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Open Access
Article
Publication date: 5 July 2019

Rod Sheaff, Joyce Halliday, Mark Exworthy, Alex Gibson, Pauline W. Allen, Jonathan Clark, Sheena Asthana and Russell Mannion

Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and…

2739

Abstract

Purpose

Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons?

Design/methodology/approach

An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above.

Findings

The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways.

Research limitations/implications

This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations.

Practical implications

Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary.

Originality/value

Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.

Details

Journal of Health Organization and Management, vol. 33 no. 7/8
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 19 March 2018

Dominic Detzen

The purpose of this paper is to analyze how “New Deal” regulatory initiatives, primarily the Securities Acts and the Securities and Exchange Commission (SEC), changed US auditors’…

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Abstract

Purpose

The purpose of this paper is to analyze how “New Deal” regulatory initiatives, primarily the Securities Acts and the Securities and Exchange Commission (SEC), changed US auditors’ professional knowledge conception, culminating in the 1938 expansion of the Committee on Accounting Procedure (CAP), the first US body to set accounting principles.

Design/methodology/approach

The paper combines Halliday’s (1985) knowledge mandates with Hancher and Moran’s (1989) regulatory space to attain a theory-based understanding of auditors’ changing knowledge conceptions amid regulatory pressure. It draws on a range of primary and secondary sources to examine the period from 1929 to 1938.

Findings

Following the stock market crash, the newly created SEC aimed to engage auditors as a means to regulate companies’ accounting practices based on a set of codified principles. While entailing increased status, this new role conflicted with the auditors’ knowledge conception, which was based on professional judgment and personal integrity. Pressure from the SEC and academics eventually made auditors agree to a codification of their professional knowledge and create the CAP as a cooperative regulatory solution.

Originality/value

The paper explores the role of auditors’ knowledge conceptions in the emergence of today’s standard setting. It is suggested that auditors’ incomplete control of their professional knowledge made standard setting a form of co-regulation, located between the actors occupying the regulatory space of accounting.

Details

Accounting, Auditing & Accountability Journal, vol. 31 no. 3
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 1 December 2003

Sheena Asthana and Joyce Halliday

This paper considers intermediate care as part of a whole‐systems approach to care. It argues that this perspective allows a wider appreciation of the potential benefits of…

Abstract

This paper considers intermediate care as part of a whole‐systems approach to care. It argues that this perspective allows a wider appreciation of the potential benefits of intermediate care, and that this would also be a welcome feature in future research studies. The paper draws on an evaluation of intermediate care in Cornwall and outlines the central role of intermediate care co‐ordination in the whole system. The example of residential rehabilitation is then used to examine how an individual service relates to the system as a whole. Finally, factors that may also influence local systems such as partnership working and rurality are considered; these are seen as important considerations for any other authorities which might seek to replicate the Cornwall approach to intermediate care.

Details

Journal of Integrated Care, vol. 11 no. 6
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 December 2003

Jill Manthorpe

Abstract

Details

Journal of Integrated Care, vol. 11 no. 6
Type: Research Article
ISSN: 1476-9018

Article
Publication date: 1 December 2003

Peter Thistlethwaite

Abstract

Details

Journal of Integrated Care, vol. 11 no. 6
Type: Research Article
ISSN: 1476-9018

Book part
Publication date: 13 December 2021

Benjamin O.L. Bowles, Kate Bayliss and Elisa Van Waeyenberge

Despite the fact that recent anthropological interest in infrastructure has done much to illuminate the infrastructure asset as an assemblage of actors, technologies and ideas, an…

Abstract

Despite the fact that recent anthropological interest in infrastructure has done much to illuminate the infrastructure asset as an assemblage of actors, technologies and ideas, an interdisciplinary approach is required to unpack how the infrastructure project comes together as an assemblage and to define the role that financial technologies and discourses play in shaping it. Here, an interdisciplinary approach is applied to a novel infrastructure asset, London's Thames Tideway Tunnel, in order to show how multiple actors and visions of the world are brought together to make the infrastructure asset come to fruition. The paper concludes that this interdisciplinary approach to infrastructure can allow us to keep multiple sides of the infrastructure project in sight simultaneously. This includes both the creation of a rhetorical vision and spectacle around the asset, and the underlying financial arrangements that bind it together. If we do so, we can understand how new infrastructural forms utilise particular financial technologies and ideas to change the relationship between the public and the private, and between consumers and providers, and act towards the creation of a new ‘public good’ that normalises private provision.

Details

Infrastructure, Morality, Food and Clothing, and New Developments in Latin America
Type: Book
ISBN: 978-1-80117-434-3

Keywords

Article
Publication date: 13 June 2019

Louise Ravelli

The purpose of this paper is to reflect on pedagogical strategies which support the teaching of critical analysis of visual and multimodal texts in a tertiary-level course for…

Abstract

Purpose

The purpose of this paper is to reflect on pedagogical strategies which support the teaching of critical analysis of visual and multimodal texts in a tertiary-level course for Arts students.

Design/methodology/approach

The paper describes strategies which focus on developing students’ abilities to express interpretive critique, as opposed to mere description. These strategies give students strong scaffolding towards success in their interpretive writing. The course in question is a tertiary-level Arts course which teaches Kress and van Leeuwen’s (2006) approach to “reading images” in relation to contemporary media texts. The basic structure of the course is described, along with the macro steps which underpin the pedagogy. Examples of highly successful and less successful student writing are compared to reveal the key components of effective interpretive answers.

Findings

In addition to the normal expectations regarding essay structure and style, and in addition to mastery of the technicality of the course, successful and less successful student writing depends on their mastery of a specific set of moves within the essay. These moves integrate textual observations with clear explanations and a strong relation to interpretation.

Practical implications

While the course and strategies discussed are for tertiary-level students, the strategies described are adaptable to primary and secondary levels also. Multimodal texts are an integral part of the English curriculum, and all teachers need to explore strategies for enabling their students’ critical engagement with such texts.

Originality/value

Visual and multimodal texts are an exciting and also challenging part of English curricula, and new analytical frameworks and pedagogical strategies are needed to tackle these texts. In particular, the gap between simply describing visual resources (applying the tools) and critical analysis (using the tools) is vast, and specific pedagogical strategies are needed to help students develop the necessary interpretive language.

Details

English Teaching: Practice & Critique, vol. 18 no. 1
Type: Research Article
ISSN: 1175-8708

Keywords

Book part
Publication date: 13 February 2024

Michelle Tytherleigh and Hannah Dunn

This chapter has been specifically written for readers interested in incorporating positive education into practice. Expanding on concepts and models first introduced in Chapter…

Abstract

This chapter has been specifically written for readers interested in incorporating positive education into practice. Expanding on concepts and models first introduced in Chapter 1, it starts with an overview of commonly used wellbeing models and frameworks from positive psychology adapted for application in schools. The chapter also explores the significance of positive education in enhancing educator wellbeing and shares experienced-based insights on how positive education has been implemented effectively, or not. As part of this, the chapter identifies common implementation challenges and offers key recommendations for achieving success. Aligned to this book’s overarching objective of connecting theory with practice, it provides empirical and practical insights, including a Positive Psychology in Practice case study of a UK educator’s experience with embedding positive education in further education (FE).

Details

Positive Education at All Levels: Learning to Flourish
Type: Book
ISBN: 978-1-83753-156-1

Keywords

Book part
Publication date: 20 May 2017

Jared C. Carbone and Snorre Kverndokk

Empirical studies show that years of schooling are positively correlated with good health. The implication may go from education to health, from health to education, or from…

Abstract

Empirical studies show that years of schooling are positively correlated with good health. The implication may go from education to health, from health to education, or from factors that influence both variables. We formalize a model that determines an individual’s demand for knowledge and health based on the causal effects, and study the impacts on the individual’s decisions of policy instruments such as subsidies on medical care, subsidizing schooling, income tax reduction, lump-sum transfers, and improving health at young age. Our results indicate that income redistribution policies may be the best instrument to improve welfare, while a medical care subsidy is the best instrument for longevity. Subsidies to medical care or education would require large imperfections in these markets to be more welfare improving than distributional policies.

Details

Human Capital and Health Behavior
Type: Book
ISBN: 978-1-78635-466-2

Keywords

Article
Publication date: 29 September 2020

Susan Hoadley

The paper presents an investigation into the validity and robustness of the concept of competitive productivity (CP) using linguistic analysis and theory to explore the…

Abstract

Purpose

The paper presents an investigation into the validity and robustness of the concept of competitive productivity (CP) using linguistic analysis and theory to explore the foundational CP concepts and the relationships between them.

Design/methodology/approach

The aim of this paper is to make a theoretical contribution to the conceptualisation of CP in order to inform its understanding, measurement and application.

Findings

The investigation indicates the relevance of three dimensions (instantiation, stratification and system) to understand CP as a complex, multidimensional system. Instantiation both clarifies CP as a multilevel system and highlights the need for an additional dimension(s) to understand the relationship between national, firm and individual CP (NCP, FCP and ICP). In combination, the two dimensions of stratification and system model CP as a series of nested strata (theory/models, concepts, constructs, variables and measures) through which marketing and management theory and knowledge is created and demonstrate how the options at each level can be articulated as system networks.

Research limitations/implications

Managing the complexity of CP by mapping different aspects along different dimensions and, in doing so, better understanding the nature of and relationships between different phenomena within the domain can potentially inform future qualitative and quantitative research in business studies and beyond.

Originality/value

The paper uses a novel, interdisciplinary approach to demonstrate the existence of CP as a complex, multidimensional system, where such dimensions inform the understanding, measurement and application of CP, and so is of value to marketing and management researchers and practitioners.

Details

Cross Cultural & Strategic Management, vol. 28 no. 1
Type: Research Article
ISSN: 2059-5794

Keywords

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