of the movie. So, in conclusion we can say that Rain Man followed reality pretty well in its representation of autism. ? References NICHD Staff Presentations on Autism Research. (2010, June 2). etrieved April 13 2011, from Autism Research at the NICHD Web Site: http://www. nichd. nih. gov/autism/autism. cfm Treffert, D. , & MD. (n. d. ). Kim Peek – The Real Rain Man | Wisconsin Medical Society. Physicians Page | Wisconsin Medical Society. Retrieved April 11, 2011, from http://www. wisconsinmedicalsoci ety. org/savant_syndrome/savant_profiles/kim_peek Kanashiro, N & Zieve, D (2010, April 26). Autism. retrieved April 10 2011, from Autism – PubMed Health Web Site: http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0002494/ American Psychiatric

Privacy and Internet Policy Research Paper Example | Topics and Well Written Essays - 1750 words

Privacy and Internet Policy - Research Paper Example Everybody person has the right to privacy of personal information which is private in nature. George Reynolds, in his book â€Å"Ethics in Information Technology,† argues that â€Å"Privacy is the right to be left alone – the most comprehensive of rights, and the right most valued by a free people† (Reynolds, 2010). People prefer to keep their private information secret because they do not want it to be misused by others. So they safeguard it with the help of laws as also with the help of software etc. The concept of consumer profiling is also relevant in this context. It deals with sketching of important psycho-graphical and demographical information concerning the user of a product. Such data consists of details like gender, age group, education, place of living, profession, income scale, marital status etc. Some companies explicitly gather personal information about the users of internet when they register at their websites by way of making them fill certain forms. The threat in this case is that personal data is collected and certain companies sell this information to other firms without the consent of consumers. Thus, the internet exposes individuals to the threat of leaking their private information. Therefore, protecting consumer data is a significant concern while using the internet for various purposes. Though all companies have a privacy statement, explicitly given on their websites, one cannot rule out the possibility that â€Å"existing privacy enhancing technologies fail in the event of a vendor operating against their stated privacy policy†. , leading to loss of customer privacy and security† (Pearce & Bertok, 1999, para. 1). Personal information transacted through online can be misused, which will lead to failure in safeguarding customer privacy. There are some laws to prevent the misuse of personal data, but these are not sufficient to fully safeguard privacy. Therefore, there is an urgent need to enhance or supplement the existing regulations to completely

Women in the Military Essay Example | Topics and Well Written Essays - 250 words

Women in the Military - Essay Example The reason for the exclusion of women in the military is as a result of their smaller physical body, and Fenner & DeYoung (2001 p 145) reports that women have 50 percent strength of the strength men have. According to Barno (2014), ‘in January 2014 fifty percent of women in the US marine failed to pass a physical standard test’, a test similar to the one offered to their male counterparts. The cry for greater women representation for women to serve in more diverse roles is louder than ever, in fact, the defense secretary reiterated the desire, by stating that, ‘combat positions will be more open to women’ †¦.Indeed, the civil talk of gender equality has breached the gate of the military service. The genuine need for a military service in which both men and women have equal opportunities has been thwarted by nature. Women are born naturally physically weaker than men. Debate on the roles of women in the military is as strong as ever, with the gender activist calling for standardization of the processes so that the women take positions in ground

Macroeconomics Essay Example | Topics and Well Written Essays - 500 words - 14

Macroeconomics - Essay Example Statistics have proven that good things are happening in the economic world in various regions. There are strong sales of recreational vehicles made from northern Indiana. The company has recovered and it is being referred to as the ‘white-hot center of the economy’. The CEO of Jayco projects that the industry will tie unit sales records in 2015 and break them in 2016. He argues that this will be due to the rising U.S employment rate and the continued low interest rates. The U.S as a whole is also emerging as the country that will power world growth in 2015. This is because companies such as Google creating more jobs to thousands while in Silicon Valley, Apple is selling tons of iPhones globally (Coy, 2014). The projected turnabout of the American economy is welcomed as a recovery from the financial crisis that was experienced in 2008-09. Major economies in the world such as Japan dubbed the financial crisis â€Å"Lehman shokku† as there was no growth in the global economy. The latest outlook by the International Monetary Fund called the global growth as â€Å"mediocre†. An economist by the name Blanchard views the stagnation of advanced economies remains a concern at this time. Also, emerging markets seem to not grow as fast as they used to without inflation (Coy, 2014). The IMF has projected the losers in 2015 are likely to be Argentina, Venezuela and Brazil. As to the Russian and the Western Europe economies they will be weak. The North America will be pretty solid. Growth is projected to be in South and East Asia as well as in most African countries. It is evident that the global economy is taking longer than expected to recover from the much debt during the last decade. Three year ago IMF had projected that the world economy would recover by 2015 at a 4.8 percent growth rate but to the contrary the expectations has been met only by the U.S. Analyst have argue that the disparity in growth rates among the

Law of Tort Essay Example | Topics and Well Written Essays - 2750 words

Law of Tort - Essay Example Carroll, v Fearon D , negligently manufactured a tire that led to a fatal accident on a motorway owing to its disintegration. This case did not attribute any specific negligent act to the manufacturer. Therefore, the judge held that either there was no requirement to specify the particular persons responsible for the defects, or the particular negligent act or omission. The disintegration of the tire accrued owing to the fault committed during the manufacturing process. In this case, the manufacturer was in confusion to explain how the fault connected to negligence. The duty of the judge is to identify negligent act . Negligence is the act of an individual to exercise due care. An act is negligent if the wrongdoer knew foresaw the outcome of the act one is negligent if the action done ought to take all reasonable foreseeable measures to ensure that the other party by his omissions or deeds is not injured by his omissions or deeds. In Heaven v Pender the defendant was negligent by not ensuring that the ropes in good condition before using them to hold the dock. Duty of care means the conditions, which give rise to an obligation to take care. Duty of care is the obligation to ensure that damage is not caused by observing due care . Duty of care exists where a person reasonably might suffer an injury, damage, or loss because of another person’s actions and the other person owes the first duty of care. There are two forms of duty of care, duty recognized by law and duty brought about by the circumstances. Where law has not provided for the duty of care, the test of the foreseeable plaintiff applies; the duty is not owed to the world at large, but just to a person within the extent of the harm created, that has been for the foreseeable victim5. The duty of care serves two purposes the first is to provide a framework for various situations in which liability may arise. It assists in showing where an individual is liable to another or owes the other a duty. The other purpose is to limit claims related to the negligence of a party; it sets the boundaries from which a party could claim due to negligence. One is supposed to observe standard care in order to ensure that they do not breach the duty of care. The only way a plaintiff can succeed in any action is by establishing a duty of care. Actions cannot withhold where no duty is established. In Gates v Mckema D6, a stage hypnotist caused psychiatric damage to a volunteer from the audience. Held the level of precaution expected should be that of a reasonably careful exponent of stage hypnotism-factor to consider-standard of care skill required. Standard care in this case is the care an individual is supposed to observe in order to ensure others are not injured or suffers losses. In Marshall v Osmond7, D while in pursuit of an escaping criminal, slammed on to the car crashing it. The presiding judge interpreted that the duty of care by the police officer was the same as that owed by any other . The duty to exhibit such care and skill was reasonable since the accident was unavoidable. He also ruled that, driving alongside another car in the police attempt to make an arrest was erroneous. This is because his judgment in the case did not amount to negligence. The factors that affect the duty of care are the balance of the involved dangers and the

History of Republic of Korea and its Affect on Cultural Values, Research Paper

History of Republic of Korea and its Affect on Cultural Values, Attitudes, & Beliefs - Research Paper Example From the northeast Asian landmass, the Korean Peninsula extends a thousand kilometers southwards. Variations on climate were pronounced three hundred kilometers along the south-north axis. Variations of these climates mark the differences in plant vegetation along the axis making the southern half of peninsula warm. Mountain ranges served as boundary markers between the regions. The natural boundaries inhibited numerous interactions between the populace living on either side of subtle, range or substantial resulted to the development of regional differences in both the customs and spoken language of the people. Town-states of Korea eventually united into tribal leagues involving complex political structures leading to the growth of three kingdoms. Between 37 B.C. and 668A.D, Goguryeo tribal league, located along the middle course of the Yalu River became the first to grow into a kingdom. Goguryeo occupied a large area of land in the segments of Korean Peninsula and Manchuria. Goguryeo attained complete trappings of an empire after subsequent establishment of a political structure (Peterson & Margulies, 2010). Baekje is the second kingdom which grew between 18 B.C and 660 A.D. Baekje kingdom grew from the town-state that was located in the south of Hangang River which is today referred as Seoul. Silla kingdom developed between 57 B.C and 935 A.D. Silla kingdom was the weakest and underdeveloped compared to the three kingdoms. Silla was located in the southeastern area of the peninsula (Peterson & Margulies, 2010). The kingdom had no Chinese influence to its geographical location. Silla kingdom had advanced Buddhist order that marked class-orientation including Hwarang, who was young aristocratic warriors. Gaya kingdom developed, as a result, of the union of several tribes along the river of Nakdonggang. In the mid-sixth century, Silla controlled the neighboring-states that were

Fiduciary Duties for Directors Essay Example | Topics and Well Written Essays - 1000 words

Fiduciary Duties for Directors - Essay Example 4). The law specifies that some of the fiduciary duties of a director are care, loyalty and good faith. In Charitable Corp v. Sutton, it was explained that directors of corporations would be regarded as agents and trustees who were required by law to act with ‘fidelity and reasonable diligence† (p.6). These three duties also give rise to a fourth, but equally important duty, that of disclosure. Duty of disclosure means that directors are required to disclose full and truthful information when they are communicating with stakeholders. The Delaware Court of Chancery has in the past stated that â€Å"an obligation to the community of interest that sustains the corporation, to exercise judgment in an informed, good faith effort to maximize the corporation’s long term wealth creating capacity† (p.12). Directors of corporations that are facing insolvency owe fiduciary duties to the corporation itself and to shareholder, never to creditors. Duty of Loyalty This fid uciary duty can be traced back to the Guth v Loft case in which the state Supreme Court passed that â€Å"corporate officers and directors are not allowed to use their position of trust and confidence to further their private interests† (p.22). ... It is the way in which a director handles the corporation’s affairs that will determine whether or not his conduct led to a breach in loyalty duty. The Delaware fiduciary law lays out some of the situations in which duty of loyalty may be implicated. Thee include: contracts between the company and directors or other corporations in which the director may have some material interest, dealings between a parent company and a subsidiary, management buy outs, corporate reorganizations or acquisitions which may result in differing interests between the majority and minority stakeholders, insider trading, taking over corporate opportunities and competition by the directors with the company. If directors fail to act when faced with a known duty, they can be charged with violating duty of loyalty (p.24). Duty of Care Directors in corporations are obligated by Delaware law to seek ample information before making any business decision. They are also required to â€Å"act with the requis ite care in making such decisions† (p.32). Although the directors are requires to act with utmost diligence and highest level of due care, they are not obligated to read or to know each and every particular of a contract or any related legal documents. They only need considerable information about a particular situation so as not to make any careless decisions. If the directors are found to have made a decision out of gross negligence, then they can be charged in court for a breach in the duty of care. In order to act diligently, the law in Delaware requires that directors should regularly attend board meetings. They are also required to take their time to review, understand and evaluate all information that they have at their disposal and they should ensure

Career in retail Essay Example | Topics and Well Written Essays - 750 words

Career in retail - Essay Example 3. This position matches with the necessary skills that I have learnt as part of my education and would provide me with an ideal opportunity to put the skills to good use. Further, the job would be a good fit for me given my personality traits and other characteristics that would match the skill set requirements of the job. All in all, the job would be an ideal starting point for me and for my career into the Canadian retail industry. 4. The pros of the job are that I would be utilizing my educational background and put to use the skills that I have learnt. The job would entail training in the areas of business and management along with finance and contracting. This would enable me to pursue the related skill sets and gain valuable insights into these fields. The biggest advantage of this job is that I would be given responsibility over an entire Franchise and hence this would be an ideal start to my career in the Canadian Retail industry. 5. The cons of the job are that since the position entails responsibilities beyond the normal ones that are part of a job in the retail industry, I would have to ensure that I scale up my performance level and work longer and harder. Though I would not necessarily see this as a negative, the fact remains that this would certainly add to the burden and I have to put in that much more work to measure up to the specifications. 6. I believe that the salary being offered is reasonable considering my qualifications and the demands of the job. There is nothing in the compensation package to suggest that the salary being offered is below my expectations or is somehow not consistent with the job description. Further, I am enthused by the fact that the package involves perquisites that make up for any deficiencies in the monetary compensation. 7. http://www.olx.ca/retail-jobs-cat-386 This job posting is

Features of Efficient Market Hypothesis Essay Example | Topics and Well Written Essays - 1000 words

Features of Efficient Market Hypothesis - Essay Example As a result one cannot earn returns over and above the average return of the market provided that the information is available when invested. The following are the underlying assumptions of efficient market hypothesis. The ‘weak form’ of the efficient market hypothesis identifies prices of tradable assets like stocks, property and bonds etc, which reflect all information that was available to the public in the past. In other words, say for example, the past prices of stock A is reflected in its current stock price. The ‘strong form’ of the efficient market hypothesis is the strongest form of efficiency of financial markets. It is of the view that information, public or private in nature, is reflected through the stock prices, in the market. Thus even insider information cannot put the investor in an advantageous position (Fama, 1970, p.383). As already discussed the efficient market hypothesis makes the assertion that asset prices reflect all the information available in the market. Now we shall explain as to why it is not able to adequately explain asset pricing with respect to debt and equity. The efficient market hypothesis is the right platform to start when one is thinking of asset price formation. However evidences have suggested that it has been unable to explain some features of market behaviour. The market prices at times are subjected to misalignments which can exist for a prolonged period of time (Fama, 1991, p.8). The random walk model is one of the versions of efficient market.

Apple and employee motivation Essay Example for Free

Apple and employee motivation Essay Ideally, Apple wants to have a workplace that fosters creativity from all the employees. Apple combines extrinsic and intrinsic motivation in order to empower their employees to be innovative. There are numerous methods Apple employs to motivate its employees. Once, Apple rewarded its executives by giving them a recognition bonus of 3 to 5 percent of their base salary. This motivating incentive occurred despite the fact that they recently missed their target on a project. This implies that Apple upper management empathized with the groups efforts. Another motivating incentive is the discount on products that all Apple employees receive. Employees who work at corporate Apple can receive a free iPhone or iPod Shuffle. Giving products to employees rather than money can be a better an effective motivator because many Apple employees are simply motivated to see the end results of their efforts. It is also typically cheaper to give the employees products rather than a raise. Recently, Apple has given employees more vacation days due to the companys strong performance in product sales. These are all extrinsic examples of how Apple motivates its employees. Employee motivation also stems from the corporate culture. Most Apple employees are heavily committed to their work and can be described enjoying monotonous encoding. Perhaps it is even insightful to look at what intrinsic forces were driving Steve Jobs. Jobs Stanford commencement speech indicates that he knew he had a limited time on Earth and this motivated him to follow his heart and pursue his passion. His ultimate motivation for creating innovative products was not based around profit but what would he would personally want to have.

Strategic Management Industry Structures And Dynamics Business Strategy Essay

Strategic Management Industry Structures And Dynamics Business Strategy Essay Introduction: Dell Company was founded in 1984 by Michael Dell. It is the worlds largest direct-sale computer vendor; Dell Inc. is now also the leading seller of computer systems in the world, capturing a global market share of more than 15 percent. Dell markets desktop personal computers, notebook computers, network servers, workstations, handheld computers, monitors, printers, high-end storage products, and a variety of computer peripherals and software. In this part I will use Porters Five Forces to analysis Dells great success in the industry. Force 1: The Degree of Rivalry. The PC industry consists of a number of companies; hence the threat from industry competitors is high. Due to the product being highly standardized and shifting costs between brands is low, there is fierce competition which leads to lower margins and profitability in the market. The PC industry can be described as a high competitive industry. For Dell the main competitors are IBM, Apple, HP, TOSHIBA, Gateway etc. Dell uses several strategies to reduce the competitive rivalry between existing players. Firstly Dell differentiated its sales from other competitors. Dell used the direct sales strategy since 1984. To sell PCs directly to consumers, by passing retail stores and system integrators and offering limited customer support but dramatically lower prices. For years, that direct, low-cost sales model worked perfectly. It allowed Dell to make high margins while selling computer gear for less than its rivals. As a result, it now holds a leading 17.9% share of the world PC market and has grown much faster than competitors Hewlett-Packard and IBM. With thousands of phone and fax orders daily, $5 million in daily Internet sales, and daily contacts between the field sales force and customers of all types, the company kept its finger on the market pulse, quickly detecting shifts in sales trends and getting prompt feedback on any problems with its products. If the company got more than a few similar complaints, the information was relayed immediately to design engineers. When design flaws or components defects were found, the factory was notified and the problem corrected within a matter of days. Management believed Dells ability to respond quickly gave it a significant advantage over rivals, particularly over PC makers in Asia, which made large production runs and sold standardized products through retail channels. Dell saw its direct sales approach as a totally customer-driven system that allowed quick transitions to new generations of components and PC models. i Secondly Dell provided good customer service to compete with its rivals. In 1986 the company began providing a guarantee of free on-site service for a year with most of its PCs after users complained about having to ship their PCs back to Austin for repairs. Dell contracted with local service providers to handle customer requests for repairs; on-site service was provided on a next-day basis. Dell also provided its customers with technical support via a toll-free number, fax, and e-mail. Dell received close to 40,000 e-mail messages monthly requesting service and support and had 25 technicians to process the requests. iiBundled service policies were a major selling point for winning corporate accounts. If a customer preferred to work with his or her own service provider, Dell gave that provider the training and spare parts needed to service the customers equipment. Force 2: The Threat of new Entry. Firstly, Dell created a brand image to reduce the threat of new entries by advertising. Dell was the first computer company to use comparative ads. Its advertisements have appeared in several types of media including television, the Internet, magazines, catalogs and newspapers. Secondly, Dell cuts its price or offering free bonus products in the effect to maintain its market share. In 2006, Dell cut its price in an effort to maintain its 19.2% market share. However, this also cut profit-margins by more than half, from 8.7 to 4.3 percent. To maintain the strategy Dell continuing to accept the online and telephone purchase. The brand loyalty and the low price built up a barrier of entry for the new companies. Force 3: The Threat of Substitutes. Other devices like PDA, handheld electronics etc. are now coming out with features similar to PCs. The mobilebility is the key factor of the competition. Dell generate a smaller size laptop called mini which only has a 10.1 inch screen and only sells at the price under  £200 which is even lower than some of the handheld electronics. With the efficiency of mobile and the same function, for example Wi-Fi and Bluetooth, Dell protects its market share against those substitutes. Force 4: Bargaining Power of Customers. Dell built up its brand loyalty to reduce the bargaining power of customers. First, Dell had its own system and strategy to manage the relationship with customers. Since Dell use the direct sale strategy, customers can buy Dells products from the website or ordered by phone or fax. The customers then can personalize their computer by choosing the configuration of the computer (e.g. RAM, processors, and hard-disk capacity). On the Dells website from which people can directly choose, buy and give feedback, it divided the customers into four major groups home users, small medium business, public sector and large enterprise. Dell then treats different groups differently by offering the special service they need from different groups. For instance, Dell provides special solutions and services for higher education. Such as data consolidation and management, HPC (high performance computing environments), wireless solution, connected classroom etc. Because of its direct sale strategy, Dell can easily track the service for any individual buyers. All the buyer information will be stored in its system; dell can differentiate customers and send relevant product information and services to different customers. These special strategies in selling upgrade its brand image among customers. Second, Dell uses the advertisements to help building up its brand image. On the website, TV, newspaper, high street, people can easily find dells advertising. Those can not only increase dells market activity but also increase its brand pride. Force 5: Reducing the Bargaining Power of Suppliers. Dell has a special understanding on the SCM (supply chain management). Dells strategy is to limit the amount of supplier but pick up some outstanding supplier all over the world. Each supplier has a very close relationship with Dell in long-term. Dell uses its huge globe market to share its business with its entire suppliers. For instance, Dell built a assemble factory in Malaysia, its supplier from Ireland soon built a factory in there as well in order to gain a geographic efficiency. Dell had its assemble factories all over the world which relatively close to its suppliers. This will save a lot of transport costs. The double-win strategy makes the supply chain works well. With the double-win strategy and constant relationship, Dell will be able to ask lower price from the suppliers and reduce the bargaining power from them. Market part: Segmentation Introduction: Michael Dell emphasized the significant status of customers to the companys business by stating Finding ways to get close to your customers is critical to your success. Since different people would have different need from the computer, Dell divided its customers into several segments by discovering special needs from each segment. In the year 1994, the customer group was only divided by two primary customer and normal customer. In that year the assets of Dell is 3.5billion USD. In July 1996 Dell launched its online website www.dell.com. On the website primary client are divided into three segments which are large company, medium company and government education. Customers can easily choose and buy the products directly with advices and helps from dell.com. The assets of Dell rocketed up to 7.8 billion USD in that year. However in 1997, Dell continued differentiating its customer for more segments. Government education segment was divided to State Local Government, Federal Government and education. Small company and home users were also been created as individual segments. The net revenue of Dell was 12 billion in that year. On todays Dells website, people will be able to follow the tips and choose a suitable computer in few minutes. Whats more, customers can personalize their chosen computer by changing the configuration of the computer (e.g. color, RAM, processors, and hard-disk capacity). With this direct sale through different segments, Dell can start to assemble the computer once the transaction has been made. The inventory can then be limited as low as zero. Not like Dells competitors, Dell does not need many warehouses all over the world which will save a lot of costs for the company. Although on todays Dell.com, customers are divided into a lot segments. However, literally customers are differentiated into two segments; Relationship customers in opposing Transaction customers. Although Dell intends to build and maintain a good relationship with all customers, it also becomes clear, that the company would regard some customers more relationship worthy than others, by analyzing customer value. The relationship customers are mainly large enterprise and government etc. which occupied 40% of Dells entire customer. Transaction customers are small business and home users which have percentage of 30 among customers. The remaining 30 percentage customer is regarded as a mixed customer. The advantage for dividing customers in different segment is that the company would be able to analysis how it can encourage the customers to buy its product. For individual users or small business price is the priority. Those customers are regarded as more price insensitive. So for home and small business users the price is slightly lower than its competitors e.g. HP, Toshiba and Sony. For bigger customers such as the government or enterprise, they consider more than the price but consequent services and supports. Take large enterprise for instance, Dell supports a lots of specific services and solutions for running the business. Like Infrastructure Consulting service which is basically a plan for simplifying IT infrastructure, helping reduce operating costs while freeing up resources for new business initiatives.iii Also, Dell runs a program called Dell business Creditiv. This is the same as a loan offered by Dell, but with no interest rate and anytime to pay off the balance. Business without enough cash flow would like to take that program. One of the Dells competitors is IBM, it has a clearly customer segmentation but different from Dell. IBM is more focusing on Business and Industry market. In a simply word it is even more focusing on the Big customers. Similar as Dell did for big client, but even did more specific for the segmentation. For Dell there is no segment for industries like Aerospace, Chemicals and petroleum. More segmentation on large customers also brings more services and solutions for all kinds of industries. One of IBMs famous solutions is offering the security management for Wimbledonv. It provided the security solution for players, staff, media and spectators around the world. Conclusion: Dells market share was No.2 in 2009, IBM was far behind. But since Dells customer groups is much bigger than IBMs. In 2006 IBM sold its PC department to Lenovo, Lenovo used IBMs brand to product and sell IBMs ThinkPad series. It is very difficult to compare which segmentation is better. But for the large business users, IBM is a very strong competitor against Dell, Its high performance computer and advanced technical solutions and services makes IBM the biggest company for larger business and industries. i scribd.com Dell operation ii McGraw Hill Dell Computer Corporation mhhe.com/business/management/thompson/11e/case/dell5.html iii Dell.com Large Enterprise service iv Dell.com business credit v IBM.com Wimbledon case study

Systematic Review of the Mental Health Review Tribunal

Systematic Review of the Mental Health Review Tribunal A Systematic Review of the Mental Health Review Tribunal: Processes, Roles and Impact 1. What is the Mental Health Review Tribunal? The Mental Health Review Tribunal is a collection of independent judicial bodies that aim to review the cases of suitable applicant patients who have been appropriately detained under the Mental Health Act 1983[1]. Following strict guidelines and statutory criteria for discharge, collectively, members of the tribunal have the power to direct the discharge of applicant patients who satisfy the relevant discharge criteria. According to the official website of the tribunal (Mental Health Review Tribunal[2]), its other principal powers are: To recommend leave of absence from employment or school as appropriate To recommend supervised discharge To recommend transfer to other hospital or relevant health care professional To issue directions regarding procedural matters To reconvene if any of their recommendations from a past Tribunal hearing is not complied with In general, the Mental Health Review Tribunal serves as a safeguard against wrongful admission or unwarrantedly long detention (Wood, 1993[3]). As such, they give detained patients access to an effective appeal mechanism in order to ensure, as far as possible, legal protection of their liberty. All this is carried out in accordance with the Human Acts Right. There are five Tribunal offices in the United Kingdom (Mental Health Act 1983; Memorandum on Part V[4]). Each region in England is operated under a separate MHRT and a separate Tribunal covers the whole of the country of Wales. Accordingly, there are five Tribunal offices that provide administrative support to the respective MHRTs. The MHRT operates under the provisions of the Mental Health Act 1983 and the Mental Health Review Tribunal Rules 1983 (Her Majesty’s Stationery Office, 1983[5]). The powers and duties of the Tribunals are as set out by the Mental Act 1983, subsequently amended in the ensuing policy document, the Mental Health (Patients in Community) Act 1995. The actual Tribunal process usually takes place in the hospital where the applicant patient is being retained, and is usually held in private, unless otherwise agreed by the patient in question and the members of the Tribunal. The actual processes and review procedures of the Tribunal are defined in the Mental Health Review Tribunal Rules 1983 (Her Majesty’s Stationery Office, 1983); similarly, this has also been amended to a more current version. Tribunal procedures and deliberations should always be carried out in accordance with the principles of the statutory instrument and the principles in which the other subgroups operate when considering Definitions, Guardianship and the Mental Health Commission under the Mental Health Act. These include: Non-discrimination Equality Respect for diversity Reciprocity Participation Respect for carers Least restrictive alternative and informality Respect for rights All patients that have been detained under the Mental Health Act 1983 or that are eligible for guardianship or supervised post-discharge care have the fundamental right to appeal, i.e. to apply for a review by submitting an application to the Mental Health Review Tribunal, within the specified time limits as specified in the Mental Health Act. Furthermore, in order to ensure regular reviews of all cases, if the patient fails to make such an application the Tribunal, the appropriate body or personnel is obliged to make a referral of the case to the appropriate regional Tribunal. The party responsible for making this mandatory referral differs for various patients and depends on the restriction status of the patient (discussed further in section on types of patients): In the case of restricted patients, it is the responsibility of the Secretary of State for Justice to refer the case to the Tribunal In the case of non restricted patients, the onus falls on the hospital managers In a review of Representing the mentally ill and handicapped (Gostin and Rassaby, 1980[6]), the authors who are incidentally representatives of the National Association for Mental Health (MIND), highlights the unmet need for legal representation for applicant patients at Tribunal hearings of over 20,000 patients annually. However, as pointed out by John Hamilton (1980)[7] of the Royal College of Psychiatrists, 90% of these patients are, in fact, on short term detention orders and remain as informal patients after the expiry of the said order. In fact, a great majority of patients are compulsorily detained only for very short period of times and (from 72 hours to 28 days) and may not be eligible for a review process during that limited amount of time (Rollins, 1980[8]). As a result, the informal status of the applicant patient is very important because most of the hospitalised mental health patients in England and Wales are informal (Andoh, 2000[9]). Thus applying one safeguard provid ed in the Mental Health Act 1983, less than 10% of mental health patients who are compulsorily detained have a statutory right of appeal from an independent Mental Health Review Tribunal. In Gostin’s replying correspondence (1980[10]), he revisits the Percy Commission, and emphasises the glaring discrepancies in expected and actual rates of Tribunal hearings. According to Gostin (1980), the Percy Commission envisioned that there would be approximately 8000 ­ – 9000 Tribunal hearing every year. However, in reality, there norm is a figure of about 750, with the maximum ever annual rate being 1515 hearings. As a consequence, most Tribunal members hear only one or two cases each year and thus do not have the opportunity to garner experience and familiarity with a diverse breadth of cases that would have been beneficial to improve future judgements. In the past two decades though, there has been a major increase in the number of applicants to the Tribunals (Crossley, 2004[11]). In fact, as reported by Blumenthal and Wessely in 1994[12], applications to the Tribunal rose dramatically in the 10 years between 1983 and 1993, with the figure approaching 10,000, i.e. almost a three-fold increase since 1984 and costing approximately 12 million pounds ( £). 2. Mental Health Legislation Mental health legislation in the Commonwealth countries is changing in some common law jurisdictions (Carney 2007[13]). There is an increasing debate on whether it is, in fact, a health or legal issue and certain schools of thought question the need for special legislation in the present day. There is controversy over the non-therapeutic nature of criminal law, especially in its sentencing and penological aspects; can the inherent workings of law ever be adjusted to incorporate the perspective of therapeutic jurisprudence (McGuire, 2000[14])? Furthermore, some critics also question the beneficial role of Tribunals or legal adjudication of the detention requirements. The very fact that the term ‘detention’ is used to describe the process of admission of these often vulnerable patients is probably evidence of the need for legal contribution. As mental health patients are frequently prone to violence and can be considered a risk to the public and themselves, it is evident t hat both disciplines of health and the law need to collaborate to achieve optimal long-term management of this population. 2.1 The Mental Health Act 1983 The Mental Health Act 1983 provides legislative guidance for the compulsory ambulatory assessment, care and treatment (i.e. the overall management in hospital) of patients with a mental disorder. In the Mental Health Act document mental disorder is defined as â€Å"mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind†. As an amendment from the Mental Health Act 1959, the 1983 policy document requires that in order for a patient to fall within the criteria for ‘severe mental impairment’ or ‘mental impairment’, the patient in question has to be associated with abnormally aggressive or seriously irresponsible behaviour (Singh, 1984[15]). This definition excludes an appreciable amount of severely impaired or impaired mental health patients that are neither ‘abnormally aggressive’ nor ‘seriously irresponsible’, and thus these equally vulnerable patients rema in unprotected under the amended Mental Health Act 1983. Thus it would appear that the definitions of, under the Mental Health Act 1959, of severe mental subnormality and mental subnormality would be more considerate and fair towards such patients, as it certainly encompassed in the definition the vulnerability of this mental health patient population (Singh, 1984). In part, the Act states that, ‘severe subnormality being of such a nature or degree that the patient is incapable of living an independent life or of guarding himself against serious exploitation or will be incapable when of an age to do so, and in the case of mental subnormality of a nature or degree which requires or is susceptible to medical treatment or other special care or training of the patients’. Thus the recommendations outlined herein in this document apply not only to patients suffering from ‘more violent mental disorders’, but also vulnerable patients who may find it difficult to express their various needs, or who in some extreme, cases, may not even recognise that they need specialist help. It has been proposed that mental health should be given the same priority as physical health (Kmietowicz, 2005[16]). Application of the 1983 Act should also take into consideration exclusions from the definition of ‘mental health’, as set out in Section 1 (3) of the Act. This section of the policy document states that a person should not be treated under the provisions of the Act, if they are suffering from mental disorder purely by reason of promiscuity, other moral conduct, sexual deviance or substance misuse, including dependence on alcohol or drugs. However, the Act recognises that such behavioural problems as listed above may be accompanied by, or assoc iated with, mental disorder, and as such should be overlooked in its entirety. Real life experience apparently shows that the Act is usually fully implemented with appropriate communication and collaboration between the various disciplines involved (Ourashi and Shaw, 2008[17]). A recent of judicial practice and assessment of risk to the public in detained individuals, based on Sections 37/41 of the Act, showed that, in addition to the primary need to protect the public, an additional and almost equally important intention was to ensure compliance with both after-care services and medication. In the study sample, which was made of 12 judges from crown courts in England, it was found that restriction orders were rarely made contrary to the recommendations of the affiliated medical practitioner. It is worthy of note to consider that the recent Mental Health Act of 2007 have introduced some important modifications to core recommendations and standard roles and responsibilities of mental health practitioners (Kousoulou, 2008[18]). These amendments perhaps gain even more importance when we consider the revolutions that have occurred in psychiatry since the original Mental Health Act 1983 was implemented. Of particular importance, is the notion in 1983, that there was no link between mental illness and violence which has now since been proved invalid (Monahan 1992[19]). From October this year (2008), the Mental Health Act 2007 will be fully implemented in the procedures associated with the Mental Health Review Tribunals. 2.2 The Mental Health Act 2007 Amendments to the 1983 Mental Health Act policy document in the Mental Health Act 2007, which are directly related to any aspect of process of the Mental Health Review Tribunal and outlined topline below (Office of Public Sector Information, 2007[20]): Removal of categories of mental disorder: the key definition of ‘mental disorder’ is amended from that which is outlined in Section 1 (2) of the 1983 Act. For the definition of ‘mental disorder’ and mentally disordered’, substitute ‘mental disorder’ means any disorder or disability of the mind; and ‘mentally disordered’ shall be construed accordingly’. In addition the following statements are omitted in the recent amended version: Those of ‘severe mental impairment’ and ‘severely mentally impaired’ Those of ‘mental impairment’ and ‘mentally impaired’ That of ‘psychopathic disorder’ Amendments to the section on the Mental Health Review Tribunal include specific issues related to: Patients absent without leave Duty of hospital managers to refer cases to the Tribunal Power to reduce periods under Section 68 Restriction orders: in relation to restricted patients Conditionally discharged patients subject to limitation directions 2.3 The importance of making the right decision There have been reported cases of mental health patients who commit suicide within a mere 12 months of contact with mental health services. For example, in a national clinical survey that was carried out in England and Wales, over 2,000 mentally impaired suicide victims had had previous contact with mental healthy services in the year before (Appleby et al, 1999[21]). A review by mental health teams concluded that suicide could have been prevented in more than 20% of these cases. In conclusion, the researchers made logical recommendations for suicide prevention measures in mental health services, including strategies to improve compliance and sustain contact with the appropriate mental health services. In addition, there is also the additional threat to the innocent people of the public. The perceived threat of mentally disordered patients, who have been released from detention, to the public has been explored severally (Norris, 1984[22]; Buchanan, 1998[23]; Jamieson and Taylor, 2002[24]). In fact, several years ago, in New Zealand, there was a controversial case of a mental health patient who committed murder six hours after being released from detention (Zinn, 2003[25]). Interestingly, the said patient was found not guilty of the murder by reason of mental illness. Furthermore, the patient was awarded compensation of the value of  £300,000 after he sued the health authority for failing to detain him as an involuntary patient under the Mental Health Act. As such, it is evident that there are many incentives here for ensuring that the right intervention is applied to the right patient. 3. Members of the Tribunal: The Relevant Stakeholders Essential members who must be present at each Tribunal hearing are (Mental Health Review Tribunals website) include: The regional chairmen A legal member A medical member, and A lay member For each geographic region, the Lord Chancellor makes appointments and decides who sits on the different panels. For the other members other than the legal member (i.e. the medical and lay members), the Secretary of State for Health, for cases in England, and the Secretary of State for Wales, for cases in Wales, are also consulted in the decision making process. Each member has a specific and individual role in the co-ordination of the Tribunal hearing. In addition to the essential Tribunal members outlined above, there are other stakeholders involved in the long-term process of the review process. These could be private non-governmental organisations, such as the National Association for Mental Health (MIND). Whether these members are salaried or not is usually discretionary, but the norm is that there is no salary payable, but that members receive an attendance fee and travel and subsistence allowance. On the contrary, the Tribunal chairman is a salaried role. 3.1 Role of the regional chairman A regional chairman is appointed for each of the two Tribunal regions in England: the North Region and the South Region, which are conveniently based in Manchester and London, respectively. The roles of the regional chairman of the Tribunal are multi-factorial and include (Mental Health Review Tribunals website): The regional chairman appoints specific members to particular Tribunal hearings The regional chairman has the responsibility of ensuring that all the statutory requirements are complied with, making judicial decisions and giving necessary direction a timely and fair decision is reached in each and every case The regional member is also responsible for organising training for the members of the Tribunal to ensure that all members have the updated skills and knowledge that would be necessary to effectively carry out their individual roles It is the role of the regional member to oversee the appraisal mentoring scheme of the members of the Tribunal, thus highlighting training needs (see point above) to continually improve the review process The onus also falls upon the regional chairman to handle any complaints about the conduct of any members of the Tribunal, or to refer the case to higher authorities if warranted 3.2 Role of the legal member The legal member, more often than not, presides over the Tribunal hearings. Legal members of the Tribunal are usually elected or appointed on the basis of their specific expertise in the particular area of jurisdiction (Ferres, 2007[26]). They are required to â€Å"have such legal experience, as the Lord Chancellor considers suitable† (Department for Constitutional Affairs, DCA[27]). In addition, interpersonal skills and a good understanding of the health system are crucial as fundamental qualifications of the Tribunal legal member. The official website of the Mental Health Review Tribunal provides relevant specific information on the requirements of becoming a legal member and outlines the roles of the legal members as: The legal member acts as President of the Tribunal. Revisiting the primary role of the MHRT, which is to review the legality of the applicant patient’s detention in hospital and to direct the discharge of those to whom the statutory discharge criteria apply; and to safeguard the patient’s fundamental human right to be free from unjustified hospital detention (Richardson and Machin, 1999[28]), it is evident that this process is essential a legal one. It is thus only logical that the Tribunal be presided over by a member of the legal profession. In addition, the legal member of the Tribunal has the responsibility to ensure that the proceedings of the review process are carried out in a fair and balanced manner. The legal member is also responsible for ensuring that the legal requirements of the Mental Health Act are properly observed The legal member of the Tribunal also has the role of advising and addressing any questions of law which may arise before the hearing, during the hearing and during the deliberation discussions with the other members of the Tribunal In collaboration with the medical member and the lay member of the Tribunal, the legal member is also responsible for drafting the reasons for the reached decision, and for endorsing the record of the agreed decision One of the major that the legal members of the Tribunal face is the danger that the medical member could dominate what must essentially be a legal process (Peay, 1989[29]). 3.3 Role of the medical member As stated above, a medical practitioner is one of the necessary members of the Tribunal and their role, though clearly invaluable, is fraught with opposing views from the multidisciplinary stakeholders in the field. In 2000, Gibson[30] proposed that the role of the medical member was introduced in the 1959 Act to make the process of medical notes review less arduous â€Å"without ruffling medical feathers†. However, according to Prins (2000[31]), the origin of the required disciplines to sit in Tribunal hearings is much more complex than that, as there were conflicting views that arose during the parliamentary debates leading up to the 1959 Act, as to who was best suited to make that all-important decision regarding the patients’ release or continued detention. It is worthy of note, here, that in those early legislative days, the commonplace law was one which involved a purely judicial decision, which probably explains the disinclination to acknowledge the need for a me dical aspect in the decision making process. The medical member could be the patient’s treating psychiatrist, a nurse or any other member of the mental health team. According to the Mental Health Review Tribunal website (Mental Health Review Tribunal), the medical member is customarily a consultant psychiatrist with several years of extensive experience who is able to advise other members of the Tribunal on any relevant medical matters that should be taken into consideration in the patient’s review. There is evidence that the dual role that is expected of medical practitioners on the Tribunal is a potential barrier to having the fairly balanced and effective hearing that is the main objective of the review or appeal process. As with the legal member and all other members of the Tribunal board, interpersonal skills and a good understanding of the relevant health system are important for all Tribunal members (Ferres, 2007). In addition to this fundamental criterion, Ferres (2007) emphasises the dilemma that is brought upon the medical member as a direct consequence of his/her role as a medical practitioner and a sitting as part of the Tribunal. According to the official website of the Mental Health Review Tribunal (Mental Health Review Tribunal), the basic roles of the medical member of the Tribunal can be categorised as outlined below: Medical role: this member is required to carry out an examination of the patient before the hearing and, in so doing, make any necessary interventions – or simply make any necessary steps – that could potentially aid the decision making process in forming an opinion of the patient’s mental health condition. This is clearly in accordance with Rule 11 of the Mental Health Review Tribunal Rules (Her Majesty’s Stationery Office, 1983), which requires the medical member of the Tribunal to â€Å"at any time before the hearing†¦examine the patient and take such other steps as he (or she) considers necessary to form an opinion of the patient’s mental condition†. Judicial role: the medical member, together with the other members of the Tribunal, have a judicial responsibility to decide the patient’s fate, in terms of if the patient could still represent a danger to self or others and should thus remain in detention, or if the patient is suitably fit to be released into the public domain. Researchers in the past have shown that the duality of their roles on the Tribunal need not lead to knowledge bias, which could cause a flawed opinion (Langley 1990[32]; Brockman B; 1993[33]). However, in drastic contradiction to this, some more recent opinions expressed by critical schools of thought believe that the dual nature of the expected medical member’s role is a possible barrier to open-mindedness (Gibson, 2000; Richardson and Machin, 2000[34]). The, somewhat logical, fear is that doctors’ judicial opinions of patients’ eligibility for release would undoubtedly be swayed by findings from their preliminary observations and assessments. Apparently, for the review process to be carried out fairly, medical members of the Tribunal should strive to make their decisions based only on reports, evidence and witness and patient reports that presented to them during the Tribunal hearing. As such, any details divulged by the patient prior to the Tribunal hearing sh ould not be considered as evidence and must not be taken into account. Similar to this notion, the Law Reform Committee, in 1967, recommended that a doctor should not be compelled to give evidence of issues that he may have had access to with the patient that have no bearing on the patient’s mental or physical health (Law Reform Committee, 1967[35]). Putting it logically, general human nature may well be a barrier to such sentiments. Having conducted an examination of the applicant patient, and presumably consequently forming a clinical opinion, the medical member of the Tribunal is expected to morph into a decision making member to attend the review hearing. As the Council of Tribunals have very aptly described it, the medical member is â€Å"effectively a witness and a member of the Tribunal, deciding the validity of his own evidence† (Council on Tribunals, 1983, paragraph 322[36]). The unanswered question, thus, is: how can the medical member be expected to detach his previous medical knowledge of the said patient from evidence that is presented in the Tribunal and remain objective in his opinions and, if this distinction is necessary, does the inherent benefit of the preliminary assessment then become invalid? These questions also corroborate the idea of the protection of the doctor’s professional confidence una voidably conflicting with the interest of justice (No authors listed, 1967[37]). However, in his correspondence to the editor of the British Journal of Psychiatry, Gibson (2000) stresses the inherent advantages of the preliminary examination prior to the Tribunal hearing. The main benefits are outlined below: The preliminary examination session gives the medical member a chance to review the applicant patients’ clinical notes which may contain crucial data and clinical findings that are omitted from the reports The preliminary examination session also prepares the medical member to ask the most appropriate questions at the hearing, thus ensuring that the benefits of the review process is optimised Furthermore, Gibson (2000) has suggested that, in order to eliminate the potential prejudice that could accrue from the preliminary assessment and the associated disadvantage of the often time consuming nature, that the applicant patients’ notes should be made available to all of the Tribunal members in the half hour before the Tribunal hearing is scheduled to take place, thus dispensing with the need for the historical preliminary examination. The limitations of this proposal, as succinctly put forward by Prins (2000) are two fold: As we all know from our practical clinical experience, in many cases, medical notes are too voluminous and complex to do a proper review in half an hour. In some cases, it would take days to form an understanding of the contents of such files. Also, the feasibility of medical notes review by all members of the Tribunal is doubtful. Without a certain degree of medical expertise, it would be near impossible for the two non-medical members of the Tribunal to comprehend the contents of the applicant’s patients’ medical notes. This would then necessitate the additional step of medical interpretation for the benefit of these members, leading to longer duration of the review process, and thus, increased costs and burden on the health system. 3.4 Role of the lay member According to the official Mental Health Review Tribunal website, the lay member of the Tribunal serves to provide some form of balance to the Tribunal as a representative of the community outside the dominating, and often clashing, legal and medical professions. Normally lay members would have a background or practical experience of working in the health and welfare field in the National Health Service, voluntary organisations or private health sector. The lay member may also be experienced in social services on administration (Lodge, 2005[38]). 4. Other stakeholders involved in the Mental Health Review Tribunal 4.1 Legal representation for the mental health patient In addition to the legal member of the board, legal representation is usually advised for the patient. A legal representative can be useful to explain the law to the patient and help to protect his or her best interests (Mental Health Review Tribunal website). As a matter of circumstances, the mental health patient’s handicap or mental illness, coupled with the possible effects of having been institutionalised and various antipsychotic medications, make self-advocacy invariably difficult (Gostin, 1980). These patients do, however, have the right to choose to represent themselves; nevertheless, this option is not advisable. Furthermore, Larry Gostin of the National Association for Mental Health (MIND), in London, goes on to convincingly justify the need for legal representation for the mental health patient. Patients who attend the Tribunal without legal representation are frequently denied access to the full reasons for his confinement and subsequent decision, and medical and social reports pertaining to his or her case may be withheld from the patient as confidential (Gostin, 1980). When a legal representative is involved and present during the hearing, he or she is party to all relevant documents and can share the information with the client (in this case, the mental health patient). Another even more important advantage of having legal representation is the ability of such a legal professional to examine provision in the community for housing, care and support. Thus as highlighted above, the benefit of legal representation for the mental health patient in the Tribunal cannot be overemphasised. This calls to question the ethics of the preliminary examination session, during which the vulnerable mental health patient is examined by the medical member of the Tribunal towards forming an opinion of his or her ment