British drinking: a suitable case for treatment?

The rising consumption of alcohol per capita in Britain over the past 20 years has produced large increases in the prevalence of alcoholic cirrhosis, alcohol related violence, and heavy alcohol use, costing the British economy around £30bn ($55bn; {euro}44bn) a year.1 About 7.5% of men and 2.1% of women in Britain are dependent on alcohol, among the highest rates in the European Union.2 Two papers in this issue show that two relatively brief psychosocial interventions—motivational enhancement treatment and social network therapy—are effective and cost effective in treating alcohol dependence, when delivered under routine clinical conditions in the NHS.3 4 The UK government could realise its stated aim of increasing access to effective treatments for alcohol dependence by investing in these interventions. Britain also urgently needs to reduce the high rates of high risk drinking that produce dependence, health problems, and public disorder. Epidemiologists see the key drivers of rising consumption . . . [Full text of this article]

Deregulation, competition policy and intra-professional contests in medical education

This paper investigates how government policy directions embracing deregulation and market liberalism, together with significant pre-existing tensions within the Australian medical profession, produced ground breaking change in the funding and delivery of medical education for general practitioners. From an initial view between and within the medical profession, and government, about the goal of improving the standards of general practice education and training, segments of the general practice community, particularly those located in rural and remote settings, displayed increasingly vocal concerns about the approach and solutions proffered by the predominantly urban-influenced Royal Australian College of General Practitioners (RACGP). The extent of dissatisfaction culminated in the establishment of the Australian College of Rural and Remote Medicine (ACRRM) in 1997 and the development of an alternative curriculum for general practice. This paper focuses on two decades of changes in general practice training and how competition policy acted as a justificatory mechanism for putting general practice education out to competitive tender against a background of significant intra-professional conflict. The government's interest in increasing efficiency and deregulating the 'closed shop' practices of professions, as expressed through national competition policy, ultimately exposed the existing antagonisms within the profession to public view and allowed the government some influence on the sacred cow of professional training. Government policy has acted as a mechanism of resolution for long standing grievances of the rural GPs and propelled professional training towards an open competition model. The findings have implications for future research looking at the unanticipated outcomes of competition and internal markets.

Policy into practice:a study of public policy implementation and the role of learning

Public policy becomes managerial practice through a process of implementation. There is an established literature within Implementation Studies which explains the variables and some of the processes involved in implementation, but less attention has been focused upon how public service managers convert new policy initiatives into practice. The research proposes that managers and their organisations have to go through a process of learning in order to achieve the implementation of public policy. Data was collected over a five year period from four case studies of capital investment appraisal in the British National Health Service. Further data was collected from taped interviews by key actors within the case studies. The findings suggest that managers do learn to implement policy and four factors are important in this learning process. These are; (i) the nature of bureaucratic responsibility; (ii) the motivation of actors towards learning; (iii) the passage of time which allows for the development of competence and (iv) the use of project team structures. The research has demonstrated that the conversion of policy into practice occurs through the operationalisation of solutions to policy problems via job tasks. As such it suggests that in understanding how policy is implemented, technical learning is more important than cultural learning, in this context. In conclusion, a "Model of Learned Implementation" is presented, together with a discussion of some of the implications of the research. These are the possible use of more pilot projects for new policy initiatives and the more systematic diffusion of knowledge about implementation solutions.

Strategic HRM through the cultural looking glass:mapping the cognition of British and Indian managers

This study examines the issues of `integration' of human resource management (HRM) into the corporate strategy, `devolvement' of HRM to line managers and the perceived influence of national culture on HRM in a cross-national comparative context. In order to achieve this, the cognition of personnel specialists from a matched sample of 48 Indian and British firms in the manufacturing sector using the `Visual Cards Sorting' and `CMAP2' methodologies are analyzed. The findings show that even where there is an apparent convergence of strategy — e.g., the desire of both Indian and British personnel managers to increase integration between HRM and business strategy, and to increase the level of devolvement to line managers, the two sets of specialists clearly follow a different logic of action, which is subject to a different set of cross-cultural influences. The implications of pursuing apparently similar HRM solutions in different cross-national contexts are considered. The analysis shows that HRM strategies, when considered in a cross-national context, vary a lot. Different logic leads to the adoption of similar HR strategies, and similar strategies in turn are perceived as producing different outcomes. This variance centres around the existence and perceived influence of several contextual variables such as industrial relations systems, operation of labour markets, and changes in business systems. Specific cross-cultural influences, along with different aspects of competitive business environment associated with the generic HR strategies of integration and devolvement in the two countries are highlighted. This research contributes to the fields of cross-cultural management research, international HRM and managerial and organizational cognition. It also has important messages for policy makers.

Understanding policy implementation processes as self-organizing systems

Implementation studies and related research in organizational theory can be enhanced by drawing on the field of complex systems to understand better and, as a consequence, more successfully manage change. This article reinterprets data previously published in the British Journal of Management to reveal a new contribution, that policy implementation processes should be understood as a self-organizing system in which adaptive abilities are extremely important for stakeholders. In other words, national policy is reinterpreted at the local level, with each local organization uniquely mixing elements of national policy with their own requirements making policy implementation unpredictable and more sketchy. The original article explained different paces and directions of change in terms of traditional management processes: leadership, politics, implementation and vision. By reinterpreting the data, it is possible to reveal that deeper level processes, which are more emergent, are also at work influencing change, which the authors label possibility space. Implications for theory, policy and practice are identified.

The intra-firm diffusion of complementary innovations: Evidence from the adoption of management practices by British establishments

This paper presents a simple profitability-based decision model to show how synergistic gains generated by the joint adoption of complementary innovations may influence the firm's adoption decision. For this purpose a weighted index of intra-firm diffusion is built to investigate empirically the drivers of the intensity of joint use of a set of complementary innovations. The findings indicate that establishment size, ownership structure and product market concentration are important determinants of the intensity of use. Interestingly, the factors that affect the extent of use of technological innovations do also affect that of clusters of management practices. However, they can explain only part of the heterogeneity of the benefits from joint use.

Strategic positioning in voluntary and non-profit organizations in the UK : exploring the experiences of British charitable organizations:Exploring the experiences of British Charitable Organizations

This thesis explores the strategic positioning [SP] activities of charitable organizations [COs] within the wider sector of voluntary and non-profit organizations [VNPOs] in the UK. Despite the growing interest in SP for British COs in an increasingly competitive operating environment and changing policy context, there is lack of research in mainstream marketing/strategic management studies on this topic for charities, whilst the specialist literature on VNPOs has neglected the study of SP. The thesis begins with an extended literature review of the concept of positioning in both commercial [for-profit] and charitable organizations. It concludes that the majority of theoretical underpinnings of SP that are prescribed for COs have been derived from the commercial strategy/marketing literature. There is currently a lack of theoretical and conceptual models that can accommodate the particular context of COs and guide strategic positioning practice in them. The research contained in this thesis is intended to fill some of these research gaps. It combines an exploratory postal survey and four cross-sectional case studies to describe the SP activities of a sample of general welfare and social care charities and identifies the key factors that influence their choice of positioning strategies [PSs]. It concludes that charitable organizations have begun to undertake SP to differentiate their organizations from other charities that provide similar services. Their PSs have both generic features, and other characteristics that are unique to them. A combination of external environmental and organizational factors influences their choice of PSs. A theoretical model, which depicts these factors, is developed in this research. It highlights the role of governmental influence, other external environmental forces, the charity’s mission, organizational resources, and influential stakeholders in shaping the charity’s PS. This study concludes by considering the theoretical and managerial implications of the findings on the study of charitable and non-profit organizations.

Families 'at risk' and the family nurse partnership:the intrusion of risk into social exclusion policy

This article considers why the family nurse partnership (FNP) has been promoted as a means of tackling social exclusion in the UK. The FNP consists in a programme of visits by nurses to low-income first-time mothers, both while the mothers are pregnant and for the first two years following birth. The FNP is focused on both teaching parenthood and encouraging mothers back into education and/or into employment. Although the FNP marks a considerable discontinuity with previous approaches to family health, it is congruent with an emerging new approach to social exclusion. This new approach maintains that the most important task of social policy is to identify quickly the most 'at-risk' households, individuals and children so that interventions can be targeted more effectively at those 'at risk', either to themselves or to others. The article illustrates this new approach by analysing a succession of reports by the Social Exclusion Unit. It indicates that there is a considerable amount of ambiguity about the relationship between specific risk-factors and being 'at risk of social exclusion'. Nonetheless, this new approach helps to explain why British policy-makers may have chosen to promote the new FNP now. © 2009 Cambridge University Press.

Comparing German and British political culture through values : and analysis of the values of health care reform

This research sets out to compare the values in British and German political discourse, especially the discourse of social policy, and to analyse their relationship to political culture through an analysis of the values of health care reform. The work proceeds from the hypothesis that the known differences in political culture between the two countries will be reflected in the values of political discourse, and takes a comparison of two major recent legislative debates on health care reform as a case study. The starting point in the first chapter is a brief comparative survey of the post-war political cultures of the two countries, including a brief account of the historical background to their development and an overview of explanatory theoretical models. From this are developed the expected contrasts in values in accordance with the hypothesis. The second chapter explains the basis for selecting the corpus texts and the contextual information which needs to be recorded to make a comparative analysis, including the context and content of the reform proposals which comprise the case study. It examines any contextual factors which may need to be taken into account in the analysis. The third and fourth chapters explain the analytical method, which is centred on the use of definition-based taxonomies of value items and value appeal methods to identify, on a sentence-by-sentence basis, the value items in the corpus texts and the methods used to make appeals to those value items. The third chapter is concerned with the classification and analysis of values, the fourth with the classification and analysis of value appeal methods. The fifth chapter will present and explain the results of the analysis, and the sixth will summarize the conclusions and make suggestions for further research.

The formation and impact of hazard control policy:a study of the regulation of white lead paint in Britain

Government regulation of industrial hazards is examined in the context of the economic and technical processes of industrial development. Technical problems and costs of control are considered as factors in both the formation and impact of regulation. This thesis focuses on an historical case-study of the regulation of the hazard to painting workers from the use of lead pigments in paint. A regulatory strategy based on the prohibition of lead paints gained initial acceptance within the British state in 1911, but was subsequently rejected in favour of a strategy that allowed continued use of lead paint subject to hygiene precautions. The development of paint technology and its determinants, including concern about health hazards, are analysed, focusing on the innovation and diffusion into the paint industry of the major white pigments: white lead (PbC03 .PB(OH)2)and its substitutes. The process of regulatory development is examined, and the protracted and polarised regulatory d~bate contrasted to the prevailing 'consensual' methods of workplace regulation. The rejection of prohibition is analysed in terms of the different political and technical resources of those groups in conflict over this policy. This highlights the problems of consensus formation around such a strategy, and demonstrates certain constraints on state regulatory activity, particularly regarding industrial development. Member-states of the International Labour Organisation agreed to introduce partial prohibition of lead paint in 1921. Whether this was implemented is related to the economic importance of lead and non-lead metal and pigment industries to a nation. An analysis is made of the control of lead poisoning. The rate of control is related to the economic and technological trajectory of the regulated industry. Technical and organisational characteristics are considered as well as regulatory factors which range from voluntary compliance and informal pressures to direct legal requirements. The implications of this case-study for the analysis of the development and impacts of regulation are assessed.

Automation, rationalisation and concentration : a case study in the British chemical industry

This thesis is based upon a case study of the adoption of digital, electronic, microprocessor-based control systems by Albright & Wilson Limited - a UK chemical producer. It offers an explanation of the company's changing technology policy between 1978 and 1981, by examining its past development, internal features and industrial environment. Part One of the thesis gives an industry-level analysis which relates the development of process control technology to changes in the economic requirements of production . The rapid diffusion of microcomputers and other microelectronic equipment in the chemical industry is found to be a response to general need to raise the efficiency of all processes, imposed by the economic recession following 1973. Part Two examines the impaot of these technical and eoonomic ohanges upon Albright & Wilson Limited. The company's slowness in adopting new control technology is explained by its long history in which trends are identified whlich produced theconservatism of the 1970s. By contrast, a study of Tenneco Incorporated, a much more successful adoptor of automating technology, is offered with an analysis of the new technology policy of adoption of such equipment which it imposed upon Albright & Wilson, following the latter's takeover by Tenneco in 1978. Some indications of the consequences by this new policy of widespread adoptions of microprocessor-based control equipment are derived from a study of the first Albright & Wilson plant to use such equipment. The thesis concludes that companies which fail to adopt rapidly the new control technology may not survive in the recessionary environment, the long- established British companies may lack the flexibility to make such necessary changes and that multi-national companies may have an important role jn the planned transfer and adoption of new production technology through their subsidiaries in the UK.

Logics, thresholds, strategic power, and the promotion of liberalisation by governments: a case study from British Higher Education

Liberalisation has become an increasingly important policy trend, both in the private and public sectors of advanced industrial economies. This article eschews deterministic accounts of liberalisation by considering why government attempts to institute competition may be successful in some cases and not others. It considers the relative strength of explanations focusing on the institutional context, and on the volume and power of sectoral actors supporting liberalisation. These approaches are applied to two attempts to liberalise, one successful and one unsuccessful, within one sector in one nation – higher education in Britain. Each explanation is seen to have some explanatory power, but none is sufficient to explain why competition was generalised in the one case and not the other. The article counsels the need for scholars of liberalisation to be open to multiple explanations which may require the marshalling of multiple sources and types of evidence.

The British higher education funding debate: the perils of 'talking economics'

This article examines current debates surrounding British higher education funding from a political economy perspective, drawing on ‘positive’ and ‘institutionalist’ political economy. Adopting the lens of political economy enables a critical assessment of the use of terms drawn from economics by many higher education decision-makers. Current discussions embody particular assumptions about the nature of producers and consumers in higher education, the relationship between supply and demand, and the role of information in the higher education ‘market’. They also frequently fail to acknowledge the active rather than passive role of higher education institutions in shaping policy discussions surrounding higher education funding.

Expropriation of minority shareholders and payout policy

This paper studies the payout policy of Italian firms controlled by large majority shareholders (controlled firms). The paper reports that a firm’s share of dividends in total payout (dividends plus repurchases) is negatively related to the size of the cash flow stake of the firm’s controlling shareholder and positively associated with the wedge between the controlling shareholder’s control rights and cash flow rights. These findings are consistent with the substitute model of payout. One of the implications of this model is that controlled firms with weak corporate governance set-ups, in which controlling shareholders have strong incentives to expropriate minority shareholders, tend to prefer dividends over repurchases when disgorging cash.

Innovation and the survival of new firms across British regions

This paper analyses the survival of the complete cohort of more than 162,000 limited companies incorporated in Britain in 2001 over the subsequent five-year period. For this purpose, we estimate firms' hazards of failure and survival functions using nonparametric and semi-parametric techniques. The paper focuses on two important policy-related issues.The first is to what extent survival rates vary across regions in Britain. A second, and related, policy issue concerns innovation. The data available allows us to look at the intellectual property (IP) activity of all British firms, including that of the 162,000 new firms in 2001. The results indicate substantial differences in survival rates across regions, and also that IP activity is associated with a higher probability of survival. These differences across regions, and the importance of IP activity, remain when we condition on a large range of regional, industry and firm-level characteristics shifting firms' hazards of failure.