Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

Commodification of health care systems: The Catalan case

Commodification of the public healthcare system has been a growing process in recent decades, especially in universal healthcare systems and in high-income countries like Spain.  There are substantial differences in the healthcare systems of each autonomous region of Spain, among which Catalonia is characterized by having a mixed healthcare system with complex partnerships and interactions between the public and private healthcare sectors.  Using a narrative review approach, this article addresses various aspects of the Catalan healthcare system, characterizing the privatization and commodification of health processes in Catalonia from a historical perspective with particular attention to recent legislative changes and austerity measures.  The article approximates, the eventual effects that commodification and austerity measures will have on the health of the population and on the structure, accessibility, effectiveness, equity and quality of healthcare services.

The evolution of public–private partnership in Ireland: a sustainable pathway?

Ireland is a latecomer to Public Private Partnership (PPP) having only adopted it in 1998. Prior to the credit crisis, Ireland followed the UK model with PPPs being implemented in transport, education, housing/urban regeneration and water/wastewater. Having stalled during the credit crisis, PPP has been reactivated recently with the domestic infrastructure stimulus programme . The focus of this paper is on Ireland as a younger participant in PPP and the nexus between adoption patterns and sustainability characteristics of Irish PPP. Using document analysis and exploratory interviews, the paper examines the reasons for Ireland’s interest in PPP which cannot be attributed to economic rationales alone. We consider three explanations: voluntary adoption – where the UK model was closely followed as part of a domestic modernisation agenda; coercive adoption – where PPP policy was forced upon public sector organisations; and institutional isomorphism – where institutional creation and change around PPP was promoted to help public sector organisations gain institutional legitimacy. We find evidence of all three patterns with coercive adoption becoming more relevant in recent years, which is likely to affect sustainability adversely unless incentives for voluntary adoption are strengthened and institutional capacity building is boosted.

Making personalised nutrition the easy choice: Creating policies to break down the barriers and reap the benefits

Personalised diets based on people’s existing food choices, and/or phenotypic, and/or genetic information hold potential to improve public dietary-related health. The aim of this analysis, therefore, has been to examine the degree to which factors which determine uptake of personalised nutrition vary between EU countries to better target policies to encourage uptake, and optimise the health benefits of personalised nutrition technology. A questionnaire developed from previous qualitative research was used to survey nationally representative samples from 9 EU countries (N = 9381). Perceived barriers to the uptake of personalised nutrition comprised three factors (data protection; the eating context; and, societal acceptance). Trust in sources of information comprised four factors (commerce and media; practitioners; government; family and, friends). Benefits comprised a single factor. Analysis of Variance (ANOVA) was employed to compare differences in responses between the United Kingdom; Ireland; Portugal; Poland; Norway; the Netherlands; Germany; and, Spain. The results indicated that respondents in Greece, Poland, Ireland, Portugal and Spain, rated the benefits of personalised nutrition highest, suggesting a particular readiness in these countries to adopt personalised nutrition interventions. Greek participants were more likely to perceive the social context of eating as a barrier to adoption of personalised nutrition, implying a need for support in negotiating social situations while on a prescribed diet. Those in Spain, Germany, Portugal and Poland scored highest on perceived barriers related to data protection. Government was more trusted than commerce to deliver and provide information on personalised nutrition overall. This was particularly the case in Ireland, Portugal and Greece, indicating an imperative to build trust, particularly in the ability of commercial service providers to deliver personalised dietary regimes effectively in these countries. These findings, obtained from a nationally representative sample of EU citizens, imply that a parallel, integrated, public-private delivery system would capture the needs of most potential consumers.

Economic and trade relations between Latin America and Asia Pacific: The link with China

Includes bibliography

Affordable Housing Policies: An Overview

As urban housing markets throughout the United States increasingly exhibit challenges of affordability, federal, state, and local governments have placed renewed emphasis on housing, specifically mixed-income housing, which integrates affordable housing incentives into multifamily development projects. With such incentives, one must wonder what comprises a successful affordable housing policy and how affordable housing can be successfully implemented into a community. This article attempts to answer these questions by detailing the history of affordable housing policies, exploring some of the current affordable housing policies and programs, comparing affordable housing programs from different regions, and discussing some successful affordable housing programs and lessons that can be learned from them.

A life cycle framework for governance of Intermodal terminals; planning, operations and strategic management.

This chapter establishes a framework for the governance of intermodal terminals throughout their life cycle, based on the product life cycle. The framework covers the initial planning by the public sector, the public/private split in funding and ownership, the selection of an operator, ensuring fair access to all users, and finally reconcessioning the terminal to a new operator, managing the handover and maintaining the terminal throughout its life cycle. This last point is especially important as industry conditions change and the terminal's role in the transport network comes under threat, either by a lack of demand or by increased demand requiring expansion, redesign and reinvestment. Each stage of the life cycle framework is operationalised based on empirical examples drawn from research by the authors on intermodal terminal planning and funding, the tender process and concession and operation contracts. In future the framework can be applied in additional international contexts to form a basis for transport cost analysis, logistics planning and government policy.

Contradictory male/masculine/men's "I"s: the unwriting of men, and the concept of sex

May I start with two observations? First, men’s relations to feminism are problematic—there is always a gap, a gap between men and feminism; second, the gendering of men and masculinities is now recognised. There are several challenges here. The gender challenge concerns how to move from the presumed “genderlessness” of men towards the gender-consciousness of being a man/men. Another challenge concerns the “public/private,” the disruption of dominant narratives of “I” of men and the masculine “I.” There is also a temporal challenge, of moving away from simple linearity of the “I.” Together, these challenges can be seen as moving away from taken-for-granted “gender power-coherence” towards gender power-consciousness. To address these kinds of question means interrogating the uneven non-equivalences of what it means to be male, a man, masculine. This is not easily reduced to sex or gender. Rather gender/sex, or simply gex, helps to speak of such blurrings.

L'image principale de profil, symbole de l'individu connecté

Depuis le début du XXIe siècle, un type particulier d’images a envahi l’espace public constitué par Internet : il s’agit des images principales de profil, ces images que les utilisateurs de sites de réseaux sociaux choisissent pour les représenter auprès des autres individus connectés. Comme le plus souvent il s’agit d’une image du corps de celui ou celle qui s’affiche ainsi, il est intéressant de s’intéresser à cette pratique en la rattachant à des pratiques plus anciennes. Dans un premier temps, cette étude présente donc une perspective socio-historique en notant la ressemblance de la pratique de l’image principale de profil avec celle de l’autoportrait et du portrait commandé. Cela permet de remarquer plusieurs points de rupture ou d’inflexion dans l’usage de ce type d’images, mais aussi d’en dégager les usages sociaux typiques. Ensuite, l’observation d’un lieu particulier d’Internet permet de tirer les conclusions suivantes : si l’usage principal de ces images est facile à expliquer, elles servent à symboliser une présence dans des lieux non accessibles aux corps sensibles, ces images montrent toujours des éléments qui permettent de déduire une position sociale et elles sont fondamentalement identiques aux images produites avant Internet. Ensuite, l’étude de ces images montre qu’il y a un véritable continuum dans la manière de dévoiler son intimité qui permet d’affirmer que la frontière entre public et privé n’existe pas sur Internet. Finalement, ces images montrent une absence de canon quant à leur production et une multiplicité des façons de se mettre en scène qui laissent à penser qu’elles sont devenues des symboles à part entière dans la communication qui peut s’établir entre des étrangers sur Internet.

Akcje wielogłosowe w spółce publicznej

Występowanie akcji wielogłosowych w spółkach publicznych nie zawsze jest postrzegane jako zjawisko pozytywne. Niektóre regulacje zachodnioeuropejskie wyłączyły dopuszczalność wprowadzania akcji wielogłosowych albo doprowadziły do ich ograniczenia. Polski ustawodawca przyjął rozwiązanie, zgodnie z którym w spółce akcyjnej (niepublicznej) maksymalny pułap uprzywilejowania głosowego wynosi dwa głosy na jedną akcję. W odniesieniu jednak do spółki publicznej posłużono się niefortunnym sformułowaniem „uprzywilejowanie co do głosu nie dotyczy spółki publicznej”. W doktrynie napotkać można różnice w poglądach, co do obecnie obowiązujących przepisów regulujących tytułową problematykę. Wskazuje się, że przepis art. 351 § 2 zdanie drugie Kodeksu spółek handlowych może być rozumiany niejednolicie. Występowanie wielogłosowych akcji w spółkach publicznych wiąże się między innymi ze zmianą stanu prawnego, ale także, ze stanem faktycznym polegającym na uzyskaniu przez spółkę niepubliczną (prywatną) statusu spółki publicznej. Publikacja obejmuje teoretyczno-prawne rozważania związane z akcjami wielogłosowymi w spółkach publicznych. Celem artykułu jest przybliżenie tytułowej problematyki, począwszy od zagadnienia akcji wielogłosowych ustanowionych na gruncie nieobowiązującego już stanu prawnego, a zakończywszy na upublicznieniu spółki i wynikających z tego konsekwencjach w odniesieniu do akcji uprzywilejowanych co do głosu.

Model BOT partnerstwa publiczno-prywatnego w realizacji inwestycji infrastrukturalnych

Partnerstwo publiczno-prywatne zyskuje coraz większą popularność w realizacji zadań publicznych, szczególnie w obszarze inwestycji infrastrukturalnych. W toku upowszechniania wykorzystania kapitału i wiedzy pochodzącej z sektora prywatnego do realizacji inwestycji, które dotychczas były domeną sektora publicznego wykształciły się różne modele partnerstwa. Jednym z najpowszechniejszych z nich jest model BOT, czyli build, operate and transfer, co w przekładzie na język polski oznacza buduj, eksploatuj i przekaż. Już samo rozwinięcie tego skrótu, wystarcza do opisania w sposób ogólny tej koncepcji. Polega ona na wykorzystaniu potencjału gospodarczego i organizacyjnego partnera prywatnego do budowy określonego obiektu użyteczności publicznej, następnie podmiot ten odzyskuje poniesione koszty i zapewnia sobie odpowiednią stopę zysku dzięki eksploatacji tego obiektu na podstawie udzielonej mu koncesji. Po wygaśnięciu koncesji prawa do eksploatacji obiektu wracają w posiadanie podmiotu publicznego. Niniejszy artykuł ma charakter poglądowy. Autor na wstępie przybliża podstawy prawne partnerstwa oraz status prawny jego uczestników. Następnie w oparciu o regulacje prawne przedstawiony zostaje proces realizacji przedsięwzięcia BOT, po czym określane są potencjalne korzyści i koszty płynące z zastosowania tego modelu.

Adding Value to Manufacturing: Thirty Years of European Framework Program Activity

Part 1: Introduction

Segurança pública e privada

A presente investigação teve como objetivo analisar o carácter subsidiário e complementar dos serviços de segurança privada, face à atividade desenvolvida pelas forças e serviços de segurança. Centrada nos espetáculos desportivos, procurou mostrar de que forma se materializa a complementaridade e subsidiariedade entre serviços de segurança privada e as forças e serviços de segurança. Através de uma estratégia de investigação qualitativa, concretizada a partir de uma pesquisa documental e um inquérito por entrevista semiestruturada, cujos dados foram alvo de análise de conteúdo, pretendeu-se recolher informação que permita à GNR melhorar a sua atuação na segurança dos espetáculos desportivos. No âmbito da segurança interna, a segurança privada assume um papel fundamental no garante da segurança, a par das atividades desenvolvidas pelas forças e serviços de segurança. Nos espetáculos desportivos, esta relação simbiótica é evidente, sendo um claro exemplo de uma abordagem integrada a este direito fundamental. Conclui-se que a relação, prevista legalmente como complementar e subsidiária, entre serviços de segurança privada e forças e serviços de segurança, se materializa pela adoção e normalização de diversos mecanismos de coordenação e articulação, mas principalmente pela partilha de um fim último comum: a segurança de todos os cidadãos. Abstract: Inserted in the CEMC 2015-16, this work aims to analyze the alternative and complementary nature of private security services, due to the activity carried out by Police Forces. Focusing on sports events, this research sought to show how materializes complementarity and subsidiarity between private security services and Police forces. Through a qualitative research strategy, implemented from documental research and a survey by semi-structured interviews, whose data were subjected to content analysis, we intended to collect information to the GNR improve their performance in the safety of sports events. In the context of internal security, private agents play a key role in security guarantees, along with the activities carried out by security forces and services. In sports events, this symbiotic relationship is too obvious, being a clear example of an integrated approach to this fundamental right. It was concluded that the relationship provided legally as complementary and subsidiarity between private security companies and security forces and services, materializes the adoption and standardization of various mechanisms for coordination and articulation, but mostly by sharing an end last common: the safety of all citizens.

An interaction and network perspective of horizontal relationships in the portuguese pharmaceutical industry

Doutoramento em Gestão