The Private Finance Initiative: An Evolving Research Agenda

This article considers the development of the Private Finance Initiative (PFI) and contends that it is now deeply embedded and intertwined in policies to renew and modernize the United Kingdom's public services. After briefly reviewing prior research based upon the themes proposed by Broadbent and Laughlin (1999), this article suggests a new research agenda to reflect how the PFI has matured and developed in recent years.

Accountability and Value for Money in Private Finance Initiative Contracts

Within the context of New Public Management (NPM), successive UK governments have claimed that PFI projects provide more accountability, and arguably, more value for money (VFM) than conventional procurement for the public (HM Treasury 1995, 2000, 2003a and 2003b). However, recent empirical research in the UK on PFI has indicated its potential limitations for accountability and VFM (Broadbent, Gill and Laughlin, 2004; Edwards, Shaoul, Stafford and Arblaster, 2004; Shaoul, 2005; and Ismail and Pendlebury, 2006) albeit these are based on either published accounts or a limited number of key stakeholders. This paper attempts to partially redress this gap in the literature by presenting an interesting case of the impact of PFI on accountability and VFM in Northern Ireland's education sector. The findings of this research, based on forty two interviews with a wide range of key stakeholders, suggest that stakeholders have different and often conflicting expectations and the actual PFI accountability and VFM benefits are much more obfuscated than those claimed in Government publications.

A Review of an Initiative to Introduce a Short Ethics Component into a Non-Ethics Course at a U.K. University

This paper discusses the introduction of a short ethics component into a first-year undergraduate accounting information systems course at a UK university. The influence of this ethics component on students’ ethical perceptions – where ethical perceptions are represented by the extent to which students’ conclusions regarding unethical actions coincide with those of experts in the field – is then assessed using computer-based scenarios to represent seven categories of ethical norms. The ethical perceptions in each of the scenarios are then statistically compared between two groups of students, namely those who have studied the ethics component and those who have not. Results indicate no significant difference in ethical perceptions between the two groups across all of the ethical norms. Possible explanations for this result are discussed and implications for future ethics teaching are considered.

Annotating an Oral Corpus using the Text Encoding Initiative. Methodology, Problems, Solutions

The objective of this paper is to describe and evaluate the application of the Text Encoding Initiative (TEI) Guidelines to a corpus of oral French, this being the first corpus of oral French where the TEI has been used. The paper explains the purpose of the corpus, both in creating a specialist corpus of néo-contage that will broaden the range of oral corpora available, and, more importantly, in creating a dataset to explore a variety of oral French that has a particularly interesting status in terms of factors such as conception orale/écrite, réalisation médiale and comportement communicatif (Koch and Oesterreicher 2001). The linguistic phenomena to be encoded are both stylistic (speech and thought presentation) and syntactic (negation, detachment, inversion), and all represent areas where previous research has highlighted the significance of factors such as medium, register and discourse type, as well as a host of linguistic factors (syntactic, phonetic, lexical). After a discussion of how a tagset can be designed and applied within the TEI to encode speech and thought presentation, negation, detachment and inversion, the final section of the paper evaluates the benefits and possible drawbacks of the methodology offered by the TEI when applied to a syntactic and stylistic markup of an oral corpus.

Championing the interface between mental health and child protection: evaluation of a service initiative to improve joint working in Northern Ireland

The importance of establishing effective interagency working between adult mental health services and child care services in order to safeguard children has been repeatedly identified by research, policy, inquiries and inspection reports. This article reports on the evaluation of an initiative in one Health and Social Care Trust in Northern Ireland that aimed to facilitate joint working and so improve service provision and protection for children and families. The Champions Initiative involved identifying a champion in each multi-disciplinary community mental health team and in each family and child care team who would have responsibility for providing information, promoting joint working and identifying any obstacles to better co-operation. The evaluation of this initiative assessed levels of experience, training, confidence, understanding and awareness in the Champions and their team members at baseline. The Champions and their Team Leaders were then followed-up after six months to obtain their qualitative views of the impact of the initiative. The results include comparisons between mental health and child care staff, and crucially, views about whether the initiative has had any impact on working together. This study also generated recommendations for further service development in this complex and important area of practice.

Targeting social need in a divided society: an evaluation of a community-based adult education initiative

This article examines the impact of a community-based adult education initiative designed to target social need in Northern Ireland. Set against a backdrop of extreme civil unrest and disadvantageous socio-economic conditions a cohort of adults was identified to participate in a personal and social development programme. The initiative was funded from Peace and Reconciliation resources made available to Northern Ireland by the European Union. High levels of unemployment and negativity about previous learning experiences were characteristic features among participants. An evaluation of the effectiveness of the programme was carried out and a follow-up qualitative survey ensued 6 months after the completion of the training. Results indicate that the learner-centred methodology was effective in providing a gateway to further education and training and enhancing participants' self-esteem, confidence, motivation, tolerance, social skills, community involvement and

Identifying additional patients with diabetic nephropathy using the UK primary care initiative

AIMS:
The aim of this study was to use general practice data to estimate the prevalence of diabetic nephropathy within the registered diabetes patients and examine variation in practice prevalence and management performance since introduction of this initiative.
METHODS:
Reported quality indicators from the Northern Ireland General Practice Quality and Outcomes Framework were analysed for diabetes and diabetic nephropathy prevalence and management in the period 2004-2008. Variation in prevalence at practice level was assessed using multiple linear regression adjusting for age, practice size, deprivation and glycaemic control.
RESULTS:
In 2006-2007, 57,454 (4.1%) adult diabetic patients were registered in the denominator population of 1.4 million compared with 51,923 (3.8%) in 2004-2005 (mean practice range 0.5-7.7%). Diabetic nephropathy prevalence was 15.1 and 11.5%, respectively (8688 and 5955 patients). Documented diabetic nephropathy prevalence showed marked variation across practices (range 0-100%) and was significantly negatively correlated with diabetes list size, albumin creatinine ratio testing rates and renin-angiotensin-aldosterone system blockade use and positively correlated with exception reporting rates. Specifically, for every increase in 100 diabetic patients to a register, documented diabetic nephropathy prevalence reduced by 40% (P=0.003). On the positive side, median albumin-creatinine ratio testing rates doubled to 82% compared with figures in the pre-Framework era.
CONCLUSIONS:
Implementation of the Northern Ireland General Practice Quality and Outcomes Framework has positively benefitted testing for diabetic nephropathy and increased numbers of detected patients in a short space of time. Large variation in diabetic nephropathy prevalence remains and is associated with diabetes registry size, screening and treatment practices, suggesting that understanding this variation may help detect and better manage diabetic nephropathy.

Accountability and Value for Money: A Framework for Exploring the Relationship in Private Finance Initiative Contracts

There is an implicit assumption in the UK Treasury’s publications on public-private partnerships (PPP) – also more commonly known in the United Kingdom as private finance initiative (PFI) - that accountability and value for money (VFM) are related concepts. While recent academic studies on PPP/PFI (from now on as PFI) have focused on VFM, there is a notable absence of studies exploring the ‘presumed’ relationships between accountability and VFM. Drawing on Dubnick’s (Dubnick and Romzek, 1991, 1993; Dubnick, 1996, 1998, 2003, 2005; Dubnick and Justice, 2002) framework for accountability and PFI literature, we develop a research framework for exploring potential relationships between accountability and VFM in PFI projects by proposing alternative accountability cultures, processes and mechanisms for PFI. The PFI accountability model is then exposed to four criteria - warrantability, tractability, measurability and feasibility. Our preliminary interviews provide us guidance in identifying some of the cultures, processes and mechanisms indicated in our model which should enable future researchers to test not only the UK Government’s claimed relationships between accountability and VFM using more specific PFI empirical data, but also a potential relationship between accountability and performance in general.

Analysis of pharmacists attitudes toward a distance learning initiative on health screening

A questionnaire was developed to investigate pharmacists' attitudes to distance learning (DL) as a vehicle for continuing education (CE). It was included in each of a two part DL course on Health Screening. Part One was mailed to all community pharmacists in England (16,400) and returns were received from 1487. The questionnaire in Part Two was returned by 436 pharmacists. Attitude statements were scored using a five-point Likert scale. The mean response to all attitude statements was positive. Participants were significantly more satisfied than non-participants with DL in general and the DL course studied (P less than or equal to 0.05). Over 80 percent of respondents completing the course found DL to be enjoyable and more suitable than other CE methods. More females and less males than expected (based on registration statistics) requested (P less than or equal to 0.001) and completed the course (P less than or equal to 0.001). Pharmacists of all ages participated, although those recently qualified showed greater interest.