Water alternatives—who and what influences public acceptance?

• Water supports life, society, the environment and the economy, therefore, the task of ensuring a nation's water supply is one of the most fundamental responsibilities of every government. Water management has become a greater challenge due to the increased demand for water as a result of population growth and the impact of climate change on the variability of rainfall. In response, many cities have implemented plans to augment their traditional water supplies (e.g. dams and groundwater) with new or alternative sources (e.g. recycled wastewater and desalinated sea water). Historical evidence suggests that in order for water augmentation projects to be successfully implemented, the support of the general public is required. It is thus critical to understand the factors which influence people's attitudes regarding water‐related matters. The aim of this study is to identify these influencing factors. Results from an empirical study including both qualitative and quantitative components indicate that a number of factors are influential in the public's acceptance of alternative water sources, including research findings, the experience of water shortage, consideration for future generations and news, facts and other publicized information. Notably, politicians and the government were rated by respondents as having a low level of influence. Factors which may determine differences in influence were explored. This revealed a small number of differences for people with low acceptance levels of recycled and desalinated water, and for people with higher levels of education. Systematic differences were identified by comparing the general Australian population with that of Toowoomba, a regional town in Queensland where a referendum on a water recycling project was held. Policy implications are discussed.

Copyright © 2010 John Wiley & Sons, Ltd.     

A shrinking state? Politics,economics and private health care in Thailand

This article explores the political and economic forces involved in the development of privatization policies within the health care sector in Thailand. It is suggested that many of the motivating factors behind private sector growth are outside of the health sector; the general macroeconomic environment and tax incentives have stimulated private sector expansion. Within the Ministry of Public Health a preoccupation with improving care in rural areas and an unclear policy line on the private sector has facilitated this expansion. Only recently has private sector growth come to the policy agenda. During this lag period a number of interest groups have developed. It will be difficult to overcome these entrenched interests in order to change policy direction. Meanwhile, problems of rapid cost inflation and inequity face the Thai health care system. Although this case study focuses upon the health care sector in Thailand it would appear relevant both to other sectors and to other countries. The relationship between development models based upon pro-private, pro-market tenets and the establishment of a satisfactory social policy is questioned.     

A dose of reality: assessing the Federal Trade Commission/Department of Justice report in an uninsured, underserved, and vulnerable population context

Despite the size of their report, the Federal Trade Commission and Department of Justice pay virtually no attention to tens of millions of uninsured and underinsured persons. By focusing on an increasingly rarified group of health care customers--healthy, affluent, and highly insured--the report takes on an untethered quality, with only the slightest tip of the hat to its own limitations. Furthermore, the report overstates the extent of legal constraints on the market, in particular, the degree to which the market is free to select its customers and tailor its goods and services to the best risks. By miscasting the legal context of the American health care system, the report ultimately undermines much of its potential value.     

A Leap of Faith? Sanctioning Xenotransplant Clinical Trials

Introducing a new medical technique, procedure or drug to the public via clinical trials is risky at the best of times. When the trial involves a biotechnology which holds out the promise of prolonging, if not saving, life the push to move from the laboratory to clinical trials may be hard to resist. In this article I explore whether the regulatory scheme for clinical trials in the UK is able to accommodate developing technologies by considering how the current legal and ethical frameworks determine when a procedure such as xenotransplantation should proceed to trials. In particular, I discuss whether basing our regulatory schemes on the principles espoused in the Declaration of Helsinki offer sufficient protection to those who may be affected by xenotransplant trials – the recipient, their health-care workers, close contacts and, unusually, the wider public. I question whether it is possible for a technology to be approved for clinical trials when allowing such trials may benefit the individual but ultimately negatively impact on society as a whole.