2006 Drugs estimate refuels debate on governance, Issue 17, Spring 2006

In November 2005 €34.027 million was voted for the Drugs Initiative, which funds the local and regional drugs task forces, and the Young People’s Facilities and Services Fund (YPFSF), in 2006 – an 8 per cent increase on the allocation for 2005 and ‘well in excess of inflation’ according to the government. The community sector strongly criticised this estimate, calling for an additional €8 million to €15 million, to fund the projects identified following the creation of the Emerging Needs Fund in January 2005. In February 2006, the government revised its drugs estimate upwards by a further €8.979 million. As well as criticising the 2006 drugs estimate, the community sector raised a series of concerns with regard to governance – the rules, processes and behaviour that affect the way in which powers are exercised4 – or, in short, decision-making with regard to drugs policy in Ireland.This resource was contributed by The National Documentation Centre on Drug Use.

Three essays in Swiss corporate governance

This dissertation is a combination of three relatively independent chapters on the subject of corporate governance. Corporate governance is presently at the epicenter of the global financial crisis. The lack of regulation and the misalignment of objectives have greatly contributed to the major crisis we are now in. Most governance research has been conducted in the United States in a context of widely held corporations and great executive power. It does not reflect the variety of situations around the world and we question the validity of this model in other contexts. The aim of this dissertation is to look at other governance models, in particular the Swiss corporate governance not only from a practical point of view, but also from a multi-theoretical approach. Traditional corporate governance literature has focused on the Anglo-American model that mainly follows the agency theory (Jensen and Meckling, 1976) in a shareholder-manager context, and overlooked other approaches. We focus on three different aspects of corporate governance using three different theories. First, we look at the ownership type of various corporations, using the agency theory in a context where issues between shareholders predominate over the typical shareholder-manager relationship. Second, we explore the adoption process of several governance mechanisms that, due to changes in legislation, has taken place in Switzerland since 2002. We use the institutional theory (DiMaggio and Powell, 1983), in a context where the environmental pressures are particularly high. Finally, we spotlight the board of directors as a key element of the governance of publicly listed corporations. Particularly, we focus on the independence of the board of directors, using a combination of the agency and resource dependence theories (Pfeffer, 1972; Pfeffer and Salancik, 1978).

The effect of patient, provider and financing regulations on the intensity of ambulatory physical therapy episodes : a multilevel analysis based on routinely available data

Background: Many studies have found considerable variations in the resource intensity of physical therapy episodes. Although they have identified several patient-and provider-related factors, few studies have examined their relative explanatory power. We sought to quantify the contribution of patients and providers to these differences and examine how effective Swiss regulations are (nine-session ceiling per prescription and bonus for first treatments). Methods: Our sample consisted of 87,866 first physical therapy episodes performed by 3,365 physiotherapists based on referrals by 6,131 physicians. We modeled the number of visits per episode using a multilevel log linear regression with crossed random effects for physiotherapists and physicians and with fixed effects for cantons. The three-level explanatory variables were patient, physiotherapist and physician characteristics. Results: The median number of sessions was nine (interquartile range 6-13). Physical therapy use increased with age, women, higher health care costs, lower deductibles, surgery and specific conditions. Use rose with the share of nine-session episodes among physiotherapists or physicians, but fell with the share of new treatments. Geographical area had no influence. Most of the variance was explained at the patient level, but the available factors explained only 4% thereof. Physiotherapists and physicians explained only 6% and 5% respectively of the variance, although the available factors explained most of this variance. Regulations were the most powerful factors. Conclusion: Against the backdrop of abundant physical therapy supply, Swiss financial regulations did not restrict utilization. Given that patient-related factors explained most of the variance, this group should be subject to closer scrutiny. Moreover, further research is needed on the determinants of patient demand.

A new pathway for the regulation and governance of health research

The Academy's review, 'A new pathway for the regulation and governance of health research' was published in January 2011. The report was prepared by a working group, chaired by Professor Sir Michael Rawlins FMedSci, convened in response to an invitation from Government to review the regulation and governance of UK health research involving human participants, their tissue or their data.The report proposes four key principles that should underpin the regulation and governance framework around health research in the UK, and makes recommendations to:Create a new Health Research Agency (HRA) to rationalise the regulation and governance of all health research. Include within the HRA a new National Research Governance Service to facilitate timely approval of research studies by NHS Trusts. Improve the UK environment for clinical trials.Provide access to patient data that protects individual interests and allows approved research to proceed effectively. Embed a culture that values research within the NHS.

Research Governance Guidance Note 1

HSC Trust Research Governance Permission - Pre-application guidance for applicants

Research Governance Guidance Note 2

HSC Trust Research Governance Permission - Submission of Application