Debating the division of labour in healthcare in France and England

As Larson (1990) states, professions are historically specific and ‘there is no pattern of social closure around an occupation that is not inflected by the latter’s past, its specific activity and typical context of performance or…the political context in which closure is obtained.’ Larson’s work focuses particularly on the differences between the establishment of professions in France, where there was considerable state intervention, with that in the US and UK, both of which were more market-oriented. This paper is based on data from an evaluation of a large European exchange programme of staff between Kent and Lille, from 2005 to 2008 and discusses the division of labour in healthcare between two occupational groups, medicine and nursing, in England and in France. This division of labour has been extensively discussed in the UK, particularly since from the mid 1990s the nursing role has been extended and innovations such as nurse prescribing have been introduced, whereas such extended roles have not been introduced in France. The paper draws particularly on interview data from mental health practitioners, in which it is argued that whilst the English nurses may on the surface seem to have a wider range of competences and autonomy, in reality they are more constrained, as they operate under protocols and therefore do not exercise professional judgement. Not only do these data illustrate the centrality of professional judgement in discussions about practice, they also demonstrate the circularity of many debates on extended roles.

Public sector pay in the UK: has the historic pattern of public/private sector pay movements been broken?

The historic pattern of public sector pay movements in the UK has been counter-cyclical with private sector pay growth. Periods of relative decline in public sector pay against private sector movements have been followed by periods of ‘catch-up’ as Government controls are eased to remedy skill shortages or deal with industrial unrest among public servants. Public sector ‘catch up’ increases have therefore come at awkward times for Government, often coinciding with economic downturn in the private sector (Trinder 1994, White 1996, Bach 2002). Several such epochs of public sector pay policy can be identified since the 1970s. The question is whether the current limits on public sector pay being imposed by the UK Government fit this historic pattern or whether the pattern has been broken and, if so, how and why? This paper takes a historical approach in considering the context to public sector pay determination in the UK. In particular the paper seeks to review the period since Labour came into office (White and Hatchett 2003) and the various pay ‘modernisation’ exercises that have been in process over the last decade (White 2004). The paper draws on national statistics on public sector employment and pay levels to chart changes in public sector pay policy and draws on secondary literature to consider both Government policy intentions and the impact of these policies for public servants.

Relating sardine recruitment in the Northern Benguela to satellite-derived sea surface height using a neural network pattern recognition approach

Processes of enrichment, concentration and retention are thought to be important for the successful recruitment of small pelagic fish in upwelling areas, but are difficult to measure. In this study, a novel approach is used to examine the role of spatio-temporal oceanographic variability on recruitment success of the Northern Benguela sardine Sardinops sagax. This approach applies a neural network pattern recognition technique, called a self-organising map (SOM), to a seven-year time series of satellite-derived sea level data. The Northern Benguela is characterised by quasi-perennial upwelling of cold, nutrient-rich water and is influenced by intrusions of warm, nutrient-poor Angola Current water from the north. In this paper, these processes are categorised in terms of their influence on recruitment success through the key ocean triad mechanisms of enrichment, concentration and retention. Moderate upwelling is seen as favourable for recruitment, whereas strong upwelling, weak upwelling and Angola Current intrusion appear detrimental to recruitment success. The SOM was used to identify characteristic patterns from sea level difference data and these were interpreted with the aid of sea surface temperature data. We found that the major oceanographic processes of upwelling and Angola Current intrusion dominated these patterns, allowing them to be partitioned into those representing recruitment favourable conditions and those representing adverse conditions for recruitment. A marginally significant relationship was found between the index of sardine recruitment and the frequency of recruitment favourable conditions (r super(2) = 0.61, p = 0.068, n = 6). Because larvae are vulnerable to environmental influences for a period of at least 50 days after spawning, the SOM was then used to identify windows of persistent favourable conditions lasting longer than 50 days, termed recruitment favourable periods (RFPs). The occurrence of RFPs was compared with back-calculated spawning dates for each cohort. Finally, a comparison of RFPs with the time of spawning and the index of recruitment showed that in years where there were 50 or more days of favourable conditions following spawning, good recruitment followed (Mann-Whitney U-test: p = 0.064, n = 6). These results show the value of the SOM technique for describing spatio-temporal variability in oceanographic processes. Variability in these processes appears to be an important factor influencing recruitment in the Northern Benguela sardine, although the available data time series is currently too short to be conclusive. Nonetheless, the analysis of satellite data, using a neural network pattern-recognition approach, provides a useful framework for investigating fisheries recruitment problems.