The impact of privatisation and regulation on the water and sewerage industry in England and Wales:a translog cost function approach

After the ten Regional Water Authorities (RWAs) of England and Wales were privatized in November 1989, the successor Water and Sewerage Companies (WASCs) faced a new regulatory regime that was designed to promote economic efficiency while simultaneously improving drinking water and environmental quality. As legally mandated quality improvements necessitated a costly capital investment programme, the industry's economic regulator, the Office of Water Services (Ofwat), implemented a retail price index (RPI)+K pricing system, which was designed to compensate the WASCs for their capital investment programme while also encouraging gains in economic efficiency. In order to analyse jointly the impact of privatization, as well as the impact of increasingly stringent economic and environmental regulation on the WASCs' economic performance, this paper estimates a translog multiple output cost function model for the period 1985–1999. Given the significant costs associated with water quality improvements, the model is augmented to include the impact of drinking water quality and environmental quality on total costs. The model is then employed to determine the extent of scale and scope economies in the water and sewerage industry, as well as the impact of privatization and economic regulation on economic efficiency.

A pilot study to evaluate the self-medication system for liver transplant patients at the Queen Elizabeth Hospital in Birmingham

Background and Objective: Medication non-compliance is a considerable obstacle in achievinga therapeutic goal, whichcan result in poorerhealthcare outcomes, increased expenditure, wastage and potential for medication resistance. The UK Government’s Audit Commission’s publication ‘A Spoonful of Sugar’1 addresses these issues and promotes self-medication systems as a possible solution. The self-medication system within the Liver Transplant Unit (LTU) was implemented to induct patients onto new post- transplantation medication regimes ready for discharge. The system involves initial consultations with both the Liver Transplant Pharmacist and Trans- plant Co-ordinator, supported with additional advice as and when necessary. Design: Following ethical approval, evaluation of the self-medication sys- tem for liver transplant patients was conducted between January and March 2004 via two methods: audit and structured post-transplantation interview. The audit enabled any discrepancies between current Hospital guidelines and Liver Transplant Unit (LTU) practices to be highlighted. Patient interviews generated a retrospective insight into patient acceptance of the self-medication system. Setting: LTU, Queen Elizabeth Hospital, Birmingham, England. Main Outcome Measures: LTU compliance with Hospital self-medication guidelines and patient insight into self-medication system. Results: A total of seven patients were audited. Findings illustrated that self- medication by transplant patients is a complex process which was not fully addressed by current Hospital self-medication guidelines. Twenty-three patients were interviewed, showing an overwhelming positive attitude to- wards participating in their own care and a high level of understanding towards their individual medication regimes. Following a drugs counselling session, 100% of patients understood why they were taking their medica- tion, and their doses, 95% understood how to take their medication and 85% were aware of potential side effects. Conclusions: From this pilot evaluation it can be stated that the LTU self-medication system is appreciated by patients and assists them in fully understanding their medication regimes. There appear to be no major defects in the system. However areas such as communication barriers and on-going internet education were illustrated as areas for possible future investigation. References: 1. Audit Commission. A spoonful of sugar – medicines management in NHS hospitals. London: Audit Commission; 2001.

Back to the local? Recalibrating the regional tier of governance in England

By contrast to the far-reaching devolution settlements elsewhere in the UK, political agreement on the governance of England outside London remains unsettled. There is cross- party consensus on the need to 'decentre down' authority to regions and localities, but limited agreement on how this should be achieved. This paper explores the welter of initiatives adopted by the recent Labour government that were ostensibly designed to make the meso-level of governance more coherent, accountable and responsive to meeting territorial priorities. Second, it explores the current Conservative-Liberal Democrat Coalition's programme of reform that involves the elimination of Labour's regional institutional architecture and is intended to restore powers to local government and communities and promote local authority co-operation around sub-regions. Labour's reforms were ineffective in achieving any substantial transfer of authority away from Whitehall and, given the Coalition's plans to cut public expenditure, the likelihood of any significant recalibration in central-local relations also appears improbable. © 2012 Copyright Taylor and Francis Group, LLC.

A qualitative investigation of decision making during help-seeking for adult hearing loss

Objective: The Any Qualified Provider framework in the National Health Service has changed the way adult audiology services are offered in England. Under the new rules, patients are being offered a choice in geographical location and audiology provider. This study aimed to explore how choices in treatment are presented and to identify what information patients need when they are seeking help with hearing loss. Design: This study adopted qualitative methods of ethnographic observations and focus group interviews to identify information needed prior to, and during, help-seeking. Observational data and focus group data were analysed using the constant comparison method of grounded theory. Study sample: Participants were recruited from a community Health and Social Care Trust in the west of England. This service incorporates both an Audiology and a Hearing Therapy service. Twenty seven participants were involved in focus groups or interviews. Results: Participants receive little information beyond the detail of hearing aids. Participants report little information that was not directly related to uptake of hearing aids. Conclusions: Participant preferences were not explored and limited information resulted in decisions that were clinician-led. The gaps in information reflect previous data on clinician communication and highlight the need for consistent information on a range of interventions to manage hearing loss.

Pirates, exiles, and empire: English seamen, Atlantic expansion, and Jamaican settlement, 1558–1658

A life of piracy offered marginal men a profession with a degree of autonomy, despite the brand of "outlaw" and the fear of prosecution. At various times throughout history, governments and crowned heads suspended much of their piracy prosecution, licensing men to work as "privateers" for the state, supplementing naval forces. This practice has a long history, but in sixteenth-century England, Elizabeth I (1558-1603) significantly altered this tradition. Recognizing her own weakness in effectively prosecuting these men and the profit they could contribute to the government, Elizabeth began incorporating pirates into the English naval corps in peacetime—not just in war. This practice increased English naval resources, income, and presence in the emerging Atlantic World, but also increased conflict with the powerful Spanish empire. By 1605, making peace with Spain, James VI/I (1603-1625) retracted Elizabeth's privateering promotion, prompting an emigration of English seamen to the American outposts they had developed in the previous century. Now exiles, no longer beholden to the Crown, seamen reverted back to piracy. The Carolinas and Jamaica served as bases for these rover communities. In 1650, the revolutionary leader Oliver Cromwell (1649-1658) once again recognized the merits of such policies. Determined to demonstrate his authority and solidify his rule, Cromwell offered citizenship and state support to Caribbean exiles in exchange for their aiding of his navy in the taking of Spanish Jamaica. Official chartering of Port Royal, Jamaica served as reward for these men's efforts and as the culmination of a century-long cycle of piracy legislation, creating one of England's most lucrative colonies in the middle of a traditionally Spanish Caribbean empire. Through legal and diplomatic records, correspondence, and naval and demographic records from England and Spain, this dissertation explores early modern piracy/privateering policy and its impact on the development of the Atlantic World. European disputes and imperial competition converged in these piracy debates with significant consequences for the definitions of criminality and citizenship and for the development of Atlantic empire.

The insured's non-disclosure in the formation of insurance contracts : a comparative perspective

The requirements that an insured disclose all facts material to a transaction as well as not misrepresent material facts in the formation of an insurance contract are universal requirements of insurance law. The nature and extent of these obligations varies from one jurisdiction to the next. Disclosure in the insurance context is distinct from the general approach in commercial contracts, and in others between persons dealing at arm's length. It is the purpose of this article therefore to examine, on a comparative basis, the approaches adopted in the Anglo-Commonwealth context of England, Australia New Zealand and Singapore to the resolution of disclose issues in the formation of insurance contracts. Particular attention is focused on the Insurance Contracts Act 1984 (Australia) as this statue effects the most significant overhaul of the common law and the National Consumer Council in the United Kingdom has advocated that similar reforms be adopted.

Developing a research method to test a new first-order decision making model for the procurement of public sector major infrastructure

Given global demand for new infrastructure, governments face substantial challenges in funding new infrastructure and simultaneously delivering Value for Money (VfM). The paper begins with an update on a key development in a new early/first-order procurement decision making model that deploys production cost/benefit theory and theories concerning transaction costs from the New Institutional Economics, in order to identify a procurement mode that is likely to deliver the best ratio of production costs and transaction costs to production benefits, and therefore deliver superior VfM relative to alternative procurement modes. In doing so, the new procurement model is also able to address the uncertainty concerning the relative merits of Public-Private Partnerships (PPP) and non-PPP procurement approaches. The main aim of the paper is to develop competition as a dependent variable/proxy for VfM and a hypothesis (overarching proposition), as well as developing a research method to test the new procurement model. Competition reflects both production costs and benefits (absolute level of competition) and transaction costs (level of realised competition) and is a key proxy for VfM. Using competition as a proxy for VfM, the overarching proposition is given as: When the actual procurement mode matches the predicted (theoretical) procurement mode (informed by the new procurement model), then actual competition is expected to match potential competition (based on actual capacity). To collect data to test this proposition, the research method that is developed in this paper combines a survey and case study approach. More specifically, data collection instruments for the surveys to collect data on actual procurement, actual competition and potential competition are outlined. Finally, plans for analysing this survey data are briefly mentioned, along with noting the planned use of analytical pattern matching in deploying the new procurement model and in order to develop the predicted (theoretical) procurement mode.

Illusions of Difference: Comparative Youth Justice in the Devolved UK

Surprisingly, there has been little or no systematic research to date that has explored the significance of UK devolution for youth justice policy and practice. This article explores the extent of differential justice in the United Kingdom, particularly as it is expressed in the myriad action plans, criminal justice reviews, frameworks for action, delivery plans and offending strategies that have surfaced since 1998. In particular, the article considers how far policy convergence and divergence are reflected through the discourses of risk, welfare, restoration and children's rights in the four administrations of England, Scotland, Wales and Northern Ireland. For comparative criminology, the United Kingdom offers a unique opportunity to explore how international and national pressures towards convergence and/or divergence can be challenged, rebranded, versioned, adapted or resisted at sub-national and local levels.

Changing parental high risk behaviour in the reduction of SIDS : the imperative of translational research

Objectives To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed or sofa with an adult or child). Design Four year population based case-control study. Parents were interviewed shortly after the death or after the reference sleep (within 24 hours) of the two control groups. Setting South west region of England (population 4.9 million, 184 800 births). Participants 80 SIDS infants and two control groups weighted for age and time of reference sleep: 87 randomly selected controls and 82 controls at high risk of SIDS (young, socially deprived, multiparous mothers who smoked). Results The median age at death (66 days) was more than three weeks less than in a study in the same region a decade earlier. Of the SIDS infants, 54% died while cosleeping compared with 20% among both control groups. Much of this excess may be explained by a significant multivariable interaction between cosleeping and recent parental use of alcohol or drugs (31% v 3% random controls) and the increased proportion of SIDS infants who had coslept on a sofa (17% v 1%). One fifth of SIDS infants used a pillow for the last sleep (21% v 3%) and one quarter were swaddled (24% v 6%). More mothers of SIDS infants than random control infants smoked during pregnancy (60% v 14%), whereas one quarter of the SIDS infants were preterm (26% v 5%) or were in fair or poor health for the last sleep (28% v 6%). All of these differences were significant in the multivariable analysis regardless of which control group was used for comparison. The significance of covering the infant’s head, postnatal exposure to tobacco smoke, dummy use, and sleeping in the side position has diminished although a significant proportion of SIDS infants were still found prone (29% v 10%). Conclusions Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa.

Church's wall of silence on sexual abuse

A SINGLE document was all it took to illuminate a dark secret in the Church of England. The two-page child protection report, unearthed by police in the archives of the diocese of Manchester, was proof, at last, that a former cathedral choirboy -- alleging years of sexual abuse by one of Britain's most senior clergyman -- was not alone. There was another boy. Also a solo soprano, on the other side of the world, who was singing from the same hymn sheet about The Very Reverend Robert Waddington. "There had been a previous referral about sexual impropriety some time ago from Australia, where RW had been the headmaster at a school. An ex-pupil had made a complaint to the Bishop of (north) Queensland who had relayed it to the Archbishop (of York)," the 2003 report says. Eli Ward's family had prompted the secret report when they told church officials, without Ward's knowledge, of the alleged abuse he suffered in the mid-1980s.

Former Archbishop of York ‘covered up’ sex abuse scandal

The former Archbishop of York stood accused last night of covering up allegations that a senior Church of England clergyman had abused choirboys and school pupils. Lord Hope of Thornes was made aware of the accusations against the Very Rev Robert Waddington, a former Dean of Manchester Cathedral and once the cleric in overall charge of Church schools, in 1999 and again in 2003. Waddington was stripped of his right to conduct church services but the archbishop did not report concerns about alleged past abuse or a potential continuing threat to children to police or child protection agencies. The extent of Waddington’s alleged history of abuse and the Church’s inaction has been revealed through a joint investigation by The Times and The Australian newspaper in Sydney.

Robert Waddington's cycle of abuse stretches beyond 50 years

THE Church of England banished serial pedophile priest Robert Waddington to Australia, where he abused children across a decade, after suspicions were raised about him molesting choirboys in his London parish. In an alleged church cover-up spanning almost 60 years, Waddington was suddenly and unexpectedly sent to a small school in regional Queensland in 1956 amid claims he was molesting the son of an English politician. Last month the Church of England ordered an independent inquiry into the handling of allegations against Waddington, after a joint investigation by The Australian and The Times of London. But it can now be revealed that Waddington - who died in 2007, facing allegations he abused students in Australia in the 1960s and English choirboys in the 80s and 90s - was molesting children as soon as he joined the church in 1953. The latest allegations have been made by Ray Munn, 70, who was recruited by Waddington, then a curate at St John's church in Bethnal Green, East London, to sing in the choir in 1953. He was almost immediately groomed by the Cambridge University-educated clergyman, who took him on holidays in the English countryside, before he began molesting the then 11-year-old.

The complete genome sequence of Escherichia coli EC958: a high quality reference sequence for the globally disseminated multidrug resistant E. coli O25b:H4-ST131 clone

Escherichia coli ST131 is now recognised as a leading contributor to urinary tract and bloodstream infections in both community and clinical settings. Here we present the complete, annotated genome of E. coli EC958, which was isolated from the urine of a patient presenting with a urinary tract infection in the Northwest region of England and represents the most well characterised ST131 strain. Sequencing was carried out using the Pacific Biosciences platform, which provided sufficient depth and read-length to produce a complete genome without the need for other technologies. The discovery of spurious contigs within the assembly that correspond to site-specific inversions in the tail fibre regions of prophages demonstrates the potential for this technology to reveal dynamic evolutionary mechanisms. E. coli EC958 belongs to the major subgroup of ST131 strains that produce the CTX-M-15 extended spectrum β-lactamase, are fluoroquinolone resistant and encode the fimH30 type 1 fimbrial adhesin. This subgroup includes the Indian strain NA114 and the North American strain JJ1886. A comparison of the genomes of EC958, JJ1886 and NA114 revealed that differences in the arrangement of genomic islands, prophages and other repetitive elements in the NA114 genome are not biologically relevant and are due to misassembly. The availability of a high quality uropathogenic E. coli ST131 genome provides a reference for understanding this multidrug resistant pathogen and will facilitate novel functional, comparative and clinical studies of the E. coli ST131 clonal lineage.

Insolvency academics contributing to the review of insolvency laws: An Australian perspective

Introduction 1 It gives me great pleasure to contribute to this publication to honour Professor Ian Fletcher on his retirement as Foundation Chair of the INSOL International Academic Group. A collection of essays that include topics on domestic, cross-border and international insolvency appropriately reflects the breadth of Professor Fletcher’s impact on the scholarship of insolvency law – not only in his “home” jurisdiction of England and Wales and closer to home in Europe, but also stretching around the globe, in this case, to Australia. 2 In the early 1990s when I first began to research in the area of cross-border insolvency law, a colleague mentioned that they had recently attended the XIIIth International Congress of Comparative Law in Montreal in August 1990 and heard the Cross-border Insolvency: General Report expertly delivered by an English academic, Ian Fletcher, who was widely regarded as an authority in the area. This was my first introduction to Professor Fletcher’s work and over the intervening years I have referred often to his scholarship....

Cultural-Evolution of Ecological Prudence

Animals often behave in a profligate fashion and decimate the populations of plants and animals they depend upon. They may, however, evolve prudent behaviour under special conditions, namely when such prudence greatly enhances the success of populations that are not too prone to invasions by profligate individuals. Cultural evolution in human societies can also lead to the adoption of prudent practices under similar conditions. These are more likely to be realized in stable environments in which the human populations tend to grow close to the carrying capacity, when the human groups are closed, and when the technology is stagnant. These conditions probably prevailed in the hunter—gatherer societies of the tropics and subtropics, and led to the adoption of a number of socially imposed restraints on the use of plant and animal resources. Such practices were rationalized in the form of Nature-worship. The Indian caste society became so organized as to fulfill these conditions, and gave rise to two religions, Buddhism and Jainism, which emphasize compassion towards all forms of life. The pastoral nomads of the middle east, on the other hand, lived in an environment which militated against prudence, and these societies gave rise to religions like Christianity, which declared war on nature. As the ruling elite and state have grown in power, they have tried to wrest control of natural resources from the local communities. This has sometimes resulted in conservation and prudent use under guidance from the state, but has often led to conflicts with local populations to the detriment of prudent behaviour. Modern technological progress has also often removed the need for conservation, as when availability of coal permitted the deforestation of England. While modern scientific understanding has led to a better appreciation of the need for prudence, the prevailing social and economic conditions often militate against any implementation of the understanding, as is seen from the history of whaling. However, the imperative for survival of the poor from the Third-World countries may finally bring about conditions in which ecological prudence may once again come to dominate human cultures as it might once have done with stable societies of hunter—gatherers.