Localism in the NHS Quasi-Market

1998 ◽  
Vol 16 (4) ◽  
pp. 449-462 ◽  
Author(s):  
M Exworthy
Keyword(s):  
National Health Service ◽  
Social Relations ◽  
Paradigm Shift ◽  
Risk Sharing ◽  
Local Area ◽  
Local Health ◽  
Market Mechanisms ◽  
Health Authorities ◽  
The Social ◽  
Local Actors

The organisation of the British National Health Service (NHS) has been hierarchical and based on defined geographical areas [for example, health authorities (HAs)]. These areas have formed the basis of local health systems in which the social relations between individuals and agencies were contained within the territorial boundaries of the respective organisation and thereby engendered, in most eases, a degree of trust and cooperation. The introduction of quasi-market mechanisms in the NHS in 1991 inferred that the social relations between local actors were not essential and hence transactions could be independent of them. Economic transactions need not therefore be confined to the local area. However, social relations have continued in various forms since the quasi-market was implemented as manifested through, inter alia, the persistence of localism in the market. Localism is evident, for example, in HA expenditure, which remains highly skewed towards local providers and, it is argued here, is a function of social relations between purchaser and providers. Localism and the social relations associated with it exemplify the relational nature of the quasi-market, which has shown signs of moves towards longer term contracts, risk-sharing and cooperation (rather than competition). Thus, by noting the persistence of localism and social relations, the author suggests that the quasi-market has yet to evince the paradigm shift intended by the 1991 reforms.

Grabbing “Green”: Markets, Environmental Governance and the Materialization of Natural Capital

2013 ◽  
Vol 6 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Catherine Corson ◽  
Kenneth Iain MacDonald ◽  
Benjamin Neimark
Keyword(s):  
Social Relations ◽  
Capital Accumulation ◽  
Environmental Governance ◽  
Natural Capital ◽  
Forest Degradation ◽  
Green Economy ◽  
Market Mechanisms ◽  
Theoretical Perspectives ◽  
The Social ◽  
Empirical Material

Over the past two decades, the incorporation of market logics into environment and conservation policy has led to a reconceptualization of “nature.” Resulting constructs like ecosystem services and biodiversity derivatives, as well as finance mechanisms like Reducing Emissions from Deforestation and Forest Degradation, species banking, and carbon trading, offer new avenues for accumulation and set the context for new enclosures. As these practices have become more apparent, geographers have been at the forefront of interdisciplinary research that has highlighted the effects of “green grabs”—in which “green credentials” are used to justify expropriation of land and resources—in specific locales. While case studies have begun to reveal the social and ecological marginalization associated with green grabs and the implementation of market mechanisms in particular sites, less attention has been paid to the systemic dimensions and “logics” mobilizing these projects. Yet, the emergence of these constructs reflects a larger transformation in international environmental governance—one in which the discourse of global ecology has accommodated an ontology of natural capital, culminating in the production of what is taking shape as “The Green Economy.” The Green Economy is not a natural or coincidental development, but is contingent upon, and coordinated by, actors drawn together around familiar and emergent institutions of environmental governance. Indeed, the terrain for green grabbing is increasingly cultivated through relationships among international environmental policy institutions, organizations, activists, academics, and transnational capitalist and managerial classes. This special issue of Human Geography brings together papers that draw on a range of theoretical perspectives to investigate the systemic dimensions and logics mobilizing green grabs and the creation of new market mechanisms. In inverting the title – “grabbing green” instead of the more conventional green grabs – we explore how “the environment” is being used instrumentally by various actors to extend the potential for capital accumulation under the auspices of “being green.” Using a diversity of empirical material that spans local to global scales, the papers reveal the formation of the social relations and metrics that markets require to function. They identify the “frictions” that inhibit the production of these social relations, and they link particular cases to the scalar configurations of power that mobilize and give them shape.

scholarly journals Make development great again? Accumulation regimes, spaces of sovereign exception and the elite development paradigm of China's Belt and Road Initiative

2019 ◽  
Vol 21 (4) ◽  
pp. 487-513 ◽  
Author(s):  
Ruben Gonzalez-Vicente
Keyword(s):  
Social Relations ◽  
Belt And Road Initiative ◽  
Social Foundations ◽  
The Social ◽  
Public Resources ◽  
Uneven And Combined Development ◽  
Local Actors ◽  
Belt And Road ◽  
Development Paradigm ◽  
Do So

AbstractThis article studies what I describe as “state-coordinated investment partnerships,” an investment modality central to the deployment of China's Belt and Road Initiative (BRI). These partnerships bring together state and business actors to export overcapacity and address infrastructural demands in underdeveloped markets. To do so, they require accumulation and sovereignty regimes that mirror, in contingent ways, similar social arrangements within China. The superposition of such regimes and the interests and social imaginaries of local actors produces forms of uneven and combined development and shapes the contours of the BRI's emerging developmental and geoeconomic footprints. The BRI exports also an elite development paradigm which promotes urbanization, connectivity and economic growth over participatory approaches. This paradigm projects a depoliticized version of China's present into the BRI's future to justify social and environmental dislocations, and shields Chinese firms from civil society scrutiny. My analysis rejects this elite perspective and favors a labor-centric approach that unearths the social foundations of the BRI. From this perspective, despite relevant differences in format, the BRI's quintessential investment modality is closely aligned to a contemporary global current of public-private partnerships endeavored to mobilize public resources and state power for the expansion of capitalist social relations.

Experiences of Women Refused National Health Service Abortion

1980 ◽  
Vol 12 (2) ◽  
pp. 201-210 ◽  
Author(s):  
John R. Ashton
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
First Trimester ◽  
Misleading Information ◽  
Health Authorities ◽  
The Social ◽  
Medical Consultations ◽  
Almost All ◽  
Experiences Of Women

SummaryOut of 197 Wessex women undergoing a legal abortion at the British Pregnancy Advisory Service (BPAS) clinic at Brighton, 31 (15·7%) had already been refused a termination of pregnancy by at least one National Health Service doctor in Wessex. Almost all of these pregnancies were terminated for reasons covered by the social clause of the 1967 Abortion Act.The principal reasons given for refusal of termination were that the women had insufficient grounds for termination under the Abortion Act, or that they were too late. Some were given misleading information. Refusal of an operation may have led to one woman having a second trimester rather a first trimester procedure when she went to BPAS. Some of these patients reported medical consultations which they had found to be upsetting or hurtful. It is suggested that the interests both of women seeking abortion and of doctors opposed to abortion would be best served if the Health Authorities were to provide alternative referral pathways to special abortion facilities.

We do not Live in an Age of Cosmopolitanism but in an Age of Cosmopolitisation: The ‘Global Other’ is in Our Midst

2011 ◽  
Vol 19 (1) ◽  
pp. 16-34 ◽  
Author(s):  
Ulrich Beck
Keyword(s):  
Social Sciences ◽  
Political Theory ◽  
Social Relations ◽  
Paradigm Shift ◽  
Social Inequalities ◽  
State Of The Art ◽  
Risk Society ◽  
Methodological Nationalism ◽  
Current State ◽  
The Social

As against the current state of the art, this article argues for a cosmopolitan vision in the social sciences and, more specifically, for a cosmopolitan turn in social and political theory and research. A critique of the prevailing methodological nationalism leads to a presentation of an agenda for researching really existing cosmopolitisation. The proposed paradigm shift is illustrated by graphic examples of drastically altered social relations and social inequalities drawn from around the globe, and its urgency is underscored by an analysis of the political dynamics and transformations characteristic of the world risk society. The development of a cosmopolitan vision in the social sciences demands not simply the token adoption of methodological cosmopolitanism, but the painful excision of deep-seated Western and Eurocentric biases.

Critical analysis of attempts to recognize an occupational disease as a non-insured event on the basis of the peculiarities of the disease investigation procedure

2019 ◽  
pp. 1020-1024 ◽  
Author(s):  
I. V. Boiko ◽  
O. N. Andreenko
Keyword(s):  
Occupational Disease ◽  
Occupational Diseases ◽  
Social Insurance ◽  
Insurance Fund ◽  
Local Health ◽  
Medical Organization ◽  
Normative Documents ◽  
Health Authorities ◽  
Social Insurance Fund ◽  
The Social

The current legislation clearly declares the guarantee of insurance compensation to the employee in connection with the diagnosis of occupational disease. Meanwhile, in recent years there have been precedents of recognition by the Social Insurance Fund of established cases of occupational diseases not insured in connection with claims to the correctness of the procedure of their investigation.The article analyzes court cases in which patients with an established diagnosis of occupational disease challenged the refusal of the insurer (Social Insurance Fund) in the appointment of insurance payments, motivated by a reference to violations of the established procedure for the investigation of occupational diseases.The insurer motivated its refusal to assign insurance payments to patients with the following arguments:— appeals of the patient to doctors at the time of establishment of the preliminary diagnosis of occupational disease were not entered in registers of rendering medical services;— sanitary and hygienic characteristics of working conditions of the patient was not based on proper documents;— examination of the connection of the disease with the profession was carried out on the personal application of the patient without registration of the direction from the medical organization;— examination of the connection of the disease with the profession was carried out in the Department of professional pathology of a medical organization that is not a vocational center;— the staff of the Department of professional pathology did not meet the requirements of normative documents;— violation of rules of registration of the notice on establishment of the fi nal diagnosis of chronic occupational disease is allowed;— the representative of the Social Insurance Fund was not included in the commission that drew up the act on the case of occupational disease.In the vast majority of cases, the violations, if any, were of the nature of technical errors and did not affect the essence of the expert opinion on the existence of a connection between the disease and the profession. In such a situation, the categorical refusal to appoint insurance payments to the patient seems unreasonable. Th e claims of the Social Insurance Fund, with a constructive approach, could be settled without a court by contacting the insurer to medical organizations and health authorities. It is necessary to correct the regulations on compulsory insurance against accidents at work and occupational diseases. Th e rules of law should not allow categorical refusal in the appointment of insurance payments to the patient, whose diagnosis of occupational disease, which led to a decrease in working capacity, is established on the merits correctly. Claims of the insurer to the procedure of investigation of a case of occupational disease are most rationally considered in the pre-trial procedure within the framework of the dialogue of the Social Insurance Fund with local health authorities.

Negotiating Global, Regional, and National Forces: Foreign Investment in Slovenia

2004 ◽  
Vol 18 (3) ◽  
pp. 455-480 ◽  
Author(s):  
Nina Bandelj
Keyword(s):  
European Union ◽  
Social Relations ◽  
Foreign Investment ◽  
Organizational Level ◽  
Parliamentary Debates ◽  
Economic Practice ◽  
The Social ◽  
Local Actors ◽  
Regional Associations ◽  
Global And Local

The article examines foreign investment in Slovenia to study the interplay between global investment flows, pressures from regional associations, and national protectionist efforts and resistance to foreign ownership. Using content analysis of policies and parliamentary debates, the author investigates how the newly established Slovenian state institutionalizes its attitudes toward the participation of foreigners in the national economy in the official policies adopted to regulate foreign investment. With case studies of foreign investment transactions, the author illustrates how foreign investment occurs in practice. The author finds that the Slovenian state officials negotiate the domestic and European Union pressures by sanctioning the decoupling between formal policies and economic practice. At the organizational level, economic actors involved in transactions negotiate the global and local interests by exploiting institutional nontransparency and differentiating between transaction partners on the basis of preexistent social relations and cultural affinities. Paying attention to the intersection between global, regional, and national forces, this study uncovers the social, cultural, and political bases of economic processes and the agency of local actors in responding to global and regional pressures.

Cultural practices and rough sociality in Mexico’s midsize cities: Tijuana, Puebla and Monterrey

Urban Studies ◽  
2021 ◽  
pp. 004209802110265
Author(s):  
Leandro Rodriguez-Medina ◽  
María Emilia Ismael Simental ◽  
Alberto Javier López Cuenca ◽  
Anne Kristiina Kurjenoja
Keyword(s):  
Public Space ◽  
Social Relations ◽  
Social Order ◽  
Cultural Policy ◽  
Cultural Practices ◽  
Cultural Work ◽  
Social Fabric ◽  
The Social ◽  
Local Actors ◽  
Knowledge Economies

It is frequently claimed that cultural agents are necessary to sustain and strengthen the social fabric, to guarantee economic growth and social development and to consolidate knowledge economies based on innovation. These arguments tend to avoid inquiring what kind of sociality these cultural actors are enacting. To address this point, we researched three Mexican midsize cities: Puebla, Tijuana, and Monterrey, between 1984 and 2017. Sociality produced by cultural dynamics, sponsored either by the public (cultural policy) or the private sector (cultural market), is generally characterised by a focus on social order, the construction of local identity, a hygienic view of public space and disempowerment of local actors. Differing from these views, our research has found a new form of sociality that we call ‘rough sociality’, produced by cultural agents from civil society. This sociality is conflictive, ephemeral, spatially bounded and affective, which has implications not only for the cultural work but, most importantly, for the social relations and the being/doing-togetherness that such work may enact and reproduce.

The SRM Approach to Family Assessment

2005 ◽  
Vol 21 (4) ◽  
pp. 216-225 ◽  
Author(s):  
William L. Cook
Keyword(s):  
High Risk ◽  
Risk Behaviors ◽  
Social Relations ◽  
Family Relationships ◽  
Family Dynamics ◽  
Family Assessment ◽  
High Risk Behaviors ◽  
Analysis Group ◽  
The Social ◽  
Direction Of Effects

Abstract. In family systems, it is possible for one to put oneself at risk by eliciting aversive, high-risk behaviors from others ( Cook, Kenny, & Goldstein, 1991 ). Consequently, it is desirable that family assessments should clarify the direction of effects when evaluating family dynamics. In this paper a new method of family assessment will be presented that identifies bidirectional influence processes in family relationships. Based on the Social Relations Model (SRM: Kenny & La Voie, 1984 ), the SRM Family Assessment provides information about the give and take of family dynamics at three levels of analysis: group, individual, and dyad. The method will be briefly illustrated by the assessment of a family from the PIER Program, a randomized clinical trial of an intervention to prevent the onset of psychosis in high-risk young people.

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