Reformas na gestão hospitalar:análise dos efeitos da empresarialização

Tese de Doutoramento em Ciências Sociais na Especialidade de Administração da Saúde

Social Services in Times of Economic and Social Crisis: The case of Spain

The financial and economic crisis which originated in 2008 has had a severe impact on the population of the Southern European countries. The economic policies of austerity and public deficit control, as well as the neo-liberal and conservative social policies are redefining the public social protection systems, in particular the Social Services. In order to get to understand the current situation, we shall explain how the Social Services were developed in Spain and analyse the causes and consequences of the economic crisis. The working hypothesis is that the greater the increase on the population’s needs, the more developed the Social Services should be. We carried out a descriptive analysis of the situation as far as the social impacts of the crisis per region are concerned. We tested the hypothesis through a parametric model of analysis of variance (one-way ANOVA) triangulating with the non-parametric Kruscal-Wallis test. The working hypothesis failed. The regions with better developed Social Services show a lower level of poverty and social exclusion. The challenges that the public Social Services system faces in times of crisis is three-fold: 1) re-modelling of local administration and transferring of the municipal Social Services responsibilities to the regional administration; 2) an increase of the population at risk of poverty and social exclusion 3) impact on social policies.

Employee engagement in the public sector:a narrative evidence synthesis

It has been claimed that employee engagement can harness public service motivation in ways that lead to better improve functioning and positive organizational outcomes, and can help address the increasingly complex challenges associated with public service in an era of austerity. Despite this, there has not yet been a systematic review of the literature that would enable researchers to understand more about the antecedent factors and the outcomes of engagement in the public sector. To address this issue, we undertook a systematic narrative synthesis of the empirical research on engagement that yielded 5111 published studies, of which just 59 were conducted in public sector settings and met our inclusion criteria. Studies generally found that motivational features of jobs (such as autonomy), group (such as social support), management (such as leader consideration), and organizations (such as voice mechanisms) as well as psychological resources were key antecedents of engagement within the public sector; and that engagement was associated with positive employee health/morale and enhanced performance behaviors. The evidence was far from conclusive, suggesting a need for much more rigorous research focused on the specific challenges of public sector settings. We make recommendations for further research on this important topic, particularly with regards to understanding the connection between public service motivation and engagement and the need to examine engagement across different public sector/service contexts.

What next for unions in Central and Eastern Europe? Invisibility, departure and the transformation of industrial relations

This article examines union revitalization in Central and Eastern Europe, focusing on two countries: Hungary and Latvia. Trade unions have not only had to cope with a declining membership base, but have also had to respond to austerity programmes and government cuts in public sector employment. We argue that the inability of unions to provide a strong voice for alternative policies to the current neoliberal orthodoxy has been driven by a declining membership base, but also by weakened social dialogue mechanisms, limited industrial representation and an ageing membership profile, exacerbated by net outward migration in recent years. However, we find that unions in Latvia and Hungary have responded differently to these issues.

Leadership in the community sector: promoting collaboration and social change in Belfast

Community development is centrally concerned with people in communities working together to achieve a common goal, that is, to collaborate, whether within local geographical communities, in communities of shared interests or among groups sharing a common identity. Its overarching goal is one of progressive transformational social change. As Belfast transitions from a conflict to a post-conflict society, there is a need for greater, more effective work at local community level in order to address a range of ongoing social and economic issues facing communities, including high levels of disadvantage and division. Given the significance of leadership in building effective collaboration and the centrality of collaboration for community development, it is important to understand how leadership is currently enacted and what kinds of leadership are required to support communities to collaborate effectively to bring about social change. This thesis thus centers on the kind of leadership practised and required to support collaboration for social change within the community sector in Belfast, a city that contains an estimated 28% of the total number of community and voluntary sector (CVS) organisations in Northern Ireland (Northern Ireland Council for Voluntary Action, 2012). Through a series of qualitative, in-depth interviews with people playing leadership roles in local communities, the study critically explores and analyses their experiences and perceptions in relation to leadership and collaboration. Community development in Belfast today is practised within a wider context of neoliberal policies, characterised by austerity and public spending cuts. Whilst not the only influencing factor, this context has had a particular and profound impact on the nature and role of community development practised, and on the kind of leadership enacted within it. The space for reflection and transformative action appears to be shrinking as the contraction of resources to support community development in local communities continues unabated. Those playing leadership roles increasingly find themselves compelled to spend time seeking resources and managing complex funding arrangements rather than focusing on the social change dimensions of their work. Collaboration as promoted by the state seems to have become an instrumental tactic used to implement its austerity measures and curtail the potential of the community sector. Despite this, local leaders are driving initiatives that attempt to push back, helping the sector refocus on its transformational goals of social change. To do this requires support. Those playing leadership roles require resources, including time, to encourage and enable communities to reconnect with the purpose and underpinning values of community development. Leaders also need support to develop and promote new, progressive narratives and visions and pursue these through building collaboration and solidarity.

The 'Arc of prosperity' revisited: Homelessness policy change in north western Europe

This paper compares continuity and change in homelessness policy in Ireland, Scotland and Norway with a particular focus on the period of post-crisis austerity measures (2008-2016). The analytical approach draws on institutional theory and the notion of path dependency, which has rarely been applied to comparative homelessness research. The paper compares welfare and housing systems in the three countries prior to presenting a detailed analysis of the conceptualisation and measurement of homelessness; the institutions which address homelessness; and the evidence of change in the post-2008 period. The analysis demonstrates that challenges remain in comparing the nature of homelessness and policy responses across nation states, even where they have a number of similar characteristics, and despite some EU influence towards homelessness policy convergence. Similarly, national-level homelessness policy change could not be interpreted as entirely a result of the external shock of the 2008 general financial crisis, as existing national policy goals and programmes were also influential. Overall, embedded national frameworks and institutions were resilient, but sufficiently flexible to deliver longer term policy shifts in response to the changing nature of the homelessness problem and national policy goals. Institutionalism and path dependency were found to be useful in developing the comparative analysis of homelessness policy change and could be fruitfully applied in future longitudinal, empirical research across a wider range of countries.

Intereses nacionales convergentes en una apuesta colectiva: la alianza del pacífico

Este documento indaga sobre los determinantes que hicieron posible la creación de la Alianza del Pacífico. Para ello, se describen elementos del contexto internacional y regional dentro del cual se gestó la Alianza, y que permitió la convergencia de unos intereses afines entre Chile, Colombia, Perú y México que, determinados por identidades similares, desembocaron en un proyecto colectivo: La Alianza del Pacífico. El argumento principal es que los intereses, las características y las identidades comunes configuraron unas preferencias nacionales que fueron materializadas en la creación de un proyecto de integración económica con características particulares, que sirve de plataforma para la coordinación, la articulación, la inserción y el desarrollo económico de sus miembros.

Solastalgia y conductas pro-ambientales en un conflicto socioambiental por la construcción de una hidroeléctrica

Introducción: La construcción de megaproyectos hídricos implica una reconfiguración territorial donde se ven afectadas las fuentes de agua dulce, la biodiversidad terrestre y acuática, y los asentamientos humanos que colindan con dichas construcciones. Objetivo: estimar la asociación entre las conductas proambientales con la solastalgia entre las personas que se encuentran ejerciendo un proceso de resistencia social contra la Central Hidrosogamoso en el departamento de Santander, Colombia. Metodología: se utilizó un diseño de estudio transversal en el que se entrevistaron integrantes y no integrantes de grupos ambientalistas de las zonas de influencia del proyecto. Se realizó un análisis descriptivo de las variables sociodemográficas de los dos grupos de comparación presentando frecuencias absolutas y relativas y diferencias significativas por medio de la prueba ji cuadrado, exacta de Fisher y U de Mann Whitney. Se utilizó un modelo de regresión lineal múltiple en el que la variable dependiente fue el puntaje de solastalgia y las variables independientes fueron las escalas de las conductas proambientales: altruismo, austeridad, equidad, conducta ecológica, deliberación, indignación y aprecio por lo natural, además, se ajustó por algunas variables sociodemográficas de interés. Resultados: los grupos comparados presentaron diferencias importantes en cuanto a la zona de procedencia, condiciones económicas y organización social. El incremento de 5 puntos en la escala del sentimiento de indignación incrementó 0.98 la escala de solastalgia (IC95%: 0.19; 1.78). Las personas sin pareja estable tuvieron 3.02 puntos menos de solastalgia comparadas con personas casadas o en unión libre (IC95%: -4.96; -1.44), mientras que aquellas con alto nivel educativo obtuvieron 2.02 puntos menos que las personas con primaria y bachillerato (IC95%: -3.99; -0.06). Un modelo alterno mostró que no pertenecer a un grupo ambientalista disminuye en 2.29 puntos la solastalgia, comparado con pertenecer a un grupo (IC95%: -4.31; -0.28),. Conclusión: posiblemente las motivaciones por las cuales los actores involucrados se resisten a las transformaciones territoriales ocasionadas por la construcción de las represas son más un reflejo de la condición socioeconómica que de la preocupación de los actores por el daño del medio ambiente y además, esta resistencia es un fenómeno que se limita a aquellos que están afectados directamente en el área de influencia del proyecto

Impact of Public Debt on Economic Growth in Advanced Economies

This paper examines the impact of public debt on the economic growth in advanced economies over a period of 1946 to 2009, using an econometric approach. The findings suggested an inverse relationship between public debt and economic growth in advanced economies. These relationships were found to be significant as well. Model results also show that the real GDP growth rate does not decline sharply whether the public debt-to-GDP ratio is lower than 220%. The public debt-to-GDP ratio elasticity of the real growth rate shows that an increase of 1% in public debt/GDP category above 120% decreases the real GDP growth rate in 1.13%. The negative effect of public debt is only stronger on the real GDP growth rate in advanced economies when the public debt-to-GDP ratio is above 220%. Finally, these findings lead us to reassess the austerity agenda, and the governments should devise new strategies for public debt management in advanced economies, taking into account their economic and financial performance.