A‘crisis’in water? The wrong sort of privatisation1

Privatisation has been less successful in water than in the other privatised utilities. The highly regulated regime is closer to the old nationalised industries than in gas, electricity and telecommunications. Moreover, the industry seems to be heading towards yet more regulation. What is required is more competition. There may be practical difficulties in introducing it, but a determined effort to overcome these problems would be a better use of resources than tighter regulation.     

Theodore Levitt's Marketing Myopia

Theodore Levitt criticizes John Kenneth Galbraith's view of advertising as artificial want creation, contending that its selling focus on the product fails to appreciate the marketing focus on the consumer. But Levitt himself not only ends up endorsing selling; he fails to confront the fact that the marketing to our most pervasive needs that he advocates really represents a sophisticated form of selling. He avoids facing this by the fiction that marketing is concerned only with the material level of existence, and absolves marketing of serious involvement in the level of meaning through the relativization of all meanings as personal preferences. The irony is that this itself reflects a particular view of meaning, a modern commercial one, so that it is this vision of life that LevittÕs marketing is really SELLING.     

Rationalizing Northern Ireland Hospital Services Towards Larger Providers: Best-Practice Efficiency Studies and Current Policy

This article explores the relative efficiency of Northern Ireland hospitals, and in particular the efficiency of small hospitals relative to their large counterparts, employing a technique called data envelopment analysis. The empirical analysis revealed that larger hospitals displayed higher cost efficiency, higher allocative efficiency and higher technical efficiency than their smaller counterparts. These results support Northern Ireland's recent strategy of concentrating hospital services in six large hospitals, supported by medium sized hospitals, and closing or restructuring smaller hospitals.     

The Existence and Nature of Physician Agency: Evidence of Stinting from the British National Health Service

The ability of physicians to make take-it-or-leave-it offers of treatment implies that even fully informed consumers of health care may receive treatments that they would not themselves choose. This paper examines both the extent and direction of this distortion away from patient choice—the physician agency effect—using a large patient-level claims-based data set for dental treatments under the British National Health Service. We find that an improvement in the outside opportunities of patients results in a small but significant increase in the level of service provided when dentists are remunerated on a fee-for-service basis. This is suggestive of stinting, wherein physician agency results in undertreatment relative to what patients would choose. We further find that the effect is increased when patients are fully insulated from the cost of their treatment.     

Regulation Inside Government: Where New Public Management Meets the Audit Explosion

This article explores the scale and growth of regulation inside UK government, defined as standard-setting and monitoring by bodies constituted at arm's-length from those they oversee. It argues regulation inside government is comparable in scale to regulation of business and has grown sharply over two decades, while public organizations in general have substantially downsized. Regulation inside government is highly diverse and there is a marked disjunction between the control regimes applied by regulators of government to those they regulate and the way the regulators are themselves assessed and controlled.     

Re-thinking the future of work: Beyond binary hierarchies

How will work be organised in the future? This paper reveals that although there are multiple stories about the future of work, a similar storyline is adopted across many of the competing visions. Most visions firstly squeeze all forms of work into one side or the other or some dichotomy and then proceed to temporally and/or normatively sequence the two sides of the dualism and finally label the resultant one-dimensional and linear trajectory as some -ism, -ation or post-something-or-other. This paper evaluates critically such hierarchical binary narratives (e.g., the shift from informal to formal work, non-commodified to commodified work, localisation to globalisation, Fordism to post-Fordism, bureaucracy to post-bureaucracy) and displays how these dominant narratives, as well as the counter narratives that simply invert the temporal and/or hierarchical sequencing of these dichotomies, over-simplify lived practice. The paper concludes by offering a way forward that transcends these one-dimensional linear tales and recognises the heterogeneous and multiple directions of work in order to provide a more kaleidoscope-like understanding of the direction of work and open up the future of work to new possibilities.