Financing road transport infrastructure

In the UK, public expenditure on transport infrastructure is nearly £6 billion for the past few years. Over £500 million per year were spent on bridge assessment and strengthening and reducing the backlog of road requiring maintenance. A further £200 million a year will be spent on keeping the safe operation of the network and efficiently through day to day maintenance, lighting and signing . The Department of Transport is planning to extend private sector experience in road management and operation by introducing Design, Build, Finance and Operate (DBFO) This paper investigates the different ways of financing road transport infrastructure including road pricing, private finance in transport infrastructure, the role of the private sector, Design, Build, Finance and Operate (DBFO) schemes, the benefits and problems of such schemes. The paper considers planning gain as a means of financing transport infrastructure with examples of developers to fund link road building and improvements to the local planning system

Access, equity and the role of rights in health care

Modern health care rhetoric promotes choice and individual patient rights as dominant values. Yet we also accept that in any regime constrained by finite resources, difficult choices between patients are inevitable. How can we balance rights to liberty, on the one hand, with equity in the allocation of scarce resources on the other? For example, the duty of health authorities to allocate resources is a duty owed to the community as a whole, rather than to specific individuals. Macro-duties of this nature are founded on the notion of equity and fairness amongst individuals rather than personal liberty. They presume that if hard choices have to be made, they will be resolved according to fair and consistent principles which treat equal cases equally, and unequal cases unequally. In this paper, we argue for greater clarity and candour in the health care rights debate. With this in mind, we discuss (1) private and public rights, (2) negative and positive rights, (3) procedural and substantive rights, (4) sustainable health care rights and (5) the New Zealand booking system for prioritising access to elective services. This system aims to consider: individual need and ability to benefit alongside the resources made available to elective health services in an attempt to give the principles of equity practical effect. We describe a continuum on which the merits of those, sometimes competing, values-liberty and equity-can be evaluated and assessed.