Pauline Allen, Kath Checkland, Valerie Moran, and Stephen Peckham (eds)
- Published in print:
- 2020
- Published Online:
- September 2020
- ISBN:
- 9781447346111
- eISBN:
- 9781447346319
- Item type:
- book
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781447346111.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
This book brings together selected research on commissioning healthcare in the English NHS carried out by national policy research unit in commissioning and the healthcare system (PRUComm) between ...
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This book brings together selected research on commissioning healthcare in the English NHS carried out by national policy research unit in commissioning and the healthcare system (PRUComm) between 2011 and 2018. PRUComm is funded by the English Department of Health’s Policy Research Programme. The bookexplores the changes to commissioning in the English NHS quasi market introduced by the Health and Social Care Act 2012 (HSCA 2012). It focuses on threemain areas: first, the development and operation of the newly formed commissioning bodies named Clinical Commissioning Groups (CCGs) which were supposed to increase clinical engagement; secondly, technical aspects of commissioning being the use of competition and cooperation by CCGs to commission care in the HSCA 2012 regulatory context encouraging competition,and the allocation of financial risk through contracts between commissioners and providers of care (including new forms of contract such as alliances); and thirdly the reorganisation of the commissioning of public health services.The research demonstrates that the HSCA 2012 has had the effect of fragmenting commissioning responsibilities and in the process impaired good governance and strong accountability of commissioners. It shows how the use of market mechanisms has declined despite the pro competition regulatory regime of the HSCA 2012, and that more cooperative processes are used at local level to reconfigure health services. It concludes that strategic planning and monitoring of services will always be essential for the English NHS, whether the term ‘commissioning’ is used to describe these activities or not in the future.Less
This book brings together selected research on commissioning healthcare in the English NHS carried out by national policy research unit in commissioning and the healthcare system (PRUComm) between 2011 and 2018. PRUComm is funded by the English Department of Health’s Policy Research Programme. The bookexplores the changes to commissioning in the English NHS quasi market introduced by the Health and Social Care Act 2012 (HSCA 2012). It focuses on threemain areas: first, the development and operation of the newly formed commissioning bodies named Clinical Commissioning Groups (CCGs) which were supposed to increase clinical engagement; secondly, technical aspects of commissioning being the use of competition and cooperation by CCGs to commission care in the HSCA 2012 regulatory context encouraging competition,and the allocation of financial risk through contracts between commissioners and providers of care (including new forms of contract such as alliances); and thirdly the reorganisation of the commissioning of public health services.The research demonstrates that the HSCA 2012 has had the effect of fragmenting commissioning responsibilities and in the process impaired good governance and strong accountability of commissioners. It shows how the use of market mechanisms has declined despite the pro competition regulatory regime of the HSCA 2012, and that more cooperative processes are used at local level to reconfigure health services. It concludes that strategic planning and monitoring of services will always be essential for the English NHS, whether the term ‘commissioning’ is used to describe these activities or not in the future.
Leo F. Goodstadt
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9789888208210
- eISBN:
- 9789888268436
- Item type:
- book
- Publisher:
- Hong Kong University Press
- DOI:
- 10.5790/hongkong/9789888208210.001.0001
- Subject:
- Economics and Finance, Public and Welfare
Hong Kong is among the richest cities in the world. Yet over the past 15 years, living conditions for the average family have deteriorated despite a robust economy, ample budget surpluses and record ...
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Hong Kong is among the richest cities in the world. Yet over the past 15 years, living conditions for the average family have deteriorated despite a robust economy, ample budget surpluses and record labour productivity. Successive governments have been reluctant to invest in services for the elderly, the disabled, the long-term sick, and the poor, while education has become more elitist. The political system has helped to entrench a mistaken consensus that social spending is a threat to financial stability and economic prosperity. This trenchant attack on government mismanagement traces how officials have created a ‘new poverty’ in Hong Kong and argues that their misguided policies are both a legacy of the colonial era and a deliberate choice by modern governments, and not the result of economic crises. This provocative book will be essential reading for anyone wishing to understand why poverty returned to Hong Kong in this century.Less
Hong Kong is among the richest cities in the world. Yet over the past 15 years, living conditions for the average family have deteriorated despite a robust economy, ample budget surpluses and record labour productivity. Successive governments have been reluctant to invest in services for the elderly, the disabled, the long-term sick, and the poor, while education has become more elitist. The political system has helped to entrench a mistaken consensus that social spending is a threat to financial stability and economic prosperity. This trenchant attack on government mismanagement traces how officials have created a ‘new poverty’ in Hong Kong and argues that their misguided policies are both a legacy of the colonial era and a deliberate choice by modern governments, and not the result of economic crises. This provocative book will be essential reading for anyone wishing to understand why poverty returned to Hong Kong in this century.
Teun Zuiderent-Jerak
- Published in print:
- 2015
- Published Online:
- January 2016
- ISBN:
- 9780262029384
- eISBN:
- 9780262329439
- Item type:
- book
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262029384.001.0001
- Subject:
- Sociology, Health, Illness, and Medicine
This book considers the question of how the direct involvement of social scientists in the practices they study can lead to the production of interesting sociological knowledge. It draws together two ...
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This book considers the question of how the direct involvement of social scientists in the practices they study can lead to the production of interesting sociological knowledge. It draws together two activities that are often seen as belonging to different realms: intervening in practices and furthering sociological understanding of them. The common separation of these domains partly stems from disciplinary self-understandings within sociology as either ‘detached’ or ‘engaged’. Situated Intervention proposes that this debate is unproductive for discussing the role of social sciences in relation to their fields. Philosophers of science such as Ian Hacking have argued that natural sciences benefited tremendously from broadening their scholarly mode from theorizing about the world to intervening through experiments Adhering to an objectivist and theorizing image of scholarship within sociology thereby risks loosing a mode of knowledge production that has proven highly productive in the natural sciences. Furthermore, experimental interventions prove relevant for discussions about the normativity of sociological research. These matters are explored by analyzing organizational change projects in healthcare: the development of a hemophilia care center, pathways for hematology and oncology at an outpatient clinic, redesigning oncology care and elective surgery in sixteen hospitals, and evaluating a quality improvement collaborative in long-term care. These experiments invariably lead to the surprising production of sociological knowledge as well as producing novel normativities. The analysis thereby shows that, through situated intervention, sociology not only has more to offer to the practices it studies, but also has more to learn from it.Less
This book considers the question of how the direct involvement of social scientists in the practices they study can lead to the production of interesting sociological knowledge. It draws together two activities that are often seen as belonging to different realms: intervening in practices and furthering sociological understanding of them. The common separation of these domains partly stems from disciplinary self-understandings within sociology as either ‘detached’ or ‘engaged’. Situated Intervention proposes that this debate is unproductive for discussing the role of social sciences in relation to their fields. Philosophers of science such as Ian Hacking have argued that natural sciences benefited tremendously from broadening their scholarly mode from theorizing about the world to intervening through experiments Adhering to an objectivist and theorizing image of scholarship within sociology thereby risks loosing a mode of knowledge production that has proven highly productive in the natural sciences. Furthermore, experimental interventions prove relevant for discussions about the normativity of sociological research. These matters are explored by analyzing organizational change projects in healthcare: the development of a hemophilia care center, pathways for hematology and oncology at an outpatient clinic, redesigning oncology care and elective surgery in sixteen hospitals, and evaluating a quality improvement collaborative in long-term care. These experiments invariably lead to the surprising production of sociological knowledge as well as producing novel normativities. The analysis thereby shows that, through situated intervention, sociology not only has more to offer to the practices it studies, but also has more to learn from it.
Carole M Longson and Mirella Marlow
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199558612
- eISBN:
- 9780191595011
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199558612.003.0014
- Subject:
- Public Health and Epidemiology, Public Health
This chapter discusses the NICE IP (interventional procedures) Programme, which is intended to introduce new interventional procedures safely into the NHS. The basic requirements for achieving this ...
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This chapter discusses the NICE IP (interventional procedures) Programme, which is intended to introduce new interventional procedures safely into the NHS. The basic requirements for achieving this remain the same as they were when it was formally established by the Department of Health in 2003: where there are uncertainties about the evidence on a new interventional procedure, clinicians should take special care to inform their trust clinical governance lead that they are planning to undertake it, tell the patient about those uncertainties, audit and publicize their results.Less
This chapter discusses the NICE IP (interventional procedures) Programme, which is intended to introduce new interventional procedures safely into the NHS. The basic requirements for achieving this remain the same as they were when it was formally established by the Department of Health in 2003: where there are uncertainties about the evidence on a new interventional procedure, clinicians should take special care to inform their trust clinical governance lead that they are planning to undertake it, tell the patient about those uncertainties, audit and publicize their results.
Kelly Underman
- Published in print:
- 2020
- Published Online:
- January 2021
- ISBN:
- 9781479897780
- eISBN:
- 9781479836338
- Item type:
- book
- Publisher:
- NYU Press
- DOI:
- 10.18574/nyu/9781479897780.001.0001
- Subject:
- Sociology, Science, Technology and Environment
Gynecological teaching associates (GTAs) are trained laypeople who teach medical students the communication and technical skills of the pelvic examination while simultaneously serving as live models ...
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Gynecological teaching associates (GTAs) are trained laypeople who teach medical students the communication and technical skills of the pelvic examination while simultaneously serving as live models on whose bodies these same students practice. These programs are widespread in the United States and present a fascinating case for understanding contemporary emotional socialization in medical education. Feeling Medicine traces the origins of these programs in the Women’s Health Movement and in the nascent field of medical education research in the 1970s. It explores how these programs work at three major medical schools in Chicago using archival sources and interviews with GTAs, medical faculty, and medical students. This book argues that GTA programs embody the tension in medical education between the drive toward science and the ever-presence of emotion. It claims that new regimes of governance in medical education today rely on the modification of affect, or embodied capacities to feel and form attachments. Feeling Medicine thus explores what it means to make good physicians in an era of corporatized healthcare. In the process, it considers the role of simulation and the meaning of patient empowerment in the medical profession, as well as the practices that foster caring commitments between physicians and their patients—and those that are exploitable by for-profit healthcare.Less
Gynecological teaching associates (GTAs) are trained laypeople who teach medical students the communication and technical skills of the pelvic examination while simultaneously serving as live models on whose bodies these same students practice. These programs are widespread in the United States and present a fascinating case for understanding contemporary emotional socialization in medical education. Feeling Medicine traces the origins of these programs in the Women’s Health Movement and in the nascent field of medical education research in the 1970s. It explores how these programs work at three major medical schools in Chicago using archival sources and interviews with GTAs, medical faculty, and medical students. This book argues that GTA programs embody the tension in medical education between the drive toward science and the ever-presence of emotion. It claims that new regimes of governance in medical education today rely on the modification of affect, or embodied capacities to feel and form attachments. Feeling Medicine thus explores what it means to make good physicians in an era of corporatized healthcare. In the process, it considers the role of simulation and the meaning of patient empowerment in the medical profession, as well as the practices that foster caring commitments between physicians and their patients—and those that are exploitable by for-profit healthcare.
Sara Booth, Polly Edmonds, and Margaret Kendall
- Published in print:
- 2009
- Published Online:
- November 2011
- ISBN:
- 9780199238927
- eISBN:
- 9780191730092
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199238927.003.0006
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter examines funding and bureaucracy issues that may influence the operation of palliative care teams in acute hospitals in Great Britain. It describes the bureaucratic structure of the ...
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This chapter examines funding and bureaucracy issues that may influence the operation of palliative care teams in acute hospitals in Great Britain. It describes the bureaucratic structure of the National Health Service (NHS) and explains the roles of the NHS Hospital Trusts, the Healthcare Commission, the Acute Trusts, and the Foundation Trusts relevant to the palliative care team. It suggests that a detailed understanding of the structure of the wider NHS as well as the way the team's hospital, locality, and network function operates at a strategic level is essential if the team is going to develop its service effectively.Less
This chapter examines funding and bureaucracy issues that may influence the operation of palliative care teams in acute hospitals in Great Britain. It describes the bureaucratic structure of the National Health Service (NHS) and explains the roles of the NHS Hospital Trusts, the Healthcare Commission, the Acute Trusts, and the Foundation Trusts relevant to the palliative care team. It suggests that a detailed understanding of the structure of the wider NHS as well as the way the team's hospital, locality, and network function operates at a strategic level is essential if the team is going to develop its service effectively.
Pauline Allen, Kath Checkland, Stephen Peckham, Marie Sanderson, and Valerie Moran
- Published in print:
- 2020
- Published Online:
- September 2020
- ISBN:
- 9781447346111
- eISBN:
- 9781447346319
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781447346111.003.0001
- Subject:
- Public Health and Epidemiology, Public Health
This chapter introduces PRUComm, the English national policy research unit in commissioning and the healthcare system funded by the Department of Health and Social Care Policy Research Programme and ...
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This chapter introduces PRUComm, the English national policy research unit in commissioning and the healthcare system funded by the Department of Health and Social Care Policy Research Programme and itsresearch programme on that subject. It then discusses the concept of commissioning in respect of healthcare in the English National Health Service. The theoretical basis for the research, being principally realist approaches to policy analysis; socio legal theory and institutional economics is then expounded and related to the research. Each subsequent chapter is then summarised.Less
This chapter introduces PRUComm, the English national policy research unit in commissioning and the healthcare system funded by the Department of Health and Social Care Policy Research Programme and itsresearch programme on that subject. It then discusses the concept of commissioning in respect of healthcare in the English National Health Service. The theoretical basis for the research, being principally realist approaches to policy analysis; socio legal theory and institutional economics is then expounded and related to the research. Each subsequent chapter is then summarised.
John M. Kirk
- Published in print:
- 2015
- Published Online:
- May 2016
- ISBN:
- 9780813061054
- eISBN:
- 9780813051338
- Item type:
- chapter
- Publisher:
- University Press of Florida
- DOI:
- 10.5744/florida/9780813061054.003.0004
- Subject:
- Society and Culture, Latin American Studies
A case study is presented of three countries that followed the Cuban model and provided an assessment of the needs of the disabled. Venezuela, Bolivia, and Ecuador are studied in some depth, and an ...
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A case study is presented of three countries that followed the Cuban model and provided an assessment of the needs of the disabled. Venezuela, Bolivia, and Ecuador are studied in some depth, and an analysis is provided of the impact of Cuban-led nationwide campaigns for healthcare reform to assist the disabled.Less
A case study is presented of three countries that followed the Cuban model and provided an assessment of the needs of the disabled. Venezuela, Bolivia, and Ecuador are studied in some depth, and an analysis is provided of the impact of Cuban-led nationwide campaigns for healthcare reform to assist the disabled.
Mack Lipkin
- Published in print:
- 2010
- Published Online:
- November 2011
- ISBN:
- 9780199238361
- eISBN:
- 9780191730290
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199238361.003.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
Most of the history of communication skills knowledge and teaching derives from work and studies done in general medicine, or further afield, rather than in cancer care. Cancer care has been advanced ...
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Most of the history of communication skills knowledge and teaching derives from work and studies done in general medicine, or further afield, rather than in cancer care. Cancer care has been advanced in attempting, as this book reflects, to codify the processes required to accomplish some key goals: to help cancer patients to accept their diagnosis and prognosis; to accept or reject tests and difficult treatments according to their core preferences; to participate in studies; to enable them to participate meaningfully when curative care is futile; and to facilitate dying with dignity. The importance of communication in medicine generally was understood by prehistoric human healers. In 1995, the American Academy on Communication in Healthcare published its authoritative reference text, which covered clinical care, education, and research as an exposition of communication training for internal and family medicine. Since then, although there have been serial syntheses and consensus efforts (always a moving target), the core principles of communication skills training have remained quite stable, once one translates the babble of new language for common concepts.Less
Most of the history of communication skills knowledge and teaching derives from work and studies done in general medicine, or further afield, rather than in cancer care. Cancer care has been advanced in attempting, as this book reflects, to codify the processes required to accomplish some key goals: to help cancer patients to accept their diagnosis and prognosis; to accept or reject tests and difficult treatments according to their core preferences; to participate in studies; to enable them to participate meaningfully when curative care is futile; and to facilitate dying with dignity. The importance of communication in medicine generally was understood by prehistoric human healers. In 1995, the American Academy on Communication in Healthcare published its authoritative reference text, which covered clinical care, education, and research as an exposition of communication training for internal and family medicine. Since then, although there have been serial syntheses and consensus efforts (always a moving target), the core principles of communication skills training have remained quite stable, once one translates the babble of new language for common concepts.
John Keown
- Published in print:
- 2012
- Published Online:
- September 2012
- ISBN:
- 9780199589555
- eISBN:
- 9780191741036
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199589555.003.0008
- Subject:
- Law, Medical Law
This chapter considers the legal status of the human embryo in vitro. It begins by considering the legal categories available and concludes that there are two: person or chattel. It then considers ...
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This chapter considers the legal status of the human embryo in vitro. It begins by considering the legal categories available and concludes that there are two: person or chattel. It then considers the force of an analysis classifying the embryo as a person and the weaknesses of some contrary analyses classifying the embryo as property or as akin to property. It analyses two leading cases, the US case of Davis v Davis and the English case of Evans v Amicus Healthcare, both of which effectively adopted a property classification. It criticises the judgments for failing adequately to address the ontological status of the embryo. It also criticises the judgments for basing themselves on the current criminal law relating to abortion and the civil law relating to negligently inflicted pre-birth injury, instead of on the criminal law’s historical purpose of protecting human life from its beginning.Less
This chapter considers the legal status of the human embryo in vitro. It begins by considering the legal categories available and concludes that there are two: person or chattel. It then considers the force of an analysis classifying the embryo as a person and the weaknesses of some contrary analyses classifying the embryo as property or as akin to property. It analyses two leading cases, the US case of Davis v Davis and the English case of Evans v Amicus Healthcare, both of which effectively adopted a property classification. It criticises the judgments for failing adequately to address the ontological status of the embryo. It also criticises the judgments for basing themselves on the current criminal law relating to abortion and the civil law relating to negligently inflicted pre-birth injury, instead of on the criminal law’s historical purpose of protecting human life from its beginning.
Adam D. Reich
- Published in print:
- 2012
- Published Online:
- August 2016
- ISBN:
- 9780801450662
- eISBN:
- 9780801464188
- Item type:
- chapter
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9780801450662.003.0006
- Subject:
- Sociology, Occupations, Professions, and Work
This chapter examines the internal divisions within the labor movement that jeopardized workers’ chances to win their union at Santa Rosa Memorial Hospital (SRMH). More specifically, it considers the ...
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This chapter examines the internal divisions within the labor movement that jeopardized workers’ chances to win their union at Santa Rosa Memorial Hospital (SRMH). More specifically, it considers the internecine struggle between the Service Employees International Union (SEIU) and the National Union of Healthcare Workers (NUHW) as hospital workers fought a third and final round for their union. It also discusses the different visions of unionism represented by the two sides in the conflict, visions that map onto an ongoing debate within labor scholarship between “top-down” and “bottom-up” unionism. Finally, it explores how the trusteeship undermined the St. Joseph Health System campaign and forced SRMH workers to take ownership of the campaign in ways they had not been asked to before. It suggests that the two visions represented in the conflict were not mutually exclusive; indeed, a successful labor movement likely requires their convergence.Less
This chapter examines the internal divisions within the labor movement that jeopardized workers’ chances to win their union at Santa Rosa Memorial Hospital (SRMH). More specifically, it considers the internecine struggle between the Service Employees International Union (SEIU) and the National Union of Healthcare Workers (NUHW) as hospital workers fought a third and final round for their union. It also discusses the different visions of unionism represented by the two sides in the conflict, visions that map onto an ongoing debate within labor scholarship between “top-down” and “bottom-up” unionism. Finally, it explores how the trusteeship undermined the St. Joseph Health System campaign and forced SRMH workers to take ownership of the campaign in ways they had not been asked to before. It suggests that the two visions represented in the conflict were not mutually exclusive; indeed, a successful labor movement likely requires their convergence.
Terry L. Leap
- Published in print:
- 2011
- Published Online:
- August 2016
- ISBN:
- 9780801449796
- eISBN:
- 9780801460807
- Item type:
- chapter
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9780801449796.003.0004
- Subject:
- Sociology, Health, Illness, and Medicine
This chapter examines frauds instigated by major hospitals. A company's fixation on financial performance, especially bottom-line profits and stock market prices, may lead to overcharges, false ...
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This chapter examines frauds instigated by major hospitals. A company's fixation on financial performance, especially bottom-line profits and stock market prices, may lead to overcharges, false billings, upcoding, and kickbacks as well as accounting and financial fraud. Accounting fraud occurs when accounting documents and journal entries are manipulated to hide the embezzlement or the misappropriation of funds. Accounting fraud also forms the foundation for financial fraud. This chapter considers three cases of health care fraud and abuse involving Tenet Healthcare Corporation, the Hospital Corporation of America, and HealthSouth. It also discusses anti-trust violations that drive up costs and reduce the quality of health care, with particular attention to frauds committed by both large and small health care institutions. The chapter concludes with an analysis of organized crime's involvement in health care fraud.Less
This chapter examines frauds instigated by major hospitals. A company's fixation on financial performance, especially bottom-line profits and stock market prices, may lead to overcharges, false billings, upcoding, and kickbacks as well as accounting and financial fraud. Accounting fraud occurs when accounting documents and journal entries are manipulated to hide the embezzlement or the misappropriation of funds. Accounting fraud also forms the foundation for financial fraud. This chapter considers three cases of health care fraud and abuse involving Tenet Healthcare Corporation, the Hospital Corporation of America, and HealthSouth. It also discusses anti-trust violations that drive up costs and reduce the quality of health care, with particular attention to frauds committed by both large and small health care institutions. The chapter concludes with an analysis of organized crime's involvement in health care fraud.
Leo F. Goodstadt
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9789888208210
- eISBN:
- 9789888268436
- Item type:
- chapter
- Publisher:
- Hong Kong University Press
- DOI:
- 10.5790/hongkong/9789888208210.003.0002
- Subject:
- Economics and Finance, Public and Welfare
Hong Kong’s economic problems since 2000 are the official excuse for cuts in social spending. But the problems themselves are the outcome of deliberate choices made by Chief Executives and Financial ...
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Hong Kong’s economic problems since 2000 are the official excuse for cuts in social spending. But the problems themselves are the outcome of deliberate choices made by Chief Executives and Financial Secretaries. These decisions were not forced on the SAR government by business leaders, even though their main aim was to promote business interests regardless of the adverse consequences for ordinary families and for the needy and disabled individuals. These policies were a legacy from the colonial era and reflect a deeply-rooted culture shared by the business and professional classes as well as the civil service.Less
Hong Kong’s economic problems since 2000 are the official excuse for cuts in social spending. But the problems themselves are the outcome of deliberate choices made by Chief Executives and Financial Secretaries. These decisions were not forced on the SAR government by business leaders, even though their main aim was to promote business interests regardless of the adverse consequences for ordinary families and for the needy and disabled individuals. These policies were a legacy from the colonial era and reflect a deeply-rooted culture shared by the business and professional classes as well as the civil service.
Leo F. Goodstadt
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9789888208210
- eISBN:
- 9789888268436
- Item type:
- chapter
- Publisher:
- Hong Kong University Press
- DOI:
- 10.5790/hongkong/9789888208210.003.0003
- Subject:
- Economics and Finance, Public and Welfare
When a political system is as dominated by business interests as it is in Hong Kong and where social expenditure is not permitted to hinder the pursuit of profits, the credibility of both the policy ...
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When a political system is as dominated by business interests as it is in Hong Kong and where social expenditure is not permitted to hinder the pursuit of profits, the credibility of both the policy makers and their decisions must always be in danger. However, this chapter shows that the community does not judge the government and its merits by the social benefits which it provides. Income inequality does not provoke unrest, and the affluent do not arouse envy, however unfairly the workforce is rewarded for its sustained high productivity and its resilience. Incompetence is criticised, but is not politically fatal. The real test of Chief Executives and their ministers turns out to be mostly about their ethics.Less
When a political system is as dominated by business interests as it is in Hong Kong and where social expenditure is not permitted to hinder the pursuit of profits, the credibility of both the policy makers and their decisions must always be in danger. However, this chapter shows that the community does not judge the government and its merits by the social benefits which it provides. Income inequality does not provoke unrest, and the affluent do not arouse envy, however unfairly the workforce is rewarded for its sustained high productivity and its resilience. Incompetence is criticised, but is not politically fatal. The real test of Chief Executives and their ministers turns out to be mostly about their ethics.
Leo F. Goodstadt
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9789888208210
- eISBN:
- 9789888268436
- Item type:
- chapter
- Publisher:
- Hong Kong University Press
- DOI:
- 10.5790/hongkong/9789888208210.003.0004
- Subject:
- Economics and Finance, Public and Welfare
Housing is the single biggest factor in determining a family’s quality of life and is for most people their single biggest investment. Hong Kong housing standards have long been disgraceful. The SAR ...
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Housing is the single biggest factor in determining a family’s quality of life and is for most people their single biggest investment. Hong Kong housing standards have long been disgraceful. The SAR government has slashed public housing budgets, and the private sector has become increasingly unaffordable in this century. The current crisis is the predictable but preferred outcome of official policies. It can also be shown to be an unnecessary concession to the developers.Less
Housing is the single biggest factor in determining a family’s quality of life and is for most people their single biggest investment. Hong Kong housing standards have long been disgraceful. The SAR government has slashed public housing budgets, and the private sector has become increasingly unaffordable in this century. The current crisis is the predictable but preferred outcome of official policies. It can also be shown to be an unnecessary concession to the developers.
Leo F. Goodstadt
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9789888208210
- eISBN:
- 9789888268436
- Item type:
- chapter
- Publisher:
- Hong Kong University Press
- DOI:
- 10.5790/hongkong/9789888208210.003.0005
- Subject:
- Economics and Finance, Public and Welfare
Efforts to increase social expenditure by professionals in the health and welfare sectors were beleaguered by the financial and bureaucratic barriers erected by the colonial administration. The more ...
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Efforts to increase social expenditure by professionals in the health and welfare sectors were beleaguered by the financial and bureaucratic barriers erected by the colonial administration. The more generous funding allocated to health, education and welfare in the 1990s was too little to make up for earlier decades of under-spending. The future major social services were under serious threat as British rule was coming to an end. Opposition to social expenditure was gathering strength because of the growing prestige of the business model as the key to public sector efficiency. The social reforms had come so late in the colonial era that they were easily reversed.Less
Efforts to increase social expenditure by professionals in the health and welfare sectors were beleaguered by the financial and bureaucratic barriers erected by the colonial administration. The more generous funding allocated to health, education and welfare in the 1990s was too little to make up for earlier decades of under-spending. The future major social services were under serious threat as British rule was coming to an end. Opposition to social expenditure was gathering strength because of the growing prestige of the business model as the key to public sector efficiency. The social reforms had come so late in the colonial era that they were easily reversed.
Leo F. Goodstadt
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9789888208210
- eISBN:
- 9789888268436
- Item type:
- chapter
- Publisher:
- Hong Kong University Press
- DOI:
- 10.5790/hongkong/9789888208210.003.0006
- Subject:
- Economics and Finance, Public and Welfare
The chapter reviews a catalogue of policy decisions which aggravated rather than relieved the physical and mental distress of those least able to care for themselves. In both the health and the ...
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The chapter reviews a catalogue of policy decisions which aggravated rather than relieved the physical and mental distress of those least able to care for themselves. In both the health and the welfare fields, individuals and their families, suffered from mistreatment that ranged from uncaring to callous. The government-business nexus was convinced that social expenditure was a luxury that threatened even the world’s richest economies with ruin and which Hong Kong could not afford. Nevertheless, the poverty created by Hong Kong’s Third World legacy and the current shortfalls in social expenditure could not be dismissed indefinitely.Less
The chapter reviews a catalogue of policy decisions which aggravated rather than relieved the physical and mental distress of those least able to care for themselves. In both the health and the welfare fields, individuals and their families, suffered from mistreatment that ranged from uncaring to callous. The government-business nexus was convinced that social expenditure was a luxury that threatened even the world’s richest economies with ruin and which Hong Kong could not afford. Nevertheless, the poverty created by Hong Kong’s Third World legacy and the current shortfalls in social expenditure could not be dismissed indefinitely.
Leo F. Goodstadt
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9789888208210
- eISBN:
- 9789888268436
- Item type:
- chapter
- Publisher:
- Hong Kong University Press
- DOI:
- 10.5790/hongkong/9789888208210.003.0007
- Subject:
- Economics and Finance, Public and Welfare
Comprehensive Social Security Assistance (CSSA) is widely mistrusted by the community as a whole. Most of the opposition to social security is based on myths - that CSSA encourages workers to give up ...
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Comprehensive Social Security Assistance (CSSA) is widely mistrusted by the community as a whole. Most of the opposition to social security is based on myths - that CSSA encourages workers to give up their jobs - something shamelessly created by the government and business leaders and supported by respected academic opinion. The system is designed to be as unpleasant and demeaning as possible for applicants and their children. The two largest groups of beneficiary – the elderly and the unemployed - have no alternative to CSSA because of the government-business collaboration since 1967 to prevent or postpone the introduction of a universal scheme for retirement (the Mandatory Provident Fund) and unemployment (social insurance).Less
Comprehensive Social Security Assistance (CSSA) is widely mistrusted by the community as a whole. Most of the opposition to social security is based on myths - that CSSA encourages workers to give up their jobs - something shamelessly created by the government and business leaders and supported by respected academic opinion. The system is designed to be as unpleasant and demeaning as possible for applicants and their children. The two largest groups of beneficiary – the elderly and the unemployed - have no alternative to CSSA because of the government-business collaboration since 1967 to prevent or postpone the introduction of a universal scheme for retirement (the Mandatory Provident Fund) and unemployment (social insurance).
Leo F. Goodstadt
- Published in print:
- 2013
- Published Online:
- May 2014
- ISBN:
- 9789888208210
- eISBN:
- 9789888268436
- Item type:
- chapter
- Publisher:
- Hong Kong University Press
- DOI:
- 10.5790/hongkong/9789888208210.003.0008
- Subject:
- Economics and Finance, Public and Welfare
This chapter shows how the community came to give overriding priority to the preservation of Hong Kong’s unique combination of personal freedom, social stability and open and honest government, In ...
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This chapter shows how the community came to give overriding priority to the preservation of Hong Kong’s unique combination of personal freedom, social stability and open and honest government, In the process, the deprived, disadvantaged and disabled lost their traditional defenders, and the advocates of social reform declined in numbers and influence. Yet, there was still a collective conscience at work in Hong Kong, whose indignation at revelations of mistreatment of victims of life’s tragedies was usually prompt and politically too overwhelming for officials to ignore.Less
This chapter shows how the community came to give overriding priority to the preservation of Hong Kong’s unique combination of personal freedom, social stability and open and honest government, In the process, the deprived, disadvantaged and disabled lost their traditional defenders, and the advocates of social reform declined in numbers and influence. Yet, there was still a collective conscience at work in Hong Kong, whose indignation at revelations of mistreatment of victims of life’s tragedies was usually prompt and politically too overwhelming for officials to ignore.
Teun Zuiderent-Jerak
- Published in print:
- 2015
- Published Online:
- January 2016
- ISBN:
- 9780262029384
- eISBN:
- 9780262329439
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262029384.003.0005
- Subject:
- Sociology, Health, Illness, and Medicine
This chapter deals with possibilities for sociology in enacting emerging healthcare markets. Drawing on research on the development of situated standardization through process redesign in a national ...
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This chapter deals with possibilities for sociology in enacting emerging healthcare markets. Drawing on research on the development of situated standardization through process redesign in a national healthcare quality collaborative, it analyzes the possibilities for enacting healthcare markets as value- rather than cost-saving driven. Though this project was initially largely successful, sociological interventions in the construction of markets may prove more risky than some scholars in Social Studies of Markets suggest. These markets turned out to ‘work’ quite well despite the poor quality of the market devices that were to frame it as value-driven. Later on, when the quality of these devices improved, the market actually focused more on cost saving. Since many scholars who entered Social Studies of Markets from Actor-network theory, they have argued for the importance of market devices in framing values. This chapter shows the importance of sensitizing the sociological interventions to prevailing market regimes and market practices as ‘forms of the probable’ that are highly consequential for the acting space of social scientists in performing markets.Less
This chapter deals with possibilities for sociology in enacting emerging healthcare markets. Drawing on research on the development of situated standardization through process redesign in a national healthcare quality collaborative, it analyzes the possibilities for enacting healthcare markets as value- rather than cost-saving driven. Though this project was initially largely successful, sociological interventions in the construction of markets may prove more risky than some scholars in Social Studies of Markets suggest. These markets turned out to ‘work’ quite well despite the poor quality of the market devices that were to frame it as value-driven. Later on, when the quality of these devices improved, the market actually focused more on cost saving. Since many scholars who entered Social Studies of Markets from Actor-network theory, they have argued for the importance of market devices in framing values. This chapter shows the importance of sensitizing the sociological interventions to prevailing market regimes and market practices as ‘forms of the probable’ that are highly consequential for the acting space of social scientists in performing markets.
