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Worker participation has been broadly defined as “any process designed to increase the ability of a worker to make decisions, or influence the making of decisions, which relate either to a specific job within an organisation, or more broadly to the overall functioning of that organisation”. As this definition suggests, worker participation can take many forms. One of these is joint consultation. Joint consultation has been described as “the means whereby management and employees may together consider, and where appropriate determine, matters affecting their joint or respective interests”. Thus joint consultation may allow for the following different degrees of participation:

Joint consultation has had a checkered history during the last 50 years. Both in the Second World War and in the late 1940s, consultative committees were widespread in manufacturing companies. Many observers of the industrial relations scene at that time based their great optimism for post war industrial relations in Britain on the efficacy of joint consultation. Subsequently, joint consultation came to be regarded as a failure and as in a state of decline due to the growth of workplace bargaining. In the course of the last three or four years, the results of several surveys have been published which cast light on current arrangements and have led to claims of a renaissance in joint consultation.

Following on from the first part of the article the authors present the results of a survey which shows the continuing popularity of joint consultation during the recession.

This paper focuses attention upon the current public policy debate on employee participation in managerial decision‐making before the publication of the Bullock Report and, in particular, the apparent resurgence of popularity for the concept of joint consultation. In view of joint consultation's relatively unsuccessful history it may be that the implications of this development have been largely unrecognized. Current attitudes towards participation as exemplified in certain of the more important policy statements of management, unions and political parties are analysed in terms of the role allotted to joint consultation within them. Similarly, European experience with joint consultation is considered for its relevance for developments in Britain. The paper closes with discussion of the future role joint consultation could play as a vehicle in the development of employee participation and the key issues involved.

Many writers have suggested that the concept of joint consultation is outdated in Britain, no longer appropriate in the light of other changes in industrial relations practice. McCarthy, for example, has argued that joint consultation machinery at plant level has been upstaged by the growth of shop steward organisation and workplace bargaining. Further, Clegg has criticised joint consultation committees (JCC's) for contributing little to workplace industrial democracy; more recently, King and Van de Vall have echoed this sentiment, arguing that JCC's in Britain became ineffective due to a lack of decision‐making powers and a remit covering too limited a span of issues. Evidence of the widespread nature of this criticism is indicated by the decline in numbers of JCC's during the nineteen fifties and sixties. In a large‐scale survey published in 1952 by the National Institute of Industrial Psychology, consultation committees between management and employee and/or union representatives were found to be operating in 73 per cent of firms. In a similar survey carried out in the late 1960s, however, Clarke and his colleagues found this figure to have fallen to 32 per cent.

From recent evidence in both the industrial and the political arena, it would seem that diluted forms of industrial democracy/employee participation are undergoing some kind of a revival. This is probably a reflection of a change of government on the one hand and a reaction to the proposals of Bullock and the White Paper on the other. One of the forms of participation attracting most interest would appear to be joint consultation and, in a recent report in the Employment Gazette, Hawes and Brookes have argued that “in particular it seems likely that over the next few years emphasis will be placed on the voluntary development of employee participation by managements and trade unions, and the growth of new and existing forms of negotiating and consultative machinery”. It is within a context such as this that we can outline the remainder of this article.

Those who are concerned with introducing employee participation into British industry deserve our heartfelt sympathy. It must be like trying to photograph a group of five‐year‐old children whilst crossing a minefield—the subject will never sit still and one toe in the wrong place will cause an explosion. Prospects of legislation on industrial democracy seem to come and go; trade union and employers attitudes appear to fluctuate; new vogues are introduced and vanish without trace. And if this were not enough, everyone seems to be ready to give advice—much of it contradictory. The scene is tangled and confused.

This book is a policy proposal aimed at the democratic left. It is concerned with gradual but radical reform of the socio‐economic system. An integrated policy of industrial and economic democracy, which centres around the establishment of a new sector of employee‐controlled enterprises, is presented. The proposal would retain the mix‐ed economy, but transform it into a much better “mixture”, with increased employee‐power in all sectors. While there is much of enduring value in our liberal western way of life, gross inequalities of wealth and power persist in our society.

The purpose of this paper is to survey developments in four aspects of collective employment relations (ER) since the mid-1960s: collective representation and organisation; collective bargaining coverage and structure; the collective bargaining agenda; and joint consultation arrangements. It considers the reasons underlying change.

A range of published sources are drawn on, including quantitative, survey based and qualitative, case-study and other evidence.

The landscape of collective ER has changed markedly over the past half century. Membership of trade unions has fallen from around half of the workforce to one-quarter. Employers who mainly conducted collective bargaining through employers’ associations now negotiate, if at all, on a firm-by-firm basis. Collective bargaining coverage has sharply declined and now only extends to a minority of the private sector workforce. The bargaining agenda has been hollowed out. Joint consultation arrangements too are less widespread than they were around 1980.

The paper contends that change has been driven by three underlying processes. “Marketization” of collective ER entailing a shift from an industrial or occupational to an enterprise frame of reference. The rise of “micro-corporatism”, reflecting increased emphasis on the common interests of collective actors within an enterprise frame. Finally, the voluntarism, underpinning Britain’s collective ER became more “asymmetric”, with employers’ preferences increasingly predominant.

Integrated care models have shown to deliver efficient healthcare, but implementation has proven to be difficult. The Support Consultation is an integrated care model, which enables full integration by bundled payment, insurer involvement, predefined care pathways and strengthening of primary care. The purpose of this paper is to provide an indication of the improvements in healthcare delivery after implementation of this proposed model and to create a base for extension to similar interfaces between primary and secondary care.

A retrospective study was used to compare the effect on the number of referred patients with non-acute cardiac complaints and the cost effectiveness before and after implementation of the Support Consultation. Patients who previously would have been referred to the cardiologist were now discussed between general practitioner and cardiologist in a primary care setting.

The first consecutive 100 patients (age 55±16 years, male 48 percent), discussed in the Support Consultation, were analyzed. Implementation of the Support Consultation resulted in a net costs (program costs and referral costs) reduction of 61 percent compared with usual care. All involved parties were positive about the program.

The Support Consultation has the ability to provide more effective healthcare delivery and to reduce net costs. The setting of the current study can be used as example for other specialties in countries with a similar healthcare system.

This study provides the potential cost savings after implementation of an integrated care model, based on real-life data.