DEVELOPMENTS IN THE PURCHASING PROCESS IN THE NHS: TOWARDS AN EXPLICIT POLITICS OF RATIONING?

The introduction of the internal market to the National Health Service in Britain marks a major change in the form of provision of health care interventions. This article reports the findings of independent research into the development of the purchasing process in eight purchasing authorities (which collectively purchase health care for 5 per cent of the population of Britain), and considers the extent to which this has led to an explicit politics of rationing in British health care. The structure and organization of purchasing organizations is described, along with their relationship with providers of health care. The ability of purchasing organizations to assess the health needs of the populations for which they purchase health care services, and their ability to influence change in the nature of the services provided, is also examined.     

LAW ENFORCEMENT IN A TIME OF COMMUNITY POLICING*

Community policing creates the expectation that oficers will become more selective in making arrests and that those decisions will be influenced more by extralegal considerations and less by legal ones. Data on 451 nontraffic police-suspect encounters were drawn from ridealong observations in Richmond, Virginia, where the police department was implementing community policing. The arrest/no arrest decision is regressed on variables representing legal and extralegal characteristics of the situation. Legal variables show much stronger effects than extralegal ones, but that depends upon the officer's attitude toward community policing. Supporters of community policing are, as predicted, more selective in making arrests and much less influenced by legal variables than are officers with negative views. However, pro-community-policing officers are like negative officers in the extent of influence exerted by extralegal factors. There are some differences between the two groups of officers on the strength and direction of effects of predictor variables taken individually, but only 1 of 17 is significant. Thus, in a time of community policing, officers who support it do manifest some arrest decision patterns distinguishable from those of colleagues who adhere to a more traditional view of law enforcement.     

The Next 40 Years Will Be the Most Important in History

The solidarity of the G‐20 nations in staving off global financial crisis two years ago has deteriorated into a brawl over currency valuations, trade imbalances and sovereign debt, reflecting the great powershift from the West to the East and the emerging economies. In this section, we invited comments from historians, a former head of state who successfully navigated the Asian financial crisis and a prominent Chinese dissident.