House value as an indicator of cumulative wealth is strongly related to morbidity and mortality risk in older people: a census-based cross-sectional and longitudinal study

Background: There has been relatively little research into health inequalities in older populations. This may be partly explained by the difficulty in identifying appropriate indicators of socio-economic status for older people. Ideally, indicators of socio-economic status to be used in studies of health inequalities in older populations should incorporate some measure of life-time socio-economic standing, and house value may fill this role. This study examined whether an indicator of accumulated wealth based on a combination of housing tenure and house value was a strong predictor of ill-health in older populations.
Methods: A total of 191 848 people aged =65 years and not living in communal establishments were identified from the 2001 Northern Ireland Census and followed for 5 years. Self-reported health and mortality risk by housing tenure/house value groupings were examined while controlling for a range of other demographic and socio-economic characteristics.
Results: Housing tenure/house value was highly correlated with other indicators of socio-economic status. Public-sector renters had worse self-reported health and higher mortality rates than owner occupiers but significant gradients were also found between those living in the highest-and lowest-valued owner-occupier properties. The relationship between housing tenure and value was unchanged by adjustment for indicators of social support and quality of the physical environment. Adjustment for limiting long-term illness and self-reported health at baseline narrowed but did not eliminate the health gains associated with living in more expensive housing.
Conclusions: House value of residence is an accessible and powerful indicator of accumulated wealth that is highly correlated with current health status and predictive of future mortality risk in older populations.

Ireland's Innovation Performance: 1991-2005

In this paper we use data from the five waves of the Irish Innovation Panel (IIP) to profile the innovation performance of manufacturing plants in Ireland and Northern Ireland over the period 1991 to 2005. Despite considerable public sector investment on both sides of the border levels of innovation activity have remained broadly similar throughout this period although somewhat different trends are evident in Ireland and Northern Ireland. In terms of product innovation for example, the proportion of manufacturing plants making product changes has increased 5 per cent in Ireland and just over 7 per cent in Northern Ireland. In terms of process innovation a decline of almost 7 per cent in Ireland has been accompanied by a 7 per cent increase in Northern Ireland. These trends provide some evidence of convergence in innovation performance over the 1991 to 2005 period. This is evident in the narrowing gap between the proportion of product innovators in Ireland and Northern Ireland, convergence in the proportion of plants undertaking process innovation and in terms of the increasingly similar proportions of sales derived from innovative products. Looking in more detail at the determinants of manufacturing innovation emphasises the importance of R&D and backwards supply chain linkages as sources of new knowledge for innovation. Other external linkages prove less important suggesting the value of policy initiatives designed to promote knowledge sharing. We also find a significant negative innovation effect from legislative restrictions on plants’ product innovation. Public support for both product and process innovation are having positive effects on innovation outputs at the level of the individual plant. Future research interest centres on the contrast between this strong positive result at firm level and the more modest increases in innovation among the population of firms in Ireland and Northern Ireland.

The Global Financial Crisis and UK PPPs

Purpose – This paper seeks to examine how Public Private Partnerships (PPPs) have been affected by the global financial crisis (GFC). After briefly discussing PPPs and the GFC, the paper considers whether the latter has been a contributing factor in the declining number of projects reaching financial close.

Design/methodology/approach – The paper employs document content analysis to compare the time between notification of a project in the Official Journal of the European Union and its financial close in order to assess whether this period has increased since the beginning of the GFC. Two case studies are also presented.

Findings – Apart from a very small number of projects, the time between official project notification and financial close is lengthening, with the case studies providing some possible explanations for this.

Originality/value – Whilst Burger et al. provide some general statistics on the impact of the GFC on PPPs in a number of countries, this paper examines over 600 PPPs in the UK and supplements this analysis with two case studies, in order to assess whether the GFC has led to delays in projects reaching financial close.

Understanding Accountability in Social Enterprise Organisations: A Framework

Purpose: Social enterprise organisations (SEOs) operate across the boundaries of the public, private and not‐for‐profit (NFP) sectors in delivering public services and competing for resources and legitimacy. While there is a rich literature on accountability in the private and public sectors, together with the wider NFP sector, SEOs have received comparatively little attention and remain a relatively under‐researched organisational form. Drawing on accountability, legitimacy and user‐needs theories, the purpose of this paper is to develop a practical framework which can be used to explore how accountability within SEOs is constructed and discharged.

Design/methodology/approach: This paper draws on user‐needs, accountability, legitimacy and impression management theories expounded in relation to the private, public and NFP sectors.

Findings: A framework to better understand how accountability can be discharged by SEOs is developed and discussed.

Research limitations/implications: While a framework for better understanding SEO accountability is presented, it is not empirically tested. However, the framework has the potential to facilitate a deeper appreciation of the theory and practice of accountability within SEOs and, notwithstanding the inherent difficulties in measuring and managing accountability, could be used to stimulate practitioner involvement.

Practical implications
– As little is known about the current extent of SEO information disclosure or accountability relationships, the framework could be used to assess the discharge of accountability by SEOs, with the findings informing future developments. This should provide useful insights into internal processes and organisational views on accountability bases and mechanisms and can then be used to inform the debate on how SEOs can best discharge their duty to account.

Social implications
– Understanding the nature of SEO accountability reporting has important implications for those involved in advancing the SEO agenda. At a time of public sector cutbacks, and with the government searching for new and more effective ways of delivering services, the role of SEOs in this process is likely to receive greater attention and scrutiny.

Originality/value
– SEOs have grown extensively in size and prominence in recent years and policymakers have come to embrace the role that they play in societal development. This paper responds to a gap in the theoretical literature and contributes to the debate by developing a framework which can be empirically tested. Moreover, it can be used to prompt practitioner involvement and facilitate a better understanding of the complex issues surrounding accounting and accountability in this under‐researched area.

Crucial silences: When Accountability Met PFI and Finance Capital

During recent years, a wide spectrum of research has questioned whether public services/infrastructure procurement through private finance, as exemplified by the UK Private Finance Initiative (PFI), meets minimum standards of democratic accountability. While broadly agreeing with some of these arguments, this paper suggests that this debate is flawed on two grounds. Firstly, PFI is not about effective procurement, or even about a pragmatic choice of procurement mechanisms which can potentially compromise public involvement and input; rather it is about a process where the state creates new profit opportunities at a time when the international financial system is increasingly lacking in safe investment opportunities. Secondly, because of its primary function as investment opportunity, PFI, by its very nature, prioritises the risk-return criteria of private finance over the needs of the public sector client and its stakeholders. Using two case studies of recent PFI projects, the paper illustrates some of the mechanisms through which finance capital exercises control over the PFI procurement process. The paper concludes that recent proposals aimed at “reforming” or “democratising” PFI fail to recognise the objective constraints which this type of state-finance capital nexus imposes on political process.

Risks and the financing of PPP: Perspectives from the financiers

Public private partnerships (PPP) are an established model for most governments internationally to provide infrastructure-based services, using private finance. Typically the public authority will sign a contract with a special purpose vehicle (SPV), which, because of the holistic nature of PPP, in turn sub-contracts the finance, design, construction, maintenance and soft services to companies that are often related to its shareholders. Thus there is a considerable network of linked organisations that together procure and provide the PPP project. While there is an increasing body of research that examines these PPP projects, much of it is interview or case study based so that the evidence is drawn from a small number of interviews or cases in specific sectors. It also focuses on the public sector procurer and the private sector contractor in the network of organisations. Although it has been recognised that the perceptions of the financiers may vary from those of other key PPP players there is much less research that focuses on the financiers. In this paper we report the results of a postal questionnaire survey, administered to 109 providers of senior debt and equity, from which the response rate was just less than 40%. We supplement these findings with a small number of illustrative quotes from interviewees, where the cited quote represents a commonly held view. We used SPSS and Nvivo to analyse the data. The findings show that when assessing PPPs financiers perceive a very wide range of risks as important, and that it is important to them that many of these risks are either insured or allocated to sub-contractors. When considering participating in PPPs, financiers agree that working with familiar partners on familiar projects and in familiar sectors is important, which may raise barriers to entry and undermine competitive processes.

Relationship between work stress and body mass index among 45,810 female and male employees

Objective: The proportion of overweight and obese people has grown rapidly, and obesity has now been widely recognized as an important public health problem. At the came time, stress has increased in working life. The 2 problems could be connected if work stress promotes unhealthy eating habits and sedentary behavior and thereby contributes to weight gain. This study explored the association between work stress and body mass index (BMI; kg/m(2)). Methods: We used cross-sectional questionnaire data obtained from 45,810 female and male employees participating in the ongoing Finnish Public Sector Cohort Study. We constructed individual-level scores, as well as occupational- and organizational-level aggregated scores for work stress, as indicated by the demand/control model and the effort-reward imbalance model. Linear regression analyses were stratified by sex and socioeconomic status (SES) and adjusted for age, marital status, job contract, smoking, alcohol consumption, physical activity, and negative affectivity. Results: The results with the aggregated scores showed that lower job control, higher job strain, and higher effort-reward imbalance were associated with a higher BMI. In men, lower job demands were also associated with a higher BMI. These associations were not accounted for by SES, although an additional adjustment for SES attenuated the associations. The results obtained with the individual-level scores were in the same direction, but the relationships were weaker than those obtained with the aggregated scores. Conclusions: This study shows a weak association between work stress and BMI.

Psychosocial factors in GP work:the effects of taking a GP position or leaving GP work

BACKGROUND: We examined the effects of leaving public sector general practitioner (GP) work and of taking a GP position on changes in work-related psychosocial factors, such as time pressure, patient-related stress, distress and work interference with family. In addition, we examined whether changes in time pressure and patient-related stress mediated the association of employment change with changes of distress and work interference with family. METHODS: Participants were 1705 Finnish physicians (60% women) who responded to surveys in 2006 and 2010. Analyses of covariance were conducted to examine the effect of employment change to outcome changes adjusted for gender, age and response format. Mediational effects were tested following the procedures outlined by Baron and Kenny. RESULTS: Employment change was significantly associated with all the outcomes. Leaving public sector GP work was associated with substantially decreased time pressure, patient-related stress, distress and work interference with family. In contrast, taking a position as a public sector GP was associated with an increase in these factors. Mediation tests suggested that the associations of employment change with distress change and work interference with family change were partially explained by the changes in time pressure and patient-related stress. CONCLUSIONS: Our results showed that leaving public sector GP work is associated with favourable outcomes, whereas taking a GP position in the public sector is associated with adverse effects. Primary health-care organizations should pay more attention to the working conditions of their GPs, in particular, to time pressure and patient-related stress.

The translation and sedimentation of accounting reforms. A comparison of the UK, Austrian and Italian experiences

Since the late 1980s, there has been a significant and progressive movement away from the traditional Public Administration (PA) systems, in favour of NPM-type accounting tools and ideas inspired by the private sector. More recently, a new focus on governance systems, under the banner Public Governance (PG), has emerged. In this paper it is argued that reforms are not isolated events, but are embedded in more global discourses of modernisation and influenced by the institutional pressures present in a certain field at certain points in time. Using extensive document analysis in three countries with different administrative regimes (the UK, Italy and Austria), we examine public sector accounting and budgeting reforms and the underlying discourses put forward in order to support the change. We investigate the extent to which the actual content of the reforms and the discourses they are embedded within are connected over time; that is, whether, and to what degree, the reform “talk” matches the “decisions”. The research shows that in both the UK and in Italy there is consistency between the debates and the decided changes, although the dominant discourse in each country differs, while in Austria changes are decided gradually, and only after they have been announced well in advance in the political debate. We find that in all three countries the new ideas and concepts layer and sediment above the existing ones, rather than replace them. Although all three countries underwent similar accounting and budgeting reforms and relied on similar institutional discourses, each made its own specific translation of the ideas and concepts and is characterised by a specific formation of sedimentations. In addition, the findings suggest that, at present in the three countries, the PG discourse is used to supplement, rather than supplant, other prevailing discourses.

Reforming central government: An evaluation of an accounting innovation

This paper examines a significant accounting innovation in central government accounting – the introduction of Resource Accounting and Budgeting (RAB) in the UK. This innovation is studied through the lens of Rogers diffusion theory. The study setting is the Scotland Parliament. This research shows that, in the terms of diffusion theory, RAB can be classified as an accounting innovation. However, the implementation of RAB is problematic. While the reform of the UK central government system was initially sought as a mechanism to enhance democratic accountability, this paper shows that RAB does not connect with parliamentarians. The introduction of RAB flows as much from a managerial agenda as it does from the aim of democratic accountability.

Procurement and Fairness in the Workplace

Public procurement is a potential lever for ensuring greater attention is given to ensuring minimum standards and effective employment rights in the workplace. Public sector purchasers may encourage or require private sector employers from whom they buy to adopt a proactive approach to ensuring fairness at work, focusing on organisational changes that the employer could make. This chapter explores whether and how far public procurement does, or could, influence whether – and how much – employment rights have an impact on employer policy and practice. It considers what public procurement offers as a strategy and what factors help to determine its effectiveness.