Evaluating Health Care Reform: the Case of the NHS Internal Market

The NHS internal market, introduced in an atmosphere of controversy, continues to generate much disagreement. This article examines the evidence on the impact of this policy with regard to a range of criteria, including efficiency, accountability, effective planning and co-ordination, patient choice and service quality, equity, and the culture of the NHS. It explores the different ways in which this evidence is perceived and seeks to make explicit the assumptions and biases of those involved in the debate about the reforms. The article also examines the policy process behind the reforms and the extent to which it has added to the problems of evaluation. By way of conclusion, the implications for future health care reform are considered and a number of procedural changes suggested.     

Interactions between scientists and public officials: A comparison of the use of science in regulatory programs in the United States and West Germany

This essay compares and contrasts important attributes of the use of scientific knowledge and judgment in regulatory decisions in the United States and West Germany. It decribes the broader historical context for such decisions in each country. Although the system in America exhibits considerable conflict and assumption of adversarial positions, it is argued that a more fundamental attribute of the system is that policy decisions are reviewed according to rules of evidence and its interpretation. Similarly, although the German system involves a great deal of consultation, a more fundamental aspect of policy decisions there is that of the determination of the social obligation to act. In the United States, it is more important that a decisionmaker has properly developed and interpreted the evidence than that he or she has consulted with all the relevant parties. In Germany, the order of importance of the two is reversed.Based on seminars given in Berlin in December 1984 at the International Institute for Environment and Society of the Science Center Berlin and in Washington, DC in January 1985 at the National Research Council of the National Academy of Sciences.The author, a National Research Council Fellow, wishes to thank his colleagues in Berlin and Washington for their comments, many of which have been integrated into this essay. The ideas presented here, however, remain the responsibility of the author.     

Area characteristics and regional variates as determinants of area property crime levels

This article seeks to examine the area characteristics that act as determinants of area property crime levels, namely, incidence and prevalence. The crime figures are extracted from the 1984 British Crime Survey. Area characteristics are taken from the 1981 UK census. Initial exploratory analysis considers the non-Gaussian nature of the crime data, the statistical implications of this, and the transformations used to overcome these problems. In addition, possible regional and inner-city/non-inner-city variations are considered. The later stages move from simple individual correlations to multiple regression models. Three regression models are considered and the reasons for refining these are explored, with the results indicating that both area characteristics and regional influences play a role as determinants of the area crime level. In particular, population density and the area population age profile have significant roles to play. The conclusions support the recent revival of the application of ecological concepts in the analysis of crime levels.     

What sort of future for critical criminology?

This article argues for a criticalcriminology that is more mindful of the growing number ofcritiques of its general epistemologicaldirection. Specifically, such criticismtakes issue with the continued emphasis incritical criminology on crime and penalty,often to the detriment of a moreencompassing focus on issues associatedwith ``social harm'. In an attempt tohighlight the current weaknesses ofcritical criminology attention is drawn toa small although revealing conference thattook place at the University of WesternSydney in February 2001. In contrast to thenarrow concerns demonstrated at thisconference the article calls for a moreexpansive approach to the study of crimeand penalty that falls under thezemiological umbrella of social harm andwhich takes account of social movements andother disciplines that have givenrecognition to the question of humanrights. Such a call derives from StanCohen's evocation of the ``voracious Gods'that must be sated if a progressive andrelevant critical criminology is to bedeveloped in an era of rapid socio-economicand political transformation.     

Parliamentary Question Times: How Legislative Accountability Mechanisms Affect Mass Political Engagement

Over time, people have been losing interest in politics. Some believe this to be one of the largest challenges facing democracy today. What causes some citizens to be more engaged than others? This paper argues that national-level political institutions are important in shaping the tone of political debate between election campaigns. Some countries have regular, accessible debates between political leaders; in others the debate is rarer and harder to follow. Parliamentary question time (QT) is a prominent forum for regular elite-level debate, and QTs featuring open, accessible debate should help induce citizens to engage with politics by providing them with an information-laden political spectacle. The data show that these open QTs are associated with higher levels of political knowledge, partisanship, and turnout.     

Objective Evaluation of Subclass Characteristics on Breech Face Marks

Subclass characteristics can be found on the breech face marks left on spent cartridge cases. Even if they are assumed to be rare and their reported number is small, they can potentially lead to false associations. Subclass characteristics have been studied empirically allowing examiners to recognize them and to understand in which conditions they are produced. Until now, however, their influence on the identification process has not been studied from a probabilistic point of view. In this study, we aim at measuring the effect of these features on the strength of association derived from examinations involving subclass characteristics. The study takes advantage of a 3D automatic comparison system allowing the calculation of likelihood ratios (LRs). The similarities between cartridge case specimens fired by thirteen S&W .40S&W Sigma pistols are quantified, and their respective LRs are computed. The results show that the influence of subclass characteristics on the LRs is limited, even when these features are prevalent among the potential sources considered in a case. We show that the proportion of firearms sharing subclass characteristics should be larger than 40% of the pool of potential firearms for the effect to be significant.     

Driving racial profiling research forward: Learning lessons from sentencing research

Discretion is an integral component of the criminal justice system and is exercised by both police and the judiciary. Based on the extant research, evidence of racial/ethnic disparities within the context of traffic stops and sentencing decisions has been documented. Due to its long history of inquiry, sentencing research has developed a more thorough understanding of disparity and its correlates. This article contends that racial profiling research could expedite its development by learning from the history of sentencing research. Specifically, the extant research on sentencing decisions has demonstrated the value and utility of theory and methods as pillars of knowledge development. Therefore, progress in racial profiling research is most likely accomplished by employing similar theoretical frameworks and appropriate quantitative and qualitative approaches.