FOCUS: Can Britain's NHS managers be business-like and should they adopt the values of business?

The NHS differs from a private business in not aiming at profits and in being obliged to provide only the single product of health care. How radically does this affect the requirement to be “business-like” and adopt business values? Dr Draper is Lecturer in Biomedical Ethics at The Medical School, The University of Birmingham, Birmingham B15 2TT. She wishes to thank Tom Sorell for his comments on the first draft of this article.     

Transaction Costs and Nonlinear Adjustment Towards Equilibrium in the US Treasury Bill Market

This paper uses nonlinear error correction models to study yield movements in the US Treasury Bill Market. Nonlinear error correction arises because portfolio adjustment is an ‘on-off’ process, which occurs only when disequilibrium in the bill market is large enough to induce investors to incur the transaction costs associated with buying/selling bills. This, together with heterogeneity of transaction costs, implies that the strength of aggregate error correction depends on both the distribution of costs and the extent of disequilibrium in the market. Smooth transition models are used to describe an aggregate adjustment process which is strong when the market is distant from equilibrium, but becomes weaker as the market approaches equilibrium. Linearity tests indicate that the types of nonlinearities that would be induced by transactions costs are statistically significant, and estimated models which incororate these nonlinearities outperform their linear counterparts, both in sample and out of sample.     

Skill, deskilling and new technology in the non-manual labour process

This article discusses the concept of skill and, using material from case studies on non-manual work, suggests that the microelectronic technology may have implications for work and skills that in each case will depend on a combination of social and technological factors.     

A Macroeconomic Analysis of Publicly Funded Health Care

In a general equilibrium, overlapping generations framework this paper examines how the tax-benefit system that underlies the U.S. health care system affects the well-being of different age groups, and the lifetime well-being of different socioeconomic groups, as well as society as a whole. We find that the optimal set and generosity of publicly funded health care programs is sensitive to the social welfare function and to the prices that various agents in society pay for medical care. Social welfare under the current financing system is also compared to alternative financing mechanisms such as Medical Savings Accounts.     

Principles and Influence in Codes of Ethics: A Centering Resonance Analysis Comparing Pre- and Post-Sarbanes-Oxley Codes of Ethics

This study examines the similarities and differences in pre- and post-Sarbanes-Oxley corporate ethics codes and codes of conduct using the framework of structuration theory. Following the passage of the Sarbanes-Oxley (SOX) legislation in 2002 in the United States, publicly traded companies there undertook development and revision of their codes of ethics in response to new regulatory requirements as well as incentives under the U.S. Corporate Sentencing Guidelines, which were also revised as part of the SOX mandates. Questions that remain are whether these new or revised codes are effective means of communicating changed ethical foci and attitudes in organizations. Centering resonance analysis (CRA) is used to identify differences and similarities across time and industries by analyzing word networks of 46 pre- and post-SOX corporate codes of ethics. Analyses focus on content and structure of generated word networks as well as resulting factors that emerged from the texts. Results are interpreted from the structuration perspective that content and structure of codes are constrained and enabled by system structures while they function to produce and reproduce those structures. Results indicate that corporate codes of ethics are formal discourses of ethics, laws, and control. Code structure has changed across time, with an increased emphasis on compliance in post-SOX codes. Implications for research and practice are discussed in light of findings.     

From Territory to Rights: New Foundations for Conceptualising Indigenous Sovereignty

Recognising how the concept of sovereignty has been affected by an indigenous and human rights agenda, this article explores the potential outcomes of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) in terms of its challenge to Westphalian notions of sovereignty in Canada’s North. It argues that the UNDRIP, adopted by the United Nations in 2007, is now playing a significant role in giving Canada’s Indigenous Peoples a voice in international affairs and for reframing the relationship between state and non-state actors in ways which privilege collective rights rather than territorial imperatives.     

Real-time data revisions and the PCE measure of inflation

This paper tracks data revisions in the Personal Consumption Expenditure using the exclusions-from-core inflation persistence model. Keeping the number of observations the same, the regression parameters of earlier vintages of real-time data, beginning with vintage 1996:Q1, are tested for coincidence against the regression parameters of the last vintage of real-time data, used in this paper, which is vintage 2008:Q2 in a parametric and two nonparametric frameworks. The effects of data revisions are not detectable in the vast majority of cases in the parametric model, but the flexibility of the two nonparametric models is able to utilize the data revisions.     

Estimating the time involved in managing the 'unoccupied bed:' a time and motion study

Occupied bed days are often used as a demand indicator when calculating the number of nurses required to provide safe care. However, such calculations fail to take into account the amount of nursing time consumed by the "unoccupied bed." This study used direct observation time-and-motion methods to estimate the time and costs associated with a bed that is unoccupied. The average time taken to complete all of the activities associated with a bed that was unoccupied due to an internal transfer was 8.65 minutes, for a patient discharge 26.27 minutes, and for a patient admission 37.7 minutes. An average daily cost for activities surrounding these patient movements was approximately $386/day (AUD) in registered/enrolled nursing salaries alone. The unoccupied bed is not resource neutral and time associated with its maintenance should be considered when calculating nursing requirements to provide safe care.