NEW FORMS OF PROVIDER IN THE ENGLISH NATIONAL HEALTH SERVICE

ABSTRACT 1 : A wide ranging set of reforms is being introduced into the English National Health Service (NHS). They are designed to increase the market‐like behaviour of providers of care with a view to improving efficiency, quality and responsiveness of services. This paper is concerned with one aspect of those reforms: namely the policy to increase the diversity of types of providers of care to NHS patients. In this context, increasing diversity means that providers will not all be standard publicly owned NHS organizations. They can be publicly owned but autonomous, or independent (both in for‐profit and not for profit). The paper discusses the wide range of organizational forms available, analyzing their governance structures It then discusses the small amount of evidence currently available about the performance of diverse providers of health care.     

Trip end models of local rail demand in England and Wales

This paper details models which have been developed to forecast the total number of trips made from local rail stations in England and Wales over a one year period. The use of multiple linear regression and geographically weighted regression in calibration are compared, with both explaining over 75% of the variation in the observed data. The latter technique has not previously been used in rail demand modelling, and allows significant spatial variations in the effect of independent variables to be identified and mapped. A number of catchment definition methods are investigated, as is the inclusion of a wide range of demographic and service related explanatory variables. The models developed are used to forecast usage at stations on the recently opened Ebbw Vale branch line in South Wales and these predictions are compared to initial usage figures.     

Knowlege networks for innovation in small Scottish software firms

This paper examines the emergence of small indigenous software companies in Scotland, focusing on the strengths and weaknesses of the region's socio-economic infrastructure as a foundation for innovative new business ventures. Following a brief review of some of the accepted wisdom on high-tech start-ups and regional economic development the paper provides some background information on the Scottish region, comparing new firms in the software industry with the foreign multinationals that dominate the local IT industry. A framework - the ‘sociotechnical constituencies’ approach - is then proposed that allows the author to examine networks of specialist knowledge that underlie new business development. Agglomeration effects and the influence of ‘clusters’ of complementary types of knowledge, expertise and innovative competencies at the regional level are at the heart of the analysis. The framework is applied to a sample of local firms, looking at how ‘learning’ via sociotechnical networks underlies their evolution. Policy-makers' attempts to boost the region's new business birth rate and promote the hoped-for ‘silicon glen’ effect are viewed in the light of the study's findings.     

Jousting with Malthus’ ghost: Environment and conflict after the cold war

G. Baechler, Violence through Environmental Discrimination: Causes, Rwanda Arena, and Conflict Model, Dordrecht: Kluwer 1999.

A. Carius and K.M. Lietzmann (eds), Environmental Change and Security: A European Perspective, Berlin: Springer 1999.

T. Homer Dixon, Environment, Scarcity and Violence, Princeton, NJ: Princeton University Press 1999.

K.M. Lietzmann and G.D. Vest (eds), Environment and Security in an International Context, Bonn: North Atlantic Treaty Organization Committee on the Challenges of Modern Society 1999, Report No. 232.

S.C. Lonergan (ed.), Environmental Change, Adaptation and Security, Dordrecht, Kluwer 1999.

L. Ohlsson, Environment, Scarcity and Conflict: A Study of Malthusian Concerns, Department of Peace and Development Research, Goteburg University 1999.

M. Suliman (ed.), Ecology, Politics and Violent Conflict, London: Zed 1999.     

The demand for Indonesian narrow money: long-run equilibrium,error correction and forward-looking behaviour

Since the 1960s, the banking and financial sector has been at the forefront of the Indonesian development strategy. Thus in order to gain an understanding of the problems and opportunities facing Indonesia, it is essential to understand the workings of the monetary sector of the economy. The aim of this paper is to analyse the narrow component of money demand, using modern econometric techniques. But the major innovation of the paper (in the context of a developing country) is the use of an explicit forward-looking model. This approach, the consequence of financially sophisticated behaviour on the part of Indonesian agents, has significant policy implications. One of these is that announced changes in policy, if credible, will lead to a more rapid response from the private sector than if agents were purely backward looking. This may make the operation of monetary (and other) policy more effective than would otherwise be the case.     

Internationalization of multi-source feedback systems: a six-country exploratory analysis of 360-degree feedback

In the past few years, few human resource practices have received as much attention as multi-source feedback systems (MSFSs). In the US and Canada, it is estimated that over one-third of organizations are using some form of MSFS and recent surveys show that this practice is still gaining popularity. Concurrently, a substantial amount of literature has focused on the effectiveness of this performance management practice. However, while few would dispute the popularity of MSFS, relatively little has been published on the use of these systems outside North America and thus little is known about their form and effectiveness in international contexts. This paper outlines the results of an international survey of MSFS. Interview data from HR managers and consultants from Argentina, Australia, China, Slovakia, Spain and the UK demonstrate that MSFS are being implemented, in slightly different ways, in each of these six countries. The main challenges in the application of MSFS in these various countries are the communication efforts necessary before and after implementation, and the inherent difficulty in giving and receiving feedback. The results of this study also provide data as to the perceived future of MSFS in each of the countries surveyed.     

The Impact of Mergers on Quality Provision: Evidence from the Airline Industry

We examine how mergers affect quality provision by analyzing five U.S. airline mergers, focusing on on‐time performance (OTP). We find that airline mergers have minimal negative impacts on OTP, and likely result in long‐run improvements due to efficiencies. Importantly, we show that this finding is not driven by post‐merger changes in price that could affect OTP. Consequently, at least in the case of airlines, policymakers should not, as a rule, fear the negative quality effects of mergers.     

Landscape Sensitivity and Tourism Development

The paper argues that carrying capacity is not the most effective way to analyse the relationship between the 'natural' environment and tourism pressure. Rather that concepts embedded within geomorphology, namely 'lag time', 'environmental thresholds' and 'dynamic metastable equilibrium' may provide a better approach to examine feedback between tourism and the environment. This could also provide the conceptual framework for the integration of the natural and social sciences in the study of tourism impacts, and the mechanism for truly sustainable development. The paper contends that the identification and management of threshold events and the use of base-line data on time scales of 10² to 10³ years should be at the centre of the decision-making process. The paper warns against the use of 'limits of acceptable change' as a way of managing the interplay between tourism and the environment. The relationship between shoreline management and tourism development is used to illustrate the arguments presented.