Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.

Understanding the barriers to real estate investment in developing economies

Baum (2008a) related the number of real estate funds investing in developing economies to simple economic and demographic variables, and showed that, while the popularity of markets was explained by population and GDP per capita, some countries receive more or less investment than the model predicted. Why is this? In this paper we undertake a literature review to identify the barriers which inhibit international real estate investment. We test our initial findings by questioning property investment professionals through semi-structured interviews. By doing this we were able to verify our list of barriers, identify those barriers which are most likely to affect real estate investors, and to indicate whether there are any real estate-specific variables that create barriers which have not received any academic attention. We show that distortions in international capital flows may be explained by a combination of these formal and informal barriers.

Mixed use urban regeneration at Brindleyplace, Birmingham and Gunwharf Quays, Portsmouth: an assessment of the impact on local and national economies

This independent research was commissioned by the British Property Federation. The report examines the local and national economic impact of two major, mixed use schemes in terms of tax revenue, household income, business rates and council tax and jobs creation. A regeneration balance sheet for each scheme is presented in the context of government policy and other related research. The report provides a comprehensive review of government policy and the role of retail and other land uses in regeneration. Highlighting the importance of national and local multiplier effects with detailed statistics drawn from a variety of sources, this fully illustrated colour research report builds up a detailed picture of economic impact of the mixed use regeneration schemes in the local economies of Birmingham and Portsmouth. The report will be of interest to property people, planners and all involved in regeneration and local economies.

The role of location in knowledge creation and diffusion: evidence of centripetal and centrifugal forces in the City of London financial services agglomeration

In this paper we report on a major empirical study of centripetal and centrifugal forces in the City of London financial services agglomeration. The study sheds light on (1) the manner and magnitude of firm interaction in the agglomeration; (2) the characteristics of the agglomeration that aid the competitiveness of incumbent firms; and (3) the problems associated with agglomeration. In addressing these issues, we use the data to (1) test emerging theory that explains the high productivity and innovation of agglomerations in terms of their ability to generate and diffuse knowledge; and (2) evaluate the ‘end of geography’ thesis.

Do real balance effects invalidate the Taylor principle in closed and open economies?

This paper examines the determinacy implications of forecast-based monetary policy rules that set the interest rate in response to expected future inflation in a Neo-Wicksellian model that incorporates real balance effects. We show that the presence of such effects in closed economies restricts the ability of the Taylor principle to prevent indeterminacy of the rational expectations equilibrium. The problem is exacerbated in open economies, particularly if the policy rule reacts to consumer-price, rather than domestic-price, inflation. However, determinacy can be restored in both closed and open economies with the addition of monetary policy inertia.

Internal equity financing and the performance of multinational subsidiaries in emerging economies

We examine the internal equity financing of the multinational subsidiary which retains and reinvests its own earnings. Internal equity financing is a type of firm-specific advantage (FSA) along with other traditional FSAs in innovation, research and development, brands and management skills. It also reflects subsidiary-level financial management decision-making. Here we test the contributions of internal equity financing and subsidiary-level financial management decision-making to subsidiary performance, using original survey data from British multinational subsidiaries in six emerging countries in the South East Asia region. Our first finding is that internal equity financing acts as an FSA to improve subsidiary performance. Our second finding is that over 90% of financing sources (including capital investment by the parent firms) in the British subsidiaries come from internal funding. Our third finding is that subsidiary-level financial management decision-making has a statistically significant positive impact on subsidiary performance. Our findings advance the theoretical, empirical and managerial analysis of subsidiary performance in emerging economies.

Housing Policies in Latin America: overview of the four largest economies

The aim of this paper is to examine the differences and similarities in housing policies in the four Latin American countries of Argentina, Brazil, Chile and Colombia. The article uses the welfare regime approach, modified by a recognition of path dependence, to identify a number of phases that each country has passed through. However, attention is drawn to the substantial differences in the circumstances in each country and the extent and duration of the different phases. It is concluded that it can be beneficial to use the concept of a Latin American housing regime, but that this general picture has to be used with an understanding of the path dependence caused by the different context in the individual countries.