Education, Education, Education: the Third Way and PFI

In 1997, New Labour set about the task of reforming public services in the United Kingdom through the use of an ideology that became known as the ‘Third Way’. This research examines the context from which this concept emerged, and explores its relationship with the tools of delivery, with particular reference to the Private Finance Initiative (PFI). The paper begins by reviewing the Third Way, before analysing the arguments for and against PFI. Using an example from the Northern Ireland education sector, the paper argues that the characteristics associated with the Third Way are mirrored in the operational tools of public service delivery, such as PFI. The paper concludes that, within the context of the case study reviewed, there is a ‘consistent pragmatism’ in play in relation to how these delivery initiatives are operated and how they relate to their conceptual underpinnings.

Modelling the impact of antibiotic use and infection control practices on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus: a time-series analysis

Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide. A wide range of factors have been suggested to influence the spread of MRSA. The objective of this study was to evaluate the effect of antimicrobial drug use and infection control practices on nosocomial MRSA incidence in a 426-bed general teaching hospital in Northern Ireland.

Methods: The present research involved the retrospective collection of monthly data on the usage of antibiotics and on infection control practices within the hospital over a 5 year period (January 2000–December 2004). A multivariate ARIMA (time-series analysis) model was built to relate MRSA incidence with antibiotic use and infection control practices.

Results: Analysis of the 5 year data set showed that temporal variations in MRSA incidence followed temporal variations in the use of fluoroquinolones, third-generation cephalosporins, macrolides and amoxicillin/clavulanic acid (coefficients = 0.005, 0.03, 0.002 and 0.003, respectively, with various time lags). Temporal relationships were also observed between MRSA incidence and infection control practices, i.e. the number of patients actively screened for MRSA (coefficient = -0.007), the use of alcohol-impregnated wipes (coefficient = -0.0003) and the bulk orders of alcohol-based handrub (coefficients = -0.04 and -0.08), with increased infection control activity being associated with decreased MRSA incidence, and between MRSA incidence and the number of new patients admitted with MRSA (coefficient = 0.22). The model explained 78.4% of the variance in the monthly incidence of MRSA.

Conclusions: The results of this study confirm the value of infection control policies as well as suggest the usefulness of restricting the use of certain antimicrobial classes to control MRSA.

Hanging Flower Baskets, Blowing in the Wind? Third Sector Groups, Cross-Border Partnerships and the EU Peace Programmes in Ireland

The EU’s Peace programmes in Ireland have promoted the cross-border activity of Third sector groups. Potentially, such activity gives substantive meaning to regional cross-border governance and helps to ameliorate ethno-national conflict by providing positive sum outcomes for ‘post-conflict’ communities. The paper mobilizes focused research conducted by the authors to explore this potential. It finds that while regional cross-border governance has indeed developed under the Peace programmes, the sustainability of the social partnerships underpinning this governance is uncertain and its significance for conflict resolution is qualified by difficulties in forming a stable power-sharing arrangement at the political elite level.