‘It ain’t easy being green’: Sustainable Development between Environment and Economy in Northern Ireland’

Given the relative lack of research on sustainable development in Northern Ireland, this paper focuses on the tensions between environmental governance and regulation on the one hand, and the ‘post-conflict’ imperative for Northern Ireland to compete and grow as a regional economy without continued British state subvention and subsidisation. The paper outlines how this ‘trade-off’ between ‘environment’ and ‘economy’ is essentially misplaced. It argues that this trade-off can be avoided if there is a shift in focus from an ‘environment versus the economy’ policy position to one in which the ‘triple bottom line’ (social, economic and environmental) of sustainable development becomes the over-arching policy agenda. Sustainable development, unlike either orthodox environmental or economic policy, also connects centrally with the unique ‘post-conflict transformation’ agenda of Northern Ireland. For example, promoting a human rights civic culture, tackling socioeconomic inequality and social exclusion, and building a shared future based on supporting sustainable communities and an innovative model of a ‘green(ing) economy’ goes beyond orthodox economic growth. However, it is clear from the Executive’s Programme for Government, failure to support the creation of an independent Environment Protection Agency, and above all the prioritisation of orthodox economic growth based on foreign direct investment that neither environmental protection nor sustainable development is or will be high on the political or policy agenda in Northern Ireland.

‘Towards a Concrete Utopian Model of Green Political Economy’

Much of the thinking about the appropriate ‘political economy’ to underpin sustainable development has been either utopian (as in some ‘green’ political views) or ‘business as usual’ approaches. This article suggests that ‘ecological modernisation’ is the dominant conceptualisation of ‘sustainable development’ within the UK and other ‘developed’ Northern polities and most corporate/business interests, and illustrates this by looking at some key ‘sustainable development’ policy documents from the UK Government. While critical of the reformist ‘policy telos’ of ecological modernisation, supporters of a more radical version of sustainable development need to also be aware of the strategic opportunities of this policy discourse. In particular, the article suggests that the discourse of ‘economic security’, which can be attached to a radicalised notion of ecological modernisation, ought to be used as a way of articulating a radical, robust and principled understanding of sustainable development, which offers a normatively compelling and policy-relevant path to outlining aspects of a ‘green political economy’ to underpin sustainable development.

Telling stories of 21st Century welfare: the UK Coalition Government and the neo-liberal discourse of worklessness and dependency’ Critical Social Policy

Policy documents are a useful source for understanding the privileging of particular ideological and policy preferences (Scrase and Ockwell, 2010) and how the language and imagery may help to construct society’s assumptions, values and beliefs. This article examines how the UK Coalition government’s 2010 Green Paper, 21st Century Welfare, and the White Paper, Universal Credit: Welfare that Works, assist in constructing a discourse about social security that favours a renewal and deepening of neo-liberalization in the context of threats to its hegemony. The documents marginalize the structural aspects of persistent unemployment and poverty by transforming these into individual pathologies of benefit dependency and worklessness. The consequence is that familiar neo-liberal policy measures favouring the intensification of punitive conditionality and economic rationality can be portrayed as new and innovative solutions to address Britain’s supposedly broken society and restore economic competitiveness.

How Prepared are UK Medical Graduates for Practice? Final report from a programme of research commissioned by the General Medical Council

This programme of research aimed to understand the extent to which current UK medical graduates are prepared for practice. Commissioned by the General Medical Council, we conducted: (1) A Rapid Review of the literature between 2009 and 2013; (2) narrative interviews with a range of stakeholders; and (3) longitudinal audio-diaries with Foundation Year 1 doctors. The Rapid Review (RR) resulted in data from 81 manuscripts being extracted and mapped against a coding framework (including outcomes from Tomorrow's Doctors (2009) (TD09)). A narrative synthesis of the data was undertaken. Narrative interviews were conducted with 185 participants from 8 stakeholder groups: F1 trainees, newly registered trainee doctors, clinical educators, undergraduate and postgraduate deans and foundation programme directors, other healthcare professionals, employers, policy and government and patient and public representatives. Longitudinal audio-diaries were recorded by 26 F1 trainees over 4 months. The data were analysed thematically and mapped against TD09. Together these data shed light onto how preparedness for practice is conceptualised, measured, how prepared UK medical graduates are for practice, the effectiveness of transition interventions and the currently debated issue of bringing full registration forward to align with medical students’ graduation. Preparedness for practice was conceptualised as both a long- and short-term venture that included personal readiness as well as knowledge, skills and attitudes. It has mainly been researched using self-report measures of generalised incidents that have been shown to be problematic. In terms of transition interventions: assistantships were found to be valuable and efficacious for proactive students as team members, shadowing is effective when undertaken close to employment/setting of F1 post and induction is generally effective but of inconsistent quality. The August transition was highlighted in our interview and audio-diary data where F1s felt unprepared, particularly for the step-change in responsibility, workload, degree of multitasking and understanding where to go for help. Evidence of preparedness for specific tasks, skills and knowledge was contradictory: trainees are well prepared for some practical procedures but not others, reasonably well prepared for history taking and full physical examinations, but mostly unprepared for adopting an holistic understanding of the patient, involving patients in their care, safe and legal prescribing, diagnosing and managing complex clinical conditions and providing immediate care in medical emergencies. Evidence for preparedness for interactional and interpersonal aspects of practice was inconsistent with some studies in the RR suggesting graduates were prepared for team working and communicating with colleagues and patients, but other studies contradicting this. Interview and audio-diary data highlights concerns around F1s preparedness for communicating with angry or upset patients and relatives, breaking bad news, communicating with the wider team (including interprofessionally) and handover communication. There was some evidence in the RR to suggest that graduates were unprepared for dealing with error and safety incidents and lack an understanding of how the clinical environment works. Interview and audio-diary data backs this up, adding that F1s are also unprepared for understanding financial aspects of healthcare. In terms of being personally prepared, RR, interview and audio diary evidence is mixed around graduates’ preparedness for identifying their own limitations, but all data points to graduates’ difficulties in the domain of time management. In terms of personal and situational demographic factors, the RR found that gender did not typically predict perceptions of preparedness, but graduates from more recent cohorts, graduate entry students, graduates from problem based learning courses, UK educated graduates and graduates with an integrated degree reported feeling better prepared. The longitudinal audio-diaries provided insights into the preparedness journey for F1s. There seems to be a general development in the direction of trainees feeling more confident and competent as they gain more experience. However, these developments were not necessarily linear as challenging circumstances (e.g. new specialty, new colleagues, lack of staffing) sometimes made them feel unprepared for situations where they had previously indicated preparedness.