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.

Empirical analysis of human capital development and economic growth in Europe

Recent discussion of the knowledge-based economy draws increasingly attention to the role that the creation and management of knowledge plays in economic development. Development of human capital, the principal mechanism for knowledge creation and management, becomes a central issue for policy-makers and practitioners at the regional, as well as national, level. Facing competition both within and across nations, regional policy-makers view human capital development as a key to strengthening the positions of their economies in the global market. Against this background, the aim of this study is to go some way towards answering the question of whether, and how, investment in education and vocational training at regional level provides these territorial units with comparative advantages. The study reviews literature in economics and economic geography on economic growth (Chapter 2). In growth model literature, human capital has gained increased recognition as a key production factor along with physical capital and labour. Although leaving technical progress as an exogenous factor, neoclassical Solow-Swan models have improved their estimates through the inclusion of human capital. In contrast, endogenous growth models place investment in research at centre stage in accounting for technical progress. As a result, they often focus upon research workers, who embody high-order human capital, as a key variable in their framework. An issue of discussion is how human capital facilitates economic growth: is it the level of its stock or its accumulation that influences the rate of growth? In addition, these economic models are criticised in economic geography literature for their failure to consider spatial aspects of economic development, and particularly for their lack of attention to tacit knowledge and urban environments that facilitate the exchange of such knowledge. Our empirical analysis of European regions (Chapter 3) shows that investment by individuals in human capital formation has distinct patterns. Those regions with a higher level of investment in tertiary education tend to have a larger concentration of information and communication technology (ICT) sectors (including provision of ICT services and manufacture of ICT devices and equipment) and research functions. Not surprisingly, regions with major metropolitan areas where higher education institutions are located show a high enrolment rate for tertiary education, suggesting a possible link to the demand from high-order corporate functions located there. Furthermore, the rate of human capital development (at the level of vocational type of upper secondary education) appears to have significant association with the level of entrepreneurship in emerging industries such as ICT-related services and ICT manufacturing, whereas such association is not found with traditional manufacturing industries. In general, a high level of investment by individuals in tertiary education is found in those regions that accommodate high-tech industries and high-order corporate functions such as research and development (R&D). These functions are supported through the urban infrastructure and public science base, facilitating exchange of tacit knowledge. They also enjoy a low unemployment rate. However, the existing stock of human and physical capital in those regions with a high level of urban infrastructure does not lead to a high rate of economic growth. Our empirical analysis demonstrates that the rate of economic growth is determined by the accumulation of human and physical capital, not by level of their existing stocks. We found no significant effects of scale that would favour those regions with a larger stock of human capital. The primary policy implication of our study is that, in order to facilitate economic growth, education and training need to supply human capital at a faster pace than simply replenishing it as it disappears from the labour market. Given the significant impact of high-order human capital (such as business R&D staff in our case study) as well as the increasingly fast pace of technological change that makes human capital obsolete, a concerted effort needs to be made to facilitate its continuous development.

What makes an effective PCT pharmacist? A study of training and development needs

This research was commissioned by the Shropshire and Staffordshire Workforce Development Confederation, to undertake a review of the education and training needs of pharmacists working at a strategic level within primary care trusts.