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.     

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.     

POLICY TRANSFER IN PRACTICE: IMPLEMENTING SUPPLIER DIVERSITY IN THE UK

This article draws on the policy transfer literature to examine a UK‐based initiative to promote supplier diversity and provides insights into three areas neglected in current research, namely: the dynamics of non‐governmental policy transfer; the factors that mediate policy transfer in different jurisdictions; and the integration of research and practice in small business related policy transfer. To this end, an innovative action research approach is deployed with the dual purpose of effecting practical change and advancing knowledge. This comprises two phases: first, a realist analysis of the US National Minority Supplier Development Council (NMSDC), an exemplar intermediary; and second, the implementation and concurrent realist evaluation of a supplier diversity initiative modelled on NMSDC, referred to as ‘Supplier Development East Midlands’ (SDEM). The findings provide lessons for academics and practitioners dealing with small and medium‐sized enterprise (SME) policy transfer in general and supplier diversity intermediaries in particular.     

MAKING THE CORE CONTINGENT: PROFESSIONAL AGENCY WORK AND ITS CONSEQUENCES IN UK SOCIAL SERVICES

In recent times, the UK has witnessed a steady growth in the use of agency workers to fill core professional roles in public sector organizations. Similar trends have been noted elsewhere, particularly in Australia and the US. In this paper our objective is to explore some of the consequences of this growth, drawing on case study research on social services. We point to a number of problems associated with the management of agency workers and to the potentially negative consequences for the quality of services. These problems, in turn, may impact on key aspects of a (largely functional) public service employment model founded on strong internal labour markets, employment stability and collegial ethos. We also note that while there are ways in which public organizations can manage this situation, certain constraints may prevent them from doing so.     

The J Curve

Globalization may yet repeal the Biblical adage that the poor will always be with us. But for now there are enough losers to go along with the winners that a slide back toward fragmentation and protectionism is a distinct possibility, as was also the case at the turn of the 20th century. Our contributors in this section offer their advice on how to make globalization work for everyone.