Developing Primary Care Groups in the New NHS: Towards Diversity or Uniformity?

This article examines how the Government's 'third way' is being implemented in relation to the involvement of primary care professionals in the commissioning of health services. Prior to 1997, the single preferred model of GP fundholding evolved into a diversity of approaches to commissioning and these approaches became increasingly collaborative rather than competitive. From this starting point, the authors examine the key assumptions underlying the present single model of the primary care group (PCG) as the commissioning body for the 'New NHS'. They suggest that PCGs will also evolve into a diversity of models, but there will be tensions arising over the greater emphasis on central direction and performance management.     

Restructuring the automotive industry in the English West Midlands

This paper investigates the changes taking places in the automotive industry in the English West Midlands. For over a century this region has been the heartland of car production in the UK, but over recent decades the volume side of the trade has been in serious decline, leading to increasing dependence on the luxury side of the industry. The implications are that the supply side of the industry will be forced to move into new technologies if the auto cluster is to prosper in future. Finally, the paper looks at the attempts made by bodies such as Advantage West Midlands and the industry itself to effect change.     

Organisational susceptibility to fraud and theft,organizational size and the effectiveness of management controls: some UK evidence

This paper examines the principal determinants of an organization's susceptibility to theft and fraud in the context of a rational economic framework in which the level of protection is determined by the minimization of cost. The empirical study shows that, adjusting for differences in organizational type and industrial sector, both organizational susceptibility and the size of a typical theft or fraud increase with organizational size. Access to resources and the manner in which the theft or fraud is perpetrated are also important determinants of the money lost. However, they are unaffected by management controls or the nature of their violation. Copyright © 2007 John Wiley & Sons, Ltd.     

Satellite and resource accounting as tools for tourism planning in southern Africa

The potential for improvements to tourism planning through development of tourism satellite accounts (TSAs) to measure economic activity, and tourism asset resource accounts (TARAs) to measure the natural asset base, was studied in southern Africa. It was concluded that economic efficiency in tourism development would be enhanced if all the countries pursue plans to develop TSA, TARA and economic models for tourism planning. Basic TSA, including consumption, production, supply and use, employment and capital tables are required. TSA development should take place step by step, with specific data collection surveys and agreements between the stakeholders. Surveys should be focused on both tourists and the suppliers of tourism products, and should be carried out by central tourism agencies in collaboration with national accounting agencies. TARAs should involve both physical accounts for specific resources, such as water or wildlife, as well as land accounts for general tourism activity and potential. TSAs and TARAs should be integrated with input-output/social accounting matrix modelling tools. Countries should match the rigour of their TSA and TARA development with their anticipated capacity for analysis and planning. Donors could assist in the process, especially in a regional context.     

Corporate Image: Employee Reactions and Implications for Managing Corporate Social Performance

Corporate image is a function of organizational signals which determine the perceptions of various stakeholders regarding the actions of an organization. Because of its relationship to the actions of an organization, image has been studied as an indicator of the social performance of the organization. Recent research has determined that social performance has direct effects on the behaviors and attitudes of the organization's employees. To better understand these effects, this study develops and empirically tests a model which links corporate leaders' actions, employees' perceptions of corporate image, and the employees' level of association with the organization. The effects of managing the social environment of an organization on its employees' perceptions of image, attitudes, and intended behaviors are discussed.     

The U.S. Medicare Disproportionate Share Hospital program and capacity planning

U.S. Medicare's Disproportionate Share Hospital (DSH) program provides financial assistance to hospitals that serve low-income populations. Statutory formulas determine the DSH payments made to hospitals; however, the formulas applied to “large” urban hospitals (at least 100 beds) are more generous than those used for “small” urban hospitals (less than 100 beds). The purpose of this study is to determine if the DSH program's 100-bed threshold influences bed capacity planning. We find that the threshold drives a significant discontinuity in the distribution of urban hospital bed capacities, with hospitals tending to maintain just enough beds to qualify for higher DSH payments. The magnitude of the discontinuity is greatest in hospitals with strong incentives to manage bed capacity; and, compared to government and not-for-profit hospitals, for-profit hospitals are more likely to manage capacity to meet the 100-bed threshold. Our findings highlight the potential for regulatory institutions to have unintended influence on capacity planning decisions.     

Experimental bias: Task,tools, and time

In any experiment, control over all possible variables affecting the response is rarely, if ever, possible. Even in a laboratory setting it is difficult to control all variables which might conceivably affect the outcome. This study identifies three variables—task relevancy, tool availability, and time allocation as variables which have potentially reactive effects in laboratory experiments. The authors gratefully acknowledge the helpful comments of Gerald Albaum and Donald Messmer.     

Closeness,strength, and satisfaction: Examining the nature of relationships between providers of financial services and their retail customers

This article presents the results of the analysis of data collected in a telephone survey of retail customers of banks and other financial institutions. The objective of the research is to identify various dimensions of the customers' relationships with their principal financial institution and to ascertain the factors that contribute to the types of close relationships that are likely to lead to customer retention, referrals, and long-term profitability. A survey of 400 adult retail bank customers provided data for analysis. The results indicate that the factors that contribute most to the establishment of close, satisfying customer relationships are affective variables, rather than situational or behavioral variables. The results also point to the existence of quite different segments of the retail bank market as defined by the type of relationship the customer wishes to have with his or her main bank. © 1997 John Wiley & Sons, Inc.. Inc.