The Business of Building Peace: Private Sector Cooperation across the Irish Border

The sustainability of cross-border peacebuilding initiatives is increasingly pertinent in a context of reduced public funding (national and European), yet the potential contribution to be made to this from private sector cooperation remains under-explored. This paper brings together quantitative data on cross-border trade with qualitative evidence from business leaders in the Irish border region in order to examine the nature of cross-border cooperation within the private sector and its possible connections to peacebuilding. This evidence is analysed in the light of three theses: spillover, contact and business-based peacebuilding. The first part of this paper assesses the conditions for cross-border business cooperation in Ireland, including funding support for economic development, European integration, and (post-Agreement) institutional change. The second part examines the particular contributions made by the private sector to peace, centring upon consciously non-political motivations (such as pragmatism and profit), networking and leadership.

Conflict Management in Public-Private Partnerships: The Case of the London Underground

Public–private partnerships (PPPs) have become common inter-organizational arrangements associated with “new public management.” Discussion about their effective operation has often focused on successful management methods, with less discussion about how these arrangements specifically overcome obstacles and problems. In this article, we seek to address this deficiency in the literature by analyzing the conflict management system employed within the London Underground PPP (when it was still in operation). We conclude by identifying several lessons from this case that we believe should inform the design of such systems, one of which is the role of knowledge management.

Public Private Partnerships: A Global Review

This book provides an international perspective on Public Private Partnerships. Through 21 case studies, it investigates the existing and fast developing body of principles and practices from a wide range of countries and is the first book to bring together leading international academics and practitioners under a common framework that enables convenient cross-country comparisons. The authors focus on the impact of the financial crisis has had on how governments have reviewed and overhauled their PPP policies as they have examined or tested new ways of partnering more effectively, efficiently and sustainably with the private sector.
Readers will be able to gauge the level of maturity of PPP development in the book’s case studies, understand similarities and differences in their practices, and gain useful insights into the regulatory framework and institutional infrastructure in place to support implementation of PPP. Finally, the book offers insights into the future challenges and opportunities that PPP offers stakeholders.

UK Public Private Partnerships and the Credit Crunch: A Case of Risk Contagion?

During the past twenty years, the UK has relied heavily on Public Private Partnerships (PPP) and especially the Private Finance Initiative in the procurement of infrastructure and services. Discussing the causes of the credit crunch and its effects on PPP, this paper notes that the provision of new public sector infrastructure and related services has been adversely affected by the impact of the credit crunch on Private Finance Initiatives (PFIs). These problems have arisen primarily from the unwillingness of commercial banks to replace collapsed PFI bond financing unless new PFI contracts reduce financial risks; which, in turn, is likely to increase the cost of these projects to the public sector. Additional financial strains have arisen for the UK government from the need to bail out collapsed PFI projects. Overall we find evidence that the UK commitment to PFI has not only increased immediate fiscal pressures on the UK when these have become least palatable, but has also created fiscal vulnerabilities at local and national levels which are likely to hamper the country’s ability to launch counter-cyclical responses to the ongoing crisis.

The Diffusion of Risks in Public Private Partnership Contracts

Purpose The UK government argues that the benefits of public private partnership (PPP) in delivering public infrastructure stem from: transferring risks to the private sector within a structure in which financiers put their own capital at risk; and, the performance based payment mechanism, reinforced by the due diligence requirements imposed by the lenders financing the projects (HM Treasury, 2010). Prior studies of risk in PPPs have investigated ‘what’ risks are allocated and to ‘whom’, that is to the public or the private sector. The purpose of this study is to examine ‘how’ and ‘why’ PPP risks are diffused by their financiers. Design/methodology/approach This study focuses on the financial structure of PPPs and on their financiers. Empirical evidence comes from interviews conducted with equity and debt financiers. Findings The findings show that the financial structure of the deals generates risk aversion in both debt and equity financiers and that the need to attract affordable finance leads to risk diffusion through a network of companies using various means that include contractual mitigation through insurance, performance support guarantees, interest rate swaps and inflation hedges. Because of the complexity this process generates, both procurers and suppliers need expensive expert advice. The risk aversion and diffusion and the consequent need for advice add cost to the projects impacting on the government’s economic argument for risk transfer. Limitations and implications The empirical work covers the private finance initiative (PFI) type of PPP arrangements and therefore the risk diffusion mechanisms may not be generalisable to other forms of PPP, especially those that do not involve the use of high leverage or private finance. Moreover, the scope of this research is limited to exploring the diffusion of risk in the private sector. Further research is needed on how risk is diffused in other settings and on the value for money implication of risk diffusion in PPP contracts. Originality/value The expectation inherent in PPP is that the private sector will better manage those risks allocated to it and because private capital is at risk, financiers will perform due diligence with the ultimate outcome that only viable projects will proceed. This paper presents empirical evidence that raises questions about these expectations. Key words: public private partnership, risk management, diffusion, private finance initiative, financiers

Is the public healthcare sector a more strenuous working environment than the private sector for a physician?

Aims: The present study examined the differences between physicians working in public and private health care in strenuous working environments (presence of occupational hazards, physical violence, and presenteeism) and health behaviours (alcohol consumption, body mass index, and physical activity). In addition, we examined whether gender or age moderated these potential differences. Methods: Cross-sectional survey data were compiled on 1422 female and 948 male randomly selected physicians aged 25-65 years from The Finnish Health Care Professionals Study. Logistic regression and linear regression analyses were used with adjustment for gender, age, specialisation status, working time, managerial position, and on-call duty. Results: Occupational hazards, physical violence, and presenteeism were more commonly reported by physicians working in the public sector than by their counterparts in the private sector. Among physicians aged 50 years or younger, those who worked in the public sector consumed more alcohol than those who worked in the private sector, whereas in those aged 50 or more the reverse was true. In addition, working in the private sector was most strongly associated with lower levels of physical violence in those who were older than 50 years, and with lower levels of presenteeism among those aged 40-50 years. Conclusions: The present study found evidence for the public sector being a more strenuous work environment for physicians than the private sector. Our results suggest that public healthcare organisations should pay more attention to the working conditions of their employees.

Clinical trial designs for rare diseases: Studies developed and discussed by the International Rare Cancers Initiative

BACKGROUND: The past three decades have seen rapid improvements in the diagnosis and treatment of most cancers and the most important contributor has been research. Progress in rare cancers has been slower, not least because of the challenges of undertaking research.

SETTINGS: The International Rare Cancers Initiative (IRCI) is a partnership which aims to stimulate and facilitate the development of international clinical trials for patients with rare cancers. It is focused on interventional--usually randomized--clinical trials with the clear goal of improving outcomes for patients. The key challenges are organisational and methodological. A multi-disciplinary workshop to review the methods used in ICRI portfolio trials was held in Amsterdam in September 2013. Other as-yet unrealised methods were also discussed.

RESULTS: The IRCI trials are each presented to exemplify possible approaches to designing credible trials in rare cancers. Researchers may consider these for use in future trials and understand the choices made for each design.

INTERPRETATION: Trials can be designed using a wide array of possibilities. There is no 'one size fits all' solution. In order to make progress in the rare diseases, decisions to change practice will have to be based on less direct evidence from clinical trials than in more common diseases.

The Role and Effectiveness of Public – Private Partnerships (NHS LIFT) in the Development of Enhanced Primary Care Premises and Services:Report for the National Institute for Health Research Service Delivery and Organisation programme

The research project analysed the role and effectiveness of LIFT via a multi-method study which included semi-structured interviews with policy elites and users, as well as case studies and an exploratory analysis of the financial characteristics of three LIFT Companies. While the team felt that it was able to identify key aspects relating to the advantages and drawbacks surrounding LIFT, some aspects relating to the representativeness of the study was adversely affected by a reluctance of PCTs to participate in the case study analysis and commercial confidentiality restrictions. The study was nonetheless able to identify important issues in relation to the funding and procurement of primary care premises and services.

Performance management systems and Public Value Strategy: a case study

Purpose
This article aims to analyze the role of performance management systems (PMS) in supporting public value strategies.

Design/methodology/approach
This article draws on the public value dynamic model by Horner and Hutton (2010). It presents the results of a case study of implementation of a PMS model, the ‘Value Pyramid’ (VP).

Findings
The results stress the need for an improved conceptualization of PMS within public value strategy. Through experimentation using the VP, the case site was able to measure and visualize what it considered public value and reflect on the internal/external causes of both creation and destruction of public value.

Research limitations/implication
This article is limited to just one case study, although in-depth and longitudinal.

Originality/value
This article is one of the first attempting to understand the role of PMS within the public value strategy framework, answering the call of Benington and Moore (2010) to consider public value from an accounting perspective.

Does the UK Local Finance Improvement Trust (Lift) Initiative Improve Risk Management in Public-Private Procurement?

The UK government introduced the Private Finance Initiative (PFI) and, latterly, the Local Improvement Finance Trust (LIFT) in an attempt to improve public service provision. As a variant of PFI, LIFT seeks to create a framework for the effective provision of primary care facilities. Like conventional PFI procurement, LIFT projects involve long-term contracts, complex multi-party interactions and thus create various risks to public sector clients. This paper investigates the advantages and disadvantages of LIFT with a focus on how this approach facilitates or impedes risk management from the public sector client perspective. Our paper concludes that LIFT has a potential for creating additional problems, including the further reduction of public sector control, conflicts of interest, the inappropriate use of enabling funds, and higher than market rental costs affecting the uptake of space in the buildings by local health care providers. However, there is also evidence that LIFT has facilitated new investment and that Primary Care Trusts (PCTs) have themselves started addressing some of the weaknesses of this procurement format through the bundling of projects and other forms of regional co-operation.