Health Authorities, Priority-setting and Resource Allocation: A Study in Decision-making in New Labour's NHS

This paper analyses the decision‐making process of health authorities under New Labour in the NHS through a study of their qualitative responses to questionnaires. We find a considerable frustration and cynicism with the government's plans for reform, with its interference at the local level with services, and an acknowledgement of the differences between health authorities’ practice and what they believe the government requires, with, often, only minimal effort being made attempting to achieve new governmental performance targets. We conclude by making suggestions for an alternative strategy less likely to antagonize local health service providers.     

Decentring the NHS: A Case Study of Resource Allocation Decisions within a Health District

The aim of New Labour's health policy is to shift more of the balance of power and responsibility for services to the local level. But, while the government proclaims a new decentralized NHS, doubts exist about the extent to which the reality on the ground matches the tone of policy. This article reports empirical work examining the level of autonomy purchasers have over budgetary allocation. A case study analysis of purchasing within a single district was undertaken for the financial year 2001/2 which included semi‐structured interviews with key officers responsible for budget allocation. Purchasers approach a new financial year with a starting position that matches the previous year's allocation—the “baseline”, this is adjusted for inflation and, as has happened over the last few years, increased further in real terms by “growth funds” for service modernization and government initiatives. The analysis shows a clear dissonance between policy and practice; although purchasers have complete control over their “baseline budgets”, the study found that this does not “ring true” at the local level. Only about a fifth of growth funds were at the discretion of purchasers as most are taken by national priorities and pay and price inflation. Further decentralization is planned, which includes transferring more control of funds to primary care trusts by 2004, the extent to which these measures will change the perceptions of those working in the service remains to be seen—only then will the government be able to claim a truly decentred service.     

The Influence of Competition on Resource Allocation in Preschool Children

To examine how competition influences resource allocation in 4‐ to 6‐year‐olds, children were assigned to one of two conditions. In the experimental condition children colored a picture for a coloring contest whereas in the control condition they colored a picture to decorate a wall. Subsequently, all children participated in a resource allocation task with another child who was introduced as another participant in the coloring contest or who would also be coloring a picture for the wall. Finally, children were asked how many crayons (out of eight) they wanted to provide to the other child. In the resource allocation task, children made decisions about how to allocate stickers to self and other across four trial types: cost and no cost variations of both advantageous and disadvantageous inequality trials. Children were less prosocial in the experimental condition than in the control condition but only in disadvantageous inequality trials involving a cost. Children in the experimental condition withheld more crayons compared to children in the control condition. These results suggest that competition not only decreases prosocial behavior directly linked to the competition but also decreases generosity when provided with an unrelated resource allocation opportunity.     

Preschool Children's Anticipation of Recipients' Emotions Affects Their Resource Allocation

The present study investigated the impact of preschoolers' anticipation of recipients' emotions on their resource allocation decisions. Three‐ to six‐year‐old children participated in one of three different scenarios before performing a resource allocation task. In the Other condition, children were led to think about another person's emotions when being shared with or not being shared with. In the Self condition, children were led to think about their own emotion when being shared with or not being shared with. In an epistemic control condition, children were asked to think about another person's knowledge state. The results showed that children were able to attribute different emotions to the respective recipient when being shared with or not being shared with. Children in the Other condition and the Self condition were more likely to allocate resources to the other when decisions were not associated with costs. Moreover, correlational analyses demonstrated that the more negatively children rated the emotion of the recipient when not being shared with the more they were to allocate resources to the recipient. This indicates that children's inclination to allocate resources to another person can be promoted by their awareness of a recipient's negative emotions when not being shared with.     

北京市区县间医疗资源配置的人口公平性研究

北京市医疗资源的增长远远落后于经济增长。通过对北京市三种主要医疗资源在十八个区县间的配置进行区县人口公平性分析,表明医疗资源存在着较明显的区县人口不公平性,并且这种不公平性在逐年加剧。同时,北京市医疗资源配置对流动人口应对不足。因此,政府应该在北京市医疗资源配置规划及实施中起到更多的主导作用,加大在医疗资源匮乏地区的投入,并且关注人口变动对医疗资源配置产生的新需求。     

大数据时代的刑事领域被遗忘权

大数据时代的到来既带来便利也带来信息失控的风险,从而必然产生对被遗忘权的需求,刑事领域也同样存在被遗忘权的适用空间。然而刑事领域的被遗忘权可能与大数据时代的信息开放、新闻自由、犯罪控制等法益产生冲突,面对冲突不同国家从立法到司法层面可能作出不同的选择。欧盟《一般数据保护条例》第17条规定了被遗忘权的适用情形及其限制条件,可以对刑事领域被遗忘权的边界确立提供参考。通过"申请+审查"的被遗忘权行使模式,可以解决其与公共安全、司法公正、人权保护等的矛盾。我国目前在司法中尚未承认被遗忘权,但刑事立法中已有被遗忘权的某些原始样态,可以在此基础上正式确立刑事领域被遗忘权并审慎地拓展其适用范围。     

伦理沦丧抑或是伦理转向:现代化视域下中国农村家庭资源的代际分配研究

本文将家庭资源分配置于三代的代际链,将家庭资源分配中的“亲代优先性”和“成年子代优先性”结合起来形成资源代际分配的四个亚类型,并以此来审视当前农村家庭养老中的资源分配。通过对CHARLS数据的分析发现,个体的现代化程度在一定程度上会影响其家庭资源的代际分配决策,其中,个体的现代化(尤其是经济状况的改进)使其在资源分配时倾向于支持子代。基于此,本文提出,农村家庭资源的代际分配并未呈现“伦理沦丧”特征,上位优先型的分配方式仍在家庭资源代际分配中占据重要位置;造成农村家庭对亲代赡养资源供给不及现象的原因并不总是“伦理危机”,而由“伦理转向”所导致的下位优先分配原则可能是上述现象的重要诱因之一。     

清代别集研究的成就及其在清代学术史中的失落

对于历代别集研究,清代堪称集大成,主要表现在三个方面:一是出现了不少大部头著作,二是对更多别集进行了较为细致的整理,三是研究更为深入。但有关清代学术的研究著作却很少提及清代别集研究的成就,其原因大致有三:一是清代别集研究不像其他学术派别那样体系清晰,二是清代学术的发展方向导致别集研究的流失,三是后代学术领域对清人别集研究的忽视。     

Circumstances Change Cases: Local Government and the NHS

The role of local government in health care matters in Britain has never been trouble-free. From the dissolution of the Boards of Guardians in 1929, through to the creation of the NHS in the 1940s and the introduction of the internal market in the 1990s, there have been political and professional arguments surrounding the issue and, for the most part, the case for democratic local governance of health care has failed to carry the day. This paper looks back to earlier debates, examines the current policy context, and looks ahead to possible future scenarios. It argues that the changing circumstances of both the NHS and local government makes this an apposite time to rethink established structures.     

Violence,Negligence and Suicidal Tendency among Physically Disabled Street Children

This study was carried out among physically disabled street children (PDSC) in the city of Dhaka in Bangladesh. The aim of the study was to explore violence, negligence and suicidal tendency among PDSC. To do this, 30 PDSC (15 male and 15 female) were conveniently selected and interviewed with an interview protocol developed by a step‐by‐step process. The results of this study revealed that all the participants experienced physical violence but female children were more likely to experience sexual violence than male children. Violence against disabled children came from both family members or relatives and other people. As with violence, all the participants experienced some sort of negligence, again both from family members or relatives and other people. More importantly, this study found that more than half of the physically disabled children had suicidal tendency to some extent, i.e. some thought of committing suicide at least once in their life, while others attempted to commit suicide due to the sufferings that came with disability. This study concludes with some policy implications, particularly: providing counseling to parents and the disabled children; training of the service providers who provide services to disabled persons; and building awareness through mass media.     

Ethnic Diversity Policy: Perceptions within the NHS

Ethnic diversity has become an important policy objective for the Labour government, particularly since the publication of the Macpherson Report (1999) . It is projected as a potential means of improving service provision in various policy areas from policing to the business sector. The contention of this article, based on research conducted in the NHS, is that much more thought needs to be given to the shape of ethnic diversity and its operationalization if services are to improve for society as a whole. The current shape of the concept, as perceived by the majority of the interview respondents who participated in the research (all of whom had responsibility for employment decisions within their organizations), promises at best disappointment, and at worst a further peripheralization of minority ethnic issues, for which communities themselves may be held responsible.     

Trust and Welfare State Reform: The Example of the NHS

This article discusses the impact of New Public Management on public trust in welfare state institutions, using the example of NHS reform. Discussion of trust in public institutions across political science, psychology and sociology indicates that it is based on both rational/objective considerations (competence and capacity to deliver the service) and affectual/subjective factors (shared values, belief that the trustee shares the trustor's interests). The New Public Management foregrounds individual responsibility and incentives for both suppliers and users of services, in the NHS example in quasi‐markets, management by target and patient choice. These accord with an individualized market rational‐actor model rather than with affective considerations. Analysis of attitude survey data on the NHS confirms that rational/objective and affectual/subjective factors contribute to public trust in this field. However, a comparison between perceptions in England, where the internal market has been vigorously pursued, and Scotland, where the purchaser/provider split was discarded after devolution, indicate that the market does not offer a royal road to perceptions of superior quality in the objective factors. Conversely, the more market‐centred system can make progress in relation to the more subjective affectual factors.     

Reducing waiting times in the Italian NHS: The case of Emilia-Romagna

In 2015, the Emilia-Romagna Regional Government implemented a plan to reduce waiting times for elective outpatient procedures. The objective set by the regional government establishes that at least 90 per cent of specialist services are to be provided within the following maximum waiting times: 30 days for the first specialist consultation, and 60 days for diagnostic tests. The plan adopted by the Emilia-Romagna Regional Government is of particular interest because it encompasses a combined strategy. Some of the interventions envisaged in the plan aim at increasing the supply of specialist services. Others address the demand side, seeking to reduce inadequate requests and discourage no-shows by patients. And others focus on combining supply and demand and neutralizing the effects of some perverse incentives. The Emilia-Romagna plan appears to have had a successful outcome. In the first 4 years of implementation, the 90 per cent target has not only been achieved but also widely exceeded.     

Allocation of the Soviet Labor Force in Productive and Nonproductive Areas

An important discussion taking place among Soviet economists deals with the proportions of the labor force in productive and nonproductive spheres. Broadly speaking, productive labor refers to labor which produces material values while nonproductive labor refers to services, selling, cultural work, etc. Neither term has any moral connotation, but is based on the production or nonproduction of value in Marxist terms. The practical import of this question lies in the fact that advanced economies tend to have an increasing proportion of the labor force work in the nonproductive sphere. According to the data and analysis in this article, this process is taking place in the Soviet Union. "Allocation and Utilization of the Soviet Labor Force During the Seven-Year Plan," Sotsialistichesky Trud (Socialist Labor), 1961, No. 3.     

我国高等教育资源配置存在的问题及解决对策

随着我国高等教育办学规模的不断扩大,高等教育资源相对不足的现实逐渐凸显出来,主要表现在人才资源特别是教师资源匮乏、各种物质资源供应不足。这其中,既存在着结构性短缺的问题,叉存在着结构性浪费的问题。鉴于此,应力求做到优化资源配置,做到人、财、物等各种资源共享,从而使高等教育资源配置逐步趋于合理和完善。     

Public Participation in the New NHS: No Closer to Citizen Control?

Over the last decade support for increasing public participation in decisions regarding the planning and delivery of health services has become a familiar feature of the policy agenda for the UK National Health Service. This paper reviews current Labour policy towards public participation and reports on the response of primary care groups (PCGs) to recent Labour directives to make patient and public involvement an integral part of the way they work, presenting the findings of a survey conducted in one English health region. The experience of these PCGs suggests that, despite the diverse backgrounds of board members, there is marked consensus between local and central decision makers as to their understanding of public participation. Whilst academic debates have tended to conceptualize participation in dualist terms as a form of consumerism or of citizenship, the survey data suggest that in the context of local implementation public participation is framed within a new public management perspective which values it as an aid to organizational learning. The findings of this study highlight obstacles to securing effective public participation, including a lack of substantive guidance regarding policy implementation that produces uncertainty amongst local decision makers as to how best to proceed. The inherent limitations of public participation within the new public management paradigm suggest that democratic renewal, one of the goals of the government's modernization agenda, is unlikely to be achieved.     

Unemployment,Youth Homelessness and the Allocation of Family Responsibility

The following discussion concerns two issues relating to what is usually called youth homelessness. The first concerns the accommodation expectations for 15 to 17 year olds to reside at their parent's home, which is encouraged by the existing government's policies, and the non-indexation of the unemployment benefit for single 16 and 17 year olds. Assumptions about family responsibility are also discussed and linked with assumptions about family dependency. The second concerns the establishing of a minimum data base from which the quantification of the number of homeless youth can begin. Additional data available, however, suggests that the numbers of young people who might be expected to experience difficulty finding accommodation is much higher than first thought.