GPs as firms: Creating an internal market for primary care

Outsiders are often amazed at the lack of contact and communication between general practitioners and other members of the primary care team on the one hand, and the rest of the national health service on the other. One way to help close the gap and improve services generally would be to provide GPS with appropriate incentives.     

A Stochastic Model for Pensionable Service

Abstract

In this paper, a stochastic model is developed for the prediction of the employee's cumulative pensionable service over his working life, as a function of his unemployment periods and his completed lengths of service, under a service requirement constraint. Distributional and first passagetime problems are considered for the total pensionable service and a generalized renewal equation is formally solved. Further useful results are obtained and numerical applications are given.     

Quality assurance: The professional's role

How can professionals, especially those in the caring professions, feel confident that the service which they are providing for clients is of an acceptable standard? Any quality assurance programme needs the commitment of professionals.     

A new theoretical framework to assess Multinational Corporations’ motivation for Foreign Direct Investment: A case study on Vietnamese service industries

PurposeThis paper develops a new theoretical framework, based on eclectic paradigm and institution theory, to evaluate Multinational Corporations’ (MNCs’) incentives for Foreign Direct Investment (FDI). The new framework is applied as a case study in the service sector across Vietnam.Design/methodology/approachThis study applies the Structural Equation Modelling (SEM) approach to investigate the motivational factors of MNCs by using primary data on MNCs working in service industries in Vietnam. This paper introduces five motivational factors, and conducts a Confirmatory Factor Analysis (CFA) to study the construct validity of the research measures and to cluster the variables into common factors that can be used to present relationships among sets of interrelated variables.FindingsThe SEM results reveal that the key determinants of MNCs’ incentives to invest in service industries are market-seeking government policies and culture, all of which have significantly contributed to FDI.Originality/valueThis study offers new knowledge and insights into the factors that motivate FDI by MNCs in general and in service industries in Vietnam. The findings are plausible and in line with the recent economic reforms launched in Vietnam, along with the increased FDI inflows into the country in the last twenty-five years.     

Working for patients: Making the internal market effective

To be effective, the internal market for health care involves a recognition that there are different types of market, each with its own characteristics. Written contracts can only go so far. There is also a need to create administrative infrastructures which will ensure that the different markets function effectively.     

On the “Output” process of a state dependent queue

Abstract

It is well known that if in a queueing situation the arrivals occur in a Poisson stream with intensity λ, and probability differential of a service completion is μd t+o(dt), then in the steady state the successive epochs of service completion also occur in a Poisson stream with intensity λ, that of arrivals. Here, we shall show that this criteria could be proved in the more general case in which the probability differential of a service completion is directly proportional to the number of customers momentarily present in the system.     

NHS Inquiries: A Time Series Analysis

This article provides a time series analysis of NHS public inquiries and inquiries related to health against the background of recent policy changes which are centralizing hazardous incident investigations within agencies such as the Healthcare Commission.     

Making sense of New Zealand’s ‘spirit of service’: social identity and the civil service

ABSTRACT

This paper explores the creation a more unified civil service in New Zealand with the Public Service Act 2020, which promotes the most profound changes to the public service since New Zealand’s New Public Management heyday in the late 1980s. Among its many reforms is an explicit attempt to foster a unified culture around a ‘spirit of service to the community’—a construct without fixed definition that appears to incorporate ideas of motivations and ethics. This paper shows that this unified culture can be traced through a series of key collaborative discussions that have taken place among New Zealand’s public sector chief executives. The authors present a case study to show how these collaborations contributed to a new social identity, and provided a foundation for a civil service unified by its spirit of service to the community. The paper contributes to this PMM theme by providing empirical evidence from the latest New Zealand experience; and also contributes to theory of social identity and sensemaking in creating civil service values.     

Performance Measurement and the English Ambulance Service

Performance indicators used in the ambulance service in England are one-dimensional and do not reflect the widening role of the ambulance paramedic. The development of a broader range of indicators is thus to be encouraged. As well as highlighting the consequences of simplistic indicators, this case study has important implications for our understanding of the New Public Management (NPM).     

Mortality investigation among persons whose applications for insurance have heen rejected

Abstract

Extract

Life insurance companies are interested III investigations of the mortality among that group of applicants whose applications for insurance, for health reasons, have not been accepted. The compa. nies thereby obtain material enabling them to decide whether their rejection policy during a period has been too strict or not, and on which points, if any, the selection of risks can be liberalized.     

Developing public servants for the future

ABSTRACT

The majority of UK civil servants are ‘developed’ within a particular service or profession and there is frequently very little movement into other service areas. Many current leaders therefore have limited experiences in services and organizations other than their own. This paper presents a new graduate programme for the training and development of future public leaders in Wales. The programme is a leadership and development programme for civil and public servants, exposing them to a range of services. The intention is that, through these experiences, future leaders will approach problems from a multi-service perspective, will be better networked and ready to deal with complexity. Areas of good practice are highlighted, together with some of the challenges of developing leaders in this way.     

New development: ‘Healing at a distance’—telemedicine and COVID-19

ABSTRACT

In extreme circumstances such as pandemics, the presence of patients in hospital emergency departments becomes untenable. Healthcare professionals and organizations worldwide are leaning on technology as a crucial ally to deal with the COVID-19 outbreak. This article focuses on the positive impact of telemedicine for helping service provision, from enabling virtual triage to mitigating the negative psychological effects of social isolation. The authors discuss the challenges and opportunities to telemedicine practices.     

How do Professional Financial Services Firms Understand their Skill Needs and Organise their Recruitment Practices?

Abstract

The recruitment practices of professional financial service firms are informed by hegemonic cultural norms embedded in global and national institutions. There is a propensity, particularly in the financial services, to employ ‘people like us’ [Erel, U. (2010). Migrating cultural capital: Bourdieu in migration studies. Sociology, 44(4), 642–660. doi:10.1177/0038038510369363], which, it is argued, has constrained the employment outcomes of skilled migrants. Using the concept of cultural fit, this paper draws on interviews with representatives of accounting firms in Australia to understand the criteria for recruiting in a highly commercialised and globalised professional labour market. The results demonstrate that client-focused firms place an emphasis on cultural fit in the recruitment process. It is concluded that a lack of cultural capital by migrants means that their efforts to infiltrate the professional accounting labour market in Australia are limited. Furthermore, from an education perspective, the skill set taught in the accounting curriculum is increasingly geared to meet the recruitment strategies of professional service firms.     

Consumer strategy in the public sector: Are you being served?

If your consumers had a choice, would they still choose you? Looking at your service through their eyes is a useful first step in working towards a positive answer to that question. Public sector managers need market sensitivity, whether or not they are monopoly suppliers of services.     

New development: COVID-19 as an accelerator of digital transformation in public service delivery

ABSTRACT

In an unexpected circumstance, such as the COVID-19 pandemic, public service delivery cannot be suspended, but must be delivered online, relying on the available digital technology. Social media, specifically, have been widely used to reach a broader portion of the population. This article discusses the digital acceleration that governments and organizations are now facing. The focus is on Italian state museums, which have been pushed for years to adopt digital tools to increase participation. This article highlights three main dilemmas in service delivery: user engagement; planning and control; and costs. The three dilemmas show the social and organizational challenges connected to digital transformation, underlining the issues that organizations will have to face in the future and not just in an emergency such as COVID-19.     

Pointers: Pay; Housing; NHS; Regional policy; Public expenditure; Industrial support; US deficits

Using performance indicators to drive improved service delivery and cost‐effectiveness has been a recognized management technique in the public sector for many years. Most managers are now convinced of the possible benefits, at least in theory. Reality, though, is much less encouraging. Partial coverage, poor implementation and unrealized expectations are still the norm. Yet the potential for radical improvement by making the most of performance measurement is even greater than most people would believe. The question is how to unlock this potential.     

Higher education

There is a growing interest in the use of marketing techniques and approaches in the management of the public services, as a result of changed perceptions of public services, and the developments in public service management in the last decade. This article discusses the nature of marketing and distinguishes strategic marketing from consumer marketing. The particular difficulties of marketing public services are considered. Specific development of marketing approaches in the civil service, local government, and the National Health Service are discussed. Finally, it is argued that the applicability of marketing concepts in the public services is limited because of the nature of the polity and the relationship between states and citizens.     

Intergenerational Transfers and Insurance Policy Design

Abstract

Group health insurance policies offering an identical benefit package to every member of the group result in lower expected health benefits for younger cohorts than older cohorts. The dispersion in insurance benefits across age groups differs among insurance policies. Simulation results presented in this paper demonstrate that a shift from comprehensive health insurance to high-deductible health insurance decreases the share of expected benefits going to younger cohorts. An estimated 81.5% of the 23-to-32-year-old cohort is expected to receive less than $500 in health benefits during a year for one prototypical high-deductible health plan. Low expected benefits for younger relatively healthy cohorts could increase the number of younger individuals who eschew health coverage. Age-rated premiums are probably the most straightforward way to stimulate demand for high-deductible health plans among younger healthier individuals.     

“Long-Term Yield Rates for Actuarial Valuations”, Jacques F. Carriere,July, 1999

Abstract

This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age fifty, with particular attention to the effect for ages 65 and over. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at the very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range. The practical effects of relative value aging curves are examined through hypothetical examples of increasing complexity in a retiree health valuation. A method to measure the impact is put forth. Three important variables are discussed in some detail. A survey to ascertain aging curve findings and preferences of health actuaries is introduced and discussed, with one representative curve presented. This curve is then measured to understand its impact vis-à-vis other curves.

It may be important to note this is not a study deriving a recommended aging curve. Rather, it is an exploration of the significance of an assumption that has not received much public actuarial scrutiny. A conclusion places the paper-s findings in a context of a dynamic health care economy in an aging society.