Restructuring the Personnel Function: the Case of Nhs Trusts1

Stephen Bach, who is Lecturer in Industrial Relations at the Warwick Business School and an Associate Fellow of its Industrial Relations Research Unit, examines the impact of the internal market in the NHS on the role, organisation and influence of the personnel function. He argues that personnel specialists have not been able to fulfil expectations of them and occupy a peripheral role within NHS trusts. This has occurred because of their limited involvement in corporate decision making, the difficulties of decentralising personnel practice and the absence of a strategic direction for the management of human resources at national level. In this context, he argues that the prospects for the personnel function and the potential for an integrated, long-term approach to the management of staff in the NHS remain at best uncertain.     

The impact of self governing trusts on trades unions and staff associations in the NHS

The creation of NHS trusts has the potential to fundamentally affect the role and influence of staff organisations in the NHS. The authors examine the extent to which this has occurred in some of the NHS trusts and the responses by staff organisations at national and local level.     

Matching structure and strategy: Towards a market orientation in health care

The introduction of an ‘internal’ or ‘managed’ market mechanism into the National Health Service required fundamental structural reorganisation, involving the separation of purchaser and provider functions. While a degree of structural change has occurred among the emergent purchasing organisations subsequent to the initial reforms, there is a lack of corresponding evidence of ongoing structural change in acute provider units. Despite the existence of a direct relationship between organisational structure and strategy, the extent of change in the organisational structure of hospitals is questionable. Indeed at the macro level current acute hospital structures, that is NHS Trusts, are remarkably similar to ‘pre-reform’ structures, despite the unsuitability of these structures for the market orientation required by the internal market. Such prevalence arguably reflects the marginal effect that current managerial structures have had on those delivering services and the predominance of the medical hierarchies. Specifically, those responsible for the marketing of hospital services in current structures are not directly linked to those who deliver the service, in spite of the introduction of clinical directorate structures. Part of a broader study of the market behaviour of acute NHS Trusts in Scotland, this paper explores the organisational avenues open to health care providers to overcome this separation in the pursuit of market-led service delivery and concomitant market orientation.     

Reshaping internal labour markets in the National Health Service: new prospects for pay and training for lower skilled service workers?

This article considers how two new strategies for improving pay and skills development have been used in the UK National Health Service (NHS) to develop labour capacity and capability by stimulating the development of relatively coherent internal labour markets for workers at the lower end of the occupational hierarchy. Drawing on data from 13 NHS trusts, we scrutinise the implications of the new national pay system, Agenda for Change, for healthcare assistants and cleaners and find substantial one‐off improvements in pay for these groups as a direct result of the new national pay framework. However, the detailed case‐study data reveal there is considerable uncertainty regarding the extent, depth and durability of pay improvements. In particular, opportunities for pay progression in reward for acquisition of new skills and qualifications were more variable as a result of the stronger role of management choice and strategy at the organisational level in implementing the new national strategy for skills development, the Skills Escalator. Moreover, management strategy shaped the demand for, and distribution of, intermediate‐level skills (through new job design, for example), which was critical to the effectiveness of trusts in pulling lower grade employees up through an internal career trajectory.     

Role redesign in a modernised NHS: the case of health care assistants

This article examines role redesign in the National Health Service (NHS), which has been central to the Labour government's modernisation agenda, focusing on the role of health care assistants (HCAs). Drawing on data from two acute hospital trusts, this article focuses on variation in HCA roles between trusts, indicating that there may not have been a uniform expansion of the HCA role as the government's HR agenda and most commentators suggest. Although the modernisation agenda has curtailed registered nurses' role in direct care, there are significant variations in the degree to which HCAs undertake a ‘relief’, ‘substitute’ or ‘apprentice’ role at trust level. These variations in HCA role stem from distinctive models of the nursing workforce with differing assumptions about the respective roles of registered and non‐registered nurses. The variations in HCA role have important consequences for the prospects for role redesign and HR policy in the NHS.     

Employee participation and union voice in the National Health Service

This article examines the role of trade unions in the health service at workplace level under the Labour government's modernisation agenda, and focuses on the shifting balance between forms of direct and indirect participation drawing on case studies of three acute hospital trusts. There has been a strong growth in forms of direct communication within the case study trusts and some increase in direct participation among professional groups. Despite this ‘dualism’ in employment relations, however, the target culture of the NHS has precluded the development of effective voice mechanisms. The policy implications for trade unions and the implications for the implementation of NHS pay modernisation are considered.     

Decentralisation of Pay In the Nhs: Diagnosis and Prognosis

This article analyses why some NHS trusts have departed from national arrangements and adopted a local pay regime, while others have not. It finds that the primary determinant is the attitude of management, particularly the chief executive. This is value driven and not a pragmatic response to the labour market. Although a healthy financial position is a necessary condition for a trust pay regime, it is not an adequate causative explanation. Moreover, while management sets the agenda, the pace, manner and extent of change, are tempered by the cohesiveness and vigour of the staff-side and the power of the medical profession. It also suggests that in some trusts more immediately pressing priorities have taken precedence over the government initiative on local pay bargaining, so it will be some time before fully fledged pay systems are adopted.     

房地产投资信托基金的收益影响因素分析——以香港为例

研究房地产投资信托基金（REITs）的收益影响因素,首先针对REITs特点计算其收益水平,并从宏观、中观和微观三个角度出发,建立房地产投资信托基金影响因素的指标体系;再以香港REITs的季度数据为研究对象,利用REITs产品的收益水平与影响因素数据进行数据处理与分析;最终建立VAR模型,并进行方差分解与脉冲响应分析,揭示不同影响因素对REITs收益的影响程度与特点。     

National Health Service Boards of Directors and Governance Models

Abstract

This article reports the findings of a year-long research project focused on the activity of boards of directors of twenty-two trusts from the British National Health Service (NHS). The evidence gathered through the use of semi-structured interviews, focus groups, workshops, feedback questionnaires and document analysis indicates that the behavioural dynamics of boards, affected by the dominance of the expert model, act as antecedents of their statutory functions and the implementation of different governance models. Only a portion of the boards involved has effectively incorporated in its modus operandi post-New Public Management (post-NPM) principles of governance.     

Transformations in- and outside the internal labour market: institutional change and continuity in Japanese employment practices

The weak performance of the Japanese economy since the 1990s has renewed the debate on the efficiency of its employment practices. Although actual changes have long trailed expectations, two major developments have taken place in recent years: a rise in non-regular employment and the introduction of performance-related pay (seikashugi). Both affect the internal labour market that has been crucial to human resource management in Japan. The first development diminishes its relevance and the second directly impacts its functioning. This paper discusses these changes and the factors that determine their character. Moreover, it argues that the changes are not just aligned with but also made possible by an important continuity in the support for the core practice of lifetime employment. What results is a story of institutional change and continuity which argues that the specific character of Japanese employment practices remains in spite of an apparent convergence.     

The problem with pay flexibility: changing pay practices in the UK health sector

This paper critically assesses models and policies of pay flexibility as applied to the public sector. Examination of the arguments for greater pay flexibility across three dimensions - external labour market flexibility, organizational flexibility, and macroeconomic flexibility - reveals a number of weaknesses, rooted in a failure to problematize the conflicting motives for greater pay flexibility in the context of pressures internal and external to the organization. An alternative 'model' of changing pay systems is developed and applied to the case of the UK health sector where there have been attempts to introduce various forms of flexible local pay arrangements. Drawing on interviews conducted during the mid-1990s with personnel and HRM managers at fifteen NHS Trusts, a number of issues are examined, such as: the impact of differential external labour market conditions of workers on the development of strategies designed to tie local pay to improved performance; the introduction of performance-related pay as a means to institutionalize wider earnings differentials within the organization; and the potential conflict between pressures to link local pay structures with local labour market conditions, on the one hand, and customary employee-held norms that link pay to occupational skills and professional status, on the other.     

NHS ancillary services and competitive tendering

Competitive tendering for NHS ancillary services has significantly increased the role of market factors in influencing locally-determined employment conditions. It has also provided an opportunity for increased managerial control. The employment and industrial relations consequences of these changes are considered in the context of two case studies.     

超市设施布置分析与研究

合理的设施与物流规划是超市提高市场竞争力和服务质量的关键因素之一。针对超市的设施规划问题,运用SLP法在分析超市商品流的基础上,分析各作业单位之间的综合接近程度,得出各单位之间的位置相关图,提出三种超市规划布局备选方案,并进行优选评价。合理的规划方案将为超市提高效率提供良好的决策支持。     

Indicators for planning of health services: assessing impacts of social and health care factors on population health.

Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.     

The Internationalisation Process of Danish Firms -Gradual Learning or Discrete Rational Choices?

Abstract

The Uppsala Internationalisation model has greatly influenced Nordic research on the internationalisation process of firms. In this article, the Uppsala model is tested on Danish empirical material. The Danish firms largely follow a sequential development as regards the geographical dimension, where, typically, they set up in culturally close markets first and later set up in the more distant markets. On the other hand, the firms seem to follow to a less extent a pattern of sequential expansion of market commitment on the single foreign markets, just as a surprising number of establishments are set up without previous activity on the market. Crucial differences cannot be found between the establishment pattern abroad of large and small firms. The Uppsala model in itself cannot explain the internationalisation pattern of the Danish firms, which is why the article advocates that the internationali-sation process should be understood as an interaction between internal conditions in the firm (“learning” processes), external competitive conditions and more basic economic factors (assessment of market potential).     

The behavioral justification for public pensions: a survey

Unfunded public pension systems are primarily justified on grounds that many individuals lack sufficient capacity to appropriately save for retirement. We begin with a review of the known principle that a standard life-cycle/permanent-income consumer who discounts the future at an exponential rate can benefit from an unfunded public pension system only if the internal rate of return exceeds the private rate of return. However, a pay-as-you-go program with a below market internal rate can in fact improve lifetime utility if the consumer misestimates social security benefits, uses a hyperbolic discount function rather than the exponential function, uses a short planning horizon, behaves impulsively, or if a fraction of the population do no saving at all. A literature has consequently arisen to study how severe these behavioral defects need to be in order to justify a pay-as-you-go program. We survey this literature, and we conclude that the results are highly mixed as to whether an unfunded public pension that earns a below-market internal rate of return can be justified on grounds of shortsightedness in model economies. The challenge for this literature is that the conclusions crucially depend on the particular values of the preference parameters that are used in the simulation experiments, and these preference parameters are not observable, nor is there much consensus concerning the values that should be used in simulations. In fact, even when the analysis is confined to a small and reasonable space of the unobservable preference parameters, it is possible to reach nearly any policy conclusion. We offer some guidance for future work in this area.

Refashioning Organizational Boundaries: Outsourcing Customer Service Work*

abstract In recent years there has been a discernible trend towards the outsourcing and subcontracting of work. However, there has been very little empirical research on employees' attitudes to work in outsourced firms. This study is conducted in the area of call centre services where there has been a substantial growth in the provision of external market suppliers. It examines employees' perceptions of their work and employment arrangements in both an in‐house producer and an external service provider and identifies and compares the factors that shape their organizational commitment and intentions to quit. The research found that the character of the internal labour market and the nature of the work regime were more important explanations of organizational commitment and intentions to quit in the external market supplier than in the in‐house producer. The paper discusses the implications of these findings for the quality of customer service provided under subcontracting arrangements.     

Determinants of European stock market integration

We analyse the determinants of stock market integration among EU member states for the period 1999–2007. First, we apply bivariate DCC-MGARCH models to extract dynamic conditional correlations between European stock markets, which are then explained by interest rate spreads, exchange rate risk, market capitalisation, and business cycle synchronisation in a pooled OLS model. By grouping the countries into euro area countries, “old” EU member states outside the euro area, and new EU member states, we also evaluate the impact of euro introduction and the European unification process on stock market integration. We find a significant trend toward more stock market integration, which is enhanced by the size of relative and absolute market capitalisation and hindered by foreign exchange risk between old member states and the euro area. Interest rate spreads and business cycle synchronisation are also significant factors in explaining equity market integration.     

工程建设单位合理性内审内控管理

项目建设属于一项结构复杂、规模庞大以及因素众多的系统工程,其建设的周期比较长,存在较高的风险,对风险实施控制是非常重要的,其关系到建设的产权主体,甚至对建筑市场的可持续发展以及经济效益等造成严重的影响。在工程建设当中,单位实施合理化以及科学化的内审内控管理,可以对于建设项目进一步推动,使其所需要的资金得到合理以及正确的使用。论文主要对于工程建设单位合理性内审内控管理进行简单的介绍,并提出针对性的措施,希望可以为相关人士带来一定的启发。     

Market-oriented product innovation at Høyang Polaris and Jøtul

This report is concerned with an action research project on market oriented product innovation at Høyang Polaris and Jøtul, where a system for assessment of user needs has been planned and implemented. Based on experience from the project, a model has been developed for the introduction of a need assessment system comprising problem analysis, planning, information, training, demonstration, application, and development.The introduction of need assessment methods may be handled as an operational problem or treated as a strategic issue. When handled as an operational problem, systematic need assessment can be introduced as a project or treated as a process integrated with the daily activities of the product innovation staff.The practical operation of a need assessment system in product innovation projects involves definition of a target group, selection of one or several need assessment methods, implementation of the study, and formulation of the need specification.The responsibility for need assessment studies may be assigned to a special staff unit or to the employees participating in the product innovation process.