Public and private psychiatry: Can they work together and is it worth the effort?

Objective: Partnerships in mental health care, particularly between public and private psychiatric services, are being increasingly recognized as important for optimizing patient management and the efficient organization of services. However, public sector mental health services and private psychiatrists do not always work well together and there seem to be a number of barriers to effective collaboration. This study set out to investigate the extent of collaborative 'shared care' arrangements between a public mental health service and private psychiatrists practising nearby. It also examined possible barriers to collaboration and some possible solutions to the identified problems. Method: A questionnaire examining the above factors was sent to all public sector mental health clinicians and all private psychiatrists in the area. Results: One hundred and five of the 154 (68.2%) public sector clinicians and 103 of the 194 (53.1%) private psychiatrists returned surveys. The main barriers to successful collaboration identified by members of both sectors were: 'Difficulty communicating' endorsed by 71.4% of public clinicians and 72% of private psychiatrists, 'Confusion of roles and responsibilities' endorsed by 62.9% and 66%, respectively, and 'Different treatment approach' by 47.6% and 45.6%, respectively. Over 60% of private psychiatrists identified problems with access to the public system as a barrier to successful shared care arrangements. It also emerged, as hypothesized, that the public and private systems tend to manage different patient populations and that public clinicians in particular are not fully aware of the private psychiatrists' range of expertise. This would result in fewer referrals for shared care across the sectors. Conclusions: A number of barriers to public sector clinicians and private psychiatrists collaborating in shared care arrangements were identified. The two groups surveyed identified similar barriers. Some of these can potentially be addressed by changes to service systems. Others require cultural shifts in both sectors. Improved communications including more opportunities for formal and informal meetings between people working in the two sectors would be likely to improve the understanding of the complementary sector's perspective and practice. Further changes would be expected to require careful work between the sectors on training, employment and practice protocols and initiatives, to allow better use of the existing services and resources.

Organizational commitment profiles and job satisfaction among Greek private and public sector employees

Recent research into organizational commitment has advocated a profiles-based approach. However, with the exception of Wasti, published findings are confined to North American samples. This article examines the relationships between organizational commitment profiles and job satisfaction in Greece. Greek organizations have rarely been the subject of detailed examination, so the study provides baseline information regarding levels of organizational commitment and job satisfaction in Greece. Both private sector (N = 1119) and public sector (N = 476) employees in Greece were surveyed, as this sectoral distinction is regularly associated with different patterns of job-related attitudes. The contrasts between Greek and Anglo-American values present a new challenge to the profiles approach. The results confirm the utility of the profiles approach to the study of organizational commitment. Affective organizational commitment was found to be most influential with respect to levels of intrinsic and extrinsic job satisfaction. This concurs with other studies of the behavioural outcomes of commitment. Copyright © 2007 Sage Publications.

Estimating additionality and leverage:between public and private sector equity finance in Ireland (2000 – 2002)

This paper aims to contribute to the debate about the role of the public sector in stimulating greater use of private sector equity for business start-up and growth in two ways. First, to examine the extent to which the provision of public sector equity finance enables individual firms to raise additional funds in the private sector market place. Second, to consider the methodological implications for an economic impact assessment of industrial policy interventions (especially those which include an equity component) at the level of the individual firm. We assess the extent to which there may be indirect positive effects (externalities) associated with public sector financial assistance to individual firms and if so how they distort standard evaluation methodologies designed to estimate the level of additionality of that support. The paper draws upon the results of a recent study of the impact of Enterprise Ireland (EI) financial assistance to indigenous Irish industry in the period 2000 to 2002. The paper demonstrates that a process of re-calibration is necessary in estimates of economic impact in order to account for these positive externalities and the result in this study was a ‘boost’ to additionality. In operational and conceptual terms, the study underlines the importance of the relationship between private and public sector sources of equity finance as an important dynamic in the attempt by industrial and regional policy to stimulate the number of firms with viable investment proposals accessing external equity finance.

Registered social landlords: private enterprise (f)or public good?

Millions of homes previously owned by councils have been transferred to the ownership of registered social landlords. Many of these are run as private companies under the principles first set out in the Combined Code of Corporate Governance. This articled considers whether it is appropriate to apply both the principles of the Code and regulation from the Housing Corporation as forms of control over such companies, and whether extensive government regulation negates the requirement for a board comprising independent directors expected to make strategic decisions while overseeing the executive. Conflict is created when trying to run these companies with a unitary board structure adhering to Combined Code principles while considering the wider interests of the community. It is questioned whether it is inefficient to try to meet these two objectives simultaneously and whether this system produces the best results for the community, the lenders and the end users.

Modelling trade offs between public and private conservation policies

To reduce global biodiversity loss, there is an urgent need to determine the most efficient allocation of conservation resources. Recently, there has been a growing trend for many governments to supplement public ownership and management of reserves with incentive programs for conservation on private land. This raises important questions, such as the extent to which private land conservation can improve conservation outcomes, and how it should be mixed with more traditional public land conservation. We address these questions, using a general framework for modelling environmental policies and a case study examining the conservation of endangered native grasslands to the west of Melbourne, Australia. Specifically, we examine three policies that involve i) spending all resources on creating public conservation areas; ii) spending all resources on an ongoing incentive program where private landholders are paid to manage vegetation on their property with 5-year contracts; and iii) splitting resources between these two approaches. The performance of each strategy is quantified with a vegetation condition change model that predicts future changes in grassland quality. Of the policies tested, no one policy was always best and policy performance depended on the objectives of those enacting the policy. Although policies to promote conservation on private land are proposed and implemented in many areas, they are rarely evaluated in terms of their ecological consequences. This work demonstrates a general method for evaluating environmental policies and highlights the utility of a model which combines ecological and socioeconomic processes.

Public ownership and control in the private sector

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Appropriate wage rate and estimate of labour availability for a public works based safety net in Cambodia

Employment generating public works (EGPW) are an important part of Royal Government of Cambodia’s (RGC’s) strategy being developed through Council for Agriculture and Rural Development (CARD) to develop a comprehensive social safety net (SSN) to provide a measure of protection from shocks for the poor and vulnerable and to contribute to poverty alleviation through short-term unskilled employment.

Appropriate wage rate and related issues for employment intensive public works programmes in Timor Leste

Employment generating public works (EGPW) are an important part of GoTL’s strategy to reduce unemployment, underemployment and poverty and contribute to social stability. The term EGPW is used in this report as a generic term to encompass labour intensive (LI) and labourbased (LB) approaches. The distinction between these approaches is made below. SEFOPE is being supported by a number of international agencies to develop and implement employment generating public works programmes (EGPWPs). Other government ministries and agencies and NGOs offering different wage rates are also engaged in such programmes and projects. In setting wage rates for such programmes, it is necessary to take account of (a) the nature of benefits they offer (e.g. the balance between employment creation and effective use of labour); (b) the beneficiaries to be targeted, and (c) any adverse impacts on other economic activities. The purposes of this assignment are: (a) to make recommendations on appropriate wage rates for unskilled casual employment on public works programmes, and (b) make a broad assessment of the labour supply response to the employment opportunities created by employment intensive programmes. The latter would help in gauging the scale of such activities required.