Provider diversity in the NHS: impact on quality and innovation

The overall objective of the research project has been to assess the impact of provider diversity on quality and innovation in the NHS. The specific research aims were to identify the differences in performance between non-profit Third Sector organisations, for-profit private enterprises, and incumbent public sector institutions within the NHS as providers of health care services, as well as the factors that affect the entry and growth of new private and Third Sector providers. The study used both qualitative and quantitative methods based on case studies of four Local Health Economies (LHEs). Qualitative methods included documentary analysis and interviews with key informants and managers of both commissioning and provider organisations. To provide a focus to the study, two tracer conditions were followed: orthopaedic surgery and home health care for frail older people. In the case of hospital inpatient care, data on patient characteristics were also collected from the HES database. The analysis of this data provided preliminary estimates of the effects of provider type on quality, controlling for client characteristics and case mix. In addition, a survey of patient experience in diverse provider organisations was analysed to compare the different dimensions of quality of provision of acute services between incumbent NHS organisations and new independent sector treatment centres. The research has shown that, in respect of inpatient hospital services, diverse providers supply health services of at least as good quality as traditional NHS providers, and that there is ample opportunity to expand their scale and scope as providers of services commissioned by the NHS. The research used patient experience survey data to investigate whether hospital ownership affects the quality of services reported by NHS patients in areas other than clinical quality. The raw survey data appear to show that private hospitals provide higher quality services than the public hospitals. However, further empirical analysis leads to a more nuanced understanding of the performance differences. Firstly, the analysis shows that each sector offers greater quality in certain specialties. Secondly, the analysis shows that differences in the quality of patients’ reported experience are mainly attributable to patient characteristics, the selection of patients into each type of hospital, and the characteristics of individual hospitals, rather than to hospital ownership as such. Controlling for such differences, NHS patients are on average likely to experience a similar quality of care in a public or privately-run hospital. Nevertheless, for specific groups of patients and for specific types of treatments, especially the more straightforward ones, the private sector provides an improved patient experience compared to the public sector. Elsewhere, the NHS continues to provide a high quality service and outperforms the private sector in a range of services and for a range of clients.

Issues in language and development in multilingual settings: a case-study of knowledge exchange and teacher education in South Africa

The quality of a country’s human-resource base can be said to determine its level of success in social and economic development. This study focuses on some␣of the major human-resource development issues that surround the implementation of South Africa’s policy of multilingualism in education. It begins by discussing the relationship between knowledge, language, and human-resource, social and economic development within the global cultural economy. It then considers the situation in South Africa and, in particular, the implications of that country’s colonial and neo-colonial past for attempts to implement the new policy. Drawing on the linguistic-diversity-in-education debate in the United Kingdom of the past three decades, it assesses the first phase of an in-service teacher-education programme that was carried out at the Project for Alternative Education in South Africa (PRAESA) based at the University of Cape Town. The authors identify key short- and long-term issues related to knowledge exchange in education in multilingual societies, especially concerning the use of African languages as mediums for teaching and learning.

New wine into old skins: the enactment of literacy policy in Singapore

To better comprehend how educational reforms and classroom practice interconnect, we need to understand the epistemic environments created for learning, as well as the pedagogical activities and the modes of classroom discourse related to these activities. This article examines how a particular innovation in English literacy, Strategies for English Language Learning and Reading (STELLAR), has been implemented in Singapore. Outlining the broader curriculum initiatives, current literacy policy landscape and pedagogical effect of classroom discourse, we look at how English language teachers in grades 1 and 2 interpret the STELLAR curriculum. Situated within the larger international zeal of educational reform, Singapore presents a rich case for the study of policy–pedagogy initiatives, literacy instruction and cultural values. Adding to the existing policy enactment research, this investigation provides an opportunity to probe both the prospects and limitations of policy implementation associated with centralised educational structures, examination-oriented systems and societal cultural frameworks.

Morphological awareness and reading development in bilingual English-Chinese children in Singapore

Addressing two aspects of morphological awareness – derivational and compound, this study investigates the relationships between morphological awareness and vocabulary and reading comprehension in English-Chinese bilingual primary 3 children in Singapore (N = 76). Comparable tasks in Chinese and English were administered to examine the children’s morphological awareness, vocabulary, and reading comprehension. The results show that morphological awareness is highly related to vocabulary and reading comprehension, with higher correlations between morphological awareness and reading comprehension than between morphological awareness and vocabulary. This indicates that morphological awareness may have direct influence on reading comprehension beyond the mediating effect of vocabulary. Furthermore, the results indicate that children displayed more compound than derivational morphological awareness for Chinese due to the dominance of compound morphology in Chinese. However the children also displayed similar levels of derivational and compound morphological awareness for English despite far more derivatives than compounds in English. The robust cross-linguistic correlations suggest that Chinese compound morphological knowledge plays a facilitating role not only in learning English compounds, but also in learning transparently derived words that do not involve phonological or orthographic shifts.

Language ideologies and Schooled Education in Rural Tanzania : The Case of Karagwe

In this article I argue that language policies for education have effects on pupils’ educational possibilities. With the case of Karagwe district in Tanzania I have found that the case of “Swahili only” in primary school education favours the small minority of the children that live in a context where Swahili is used. This leads to inequality in pupils’ chances in education and to a low level of achievement of academic content in schools. This also promote the developing and use of safety strategies among teachers and pupils that hide failure and prevent pupils’ learning.

Capability outcomes from educational and ICT capability inputs : an analysis of ICT use in informal education in Kenya

In the field of Information and Communication Technologies for Development (ICT4D) ICT use in education is well studied. Education is often seen as a pre-requisite for development and ICTs are believed to aid in education, e.g. to make it more accessible and to increase its quality. In this paper we study the access and use of ICT in a study circle (SC) education program in the south coast of Kenya. The study is qualitative reporting results based on interviews and observations with SC participants, government officers and SC coordinators and teachers. The study builds on the capability approach perspective of development where individuals’ opportunities and ability to live a life that they value are focused. The aim of the study is to investigate the capability outcomes enabled through the capability inputs access and use of ICT in education as well as the factors that enabled and/or restricted the outcomes. Findings show that many opportunities have been enabled such as an increase in the ability to generate an income, learning benefits, community development and basic human development (e.g. literacy and self-confidence). However, conversion factors such as a poorly developed infrastructure and poor IT literacy prevent many of the individuals from taking full advantage of the ICT and the opportunities it enables. 

Design and use of mobile technology in distance language education : Matching learning practices with technologies-in-practice

This thesis focuses on the adaptation of formal education to people’s technology- use patterns, theirtechnology-in-practice, where the ubiquitous use of mobile technologies is central. The research question is: How can language learning practices occuring in informal learning environments be effectively integrated with formal education through the use of mobile technology? The study investigates the technical, pedagogical, social and cultural challenges involved in a design science approach. The thesis consists of four studies. The first study systematises MALL (mobile-assisted language learning) research. The second investigates Swedish and Chinese students’ attitudes towards the use of mobile technology in education. The third examines students’ use of technology in an online language course, with a specific focus on their learning practices in informal learning contexts and their understanding of how this use guides their learning. Based on the findings, a specifically designed MALL application was built and used in two courses. Study four analyses the app use in terms of students’ perceived level of self-regulation and structuration. The studies show that technology itself plays a very important role in reshaping peoples’ attitudes and that new learning methods are coconstructed in a sociotechnical system. Technology’s influence on student practices is equally strong across borders. Students’ established technologies-in-practice guide the ways they approach learning. Hence, designing effective online distance education involves three interrelated elements: technology, information, and social arrangements. This thesis contributes to mobile learning research by offering empirically and theoretically grounded insights that shift the focus from technology design to design of information systems.

Human capital and innovation: evidence from panel cointegration tests

Panel cointegration techniques applied to pooled data for 27 economies for the period 1960-2000 indicate that: i) government spending in education and innovation indicators are cointegrated; ii) education hierarchy is relevant when explaining innovation; and iii) the relation between education and innovation can be obtained after an accommodation of a level structural break.

Should voters be afraid of hard budget constraint legislation? fiscal responsibility law in brazilian municipalities

This manuscript demonstrates that voters have nothing to be afraid of when new hard budget constraint legislation is implemented. Our claim is that this kind of legislation reduces the asymmetry of information between voters and incumbents over the budget and, as a consequence, the latter have incentives to increase the supply of public goods. As a nationwide institutional innovation, the Fiscal Responsibility Law (FRL) is exogenous to all municipalities; therefore, there is no self-selection bias in its implementation. We show that public goods expenditure increases after the FRL. Second, this increase occurs in municipalities located in the country’s poorest region. Third, our findings can be extended to the supply of public goods because the higher the expenditure with health and education, the greater the probability of incumbents being re-elected. Finally, there exists a “de facto” higher supply of public goods in education (number of per capita classrooms) after the FRL.

Accountability and yardstick competition in the public provision of education

This paper explores the institutional change introduced by the public disclosure of an education development index (IDEB, Basic Education Development Index) in 2007 to identify the e ect of education accountability on yardstick competition in education spending for Brazilian municipalities. Our results are threefold. First, political incentives are pervasive in setting the education expenditures. The spatial strategic behavior on education spending is estimated lower for lame-ducks and for those incumbents with majority support at the city council. This suggests a strong relation between commitment and accountability which reinforces yardstick competition theory. Second, we nd a minor reduction (20%) in spatial interaction for public education spending after IDEB's disclosure | compared to the spatial correlation before the disclosure of the index. This suggests that public release of information may decrease the importance of the neighbors` counterpart information on voter`s decision. Third, exploring the discontinuity of IDEB`s disclosure rule around the cut-o of 30 students enrolled in the grade under assessment, our estimates suggest that the spatial autocorrelation | and hence yardstick competition | is reduced in 54%. Finally, an unforeseen result suggests that the disclosure of IDEB increases expenditures, more than 100% according to our estimates.

National innovation surveys in Latin America: empirical evidence and policy implications

Includes bibliography