Taxation of Road Goods Vehicles – An Economic Assessment

This paper reviews the current position, recent research and potential future areas of research relating to road track costs, with particular reference to Heavy Goods Vehicles. It opens with a theoretical discussion, which concludes that the appropriate basis for changing is long run marginal social cost, but casts some doubt on whether the existing cost allocation procedure achieves this. The main reason for this is the likelihood that the marginal capital cost per unit of traffic of coping with an increase in traffic volumes greatly exceeds the average capital cost per unit of traffic at the present time. The DTp method of allocating track costs is then outlined, and the sensitivity of the results to variations in a number of the key assumptions is tested. The results show that the DTp method may only be allocating HGVfs as little as half of their costs. Hence instead of covering their allocated costs by some 30% to allow for environmental effects, as the DTp. claim, it may be that these lorries are only meeting 65% of their allocated cost. The sensitivity tests that yield the above results reflect the following concerns: (1) FUEL CONSUMPTION DTp measures lorry mileage and deduces fuel used and hence fuel tax paid. However, their fuel consumption figures look implausibly high. We have used FTA figures instead. (2) TRAFFIC FLOW DTp currently allocate many costs to vehicle kilometres (e.g. drainage, winter maintenance, traffic signs etc.), but accepts that the demand for a new road arises in proportion to PCUs (passenger car units), i.e. giving more weight to lorries. Our view is that once a road is opened any general costs involved in its continued use should also be allocated by PCUs. (3) LORRY WEIGHTS DTp use lorry weights as reported on a self completion questionnaire, which naturally omit any overloading. We have used observed values from a large study in Cheshire. (4) CAPITAL EXPENDITURE DTp charge only what is currently being spent. Following cutbacks in all government expenditure, this amount is now some 50% lower than in the early 1970s. Since capital expenditure was roughly 60% of total road expenditure, this implies that cost allocations have fallen by 30% on this account. Our view is that even this understates the true long run marginal cost of road traffic. Although the precise figures are subject to much doubt, in every case there seems good reason to suppose that the proposition is broadly correct. Taken cumulatively, they would be sufficient to convert the existing overpayment by HGVs (which presumably is intended to reflect unquantified environmental costs) into a substantial underpayment. If the increase in road haulage taxation which these figures would imply is politically unacceptable, then there is a good case for corresponding action to relieve the rail and water modes of part of their infrastructure costs

Analytical models to determine room requirements in outpatient clinics

Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room while patients visit for consultation, we call this the Patient-to-Doctor policy (PtD-policy). A different approach is the Doctor-to-Patient policy (DtP-policy), whereby the doctor travels between multiple consultation rooms, in which patients prepare for their consultation. In the latter approach, the doctor saves time by consulting fully prepared patients. We use a queueing theoretic and a discrete-event simulation approach to provide generic models that enable performance evaluations of the two policies for different parameter settings. These models can be used by managers of outpatient clinics to compare the two policies and choose a particular policy when redesigning the patient process.We use the models to analytically show that the DtP-policy is superior to the PtD-policy under the condition that the doctor’s travel time between rooms is lower than the patient’s preparation time. In addition, to calculate the required number of consultation rooms in the DtP-policy, we provide an expression for the fraction of consultations that are in immediate succession; or, in other words, the fraction of time the next patient is prepared and ready, immediately after a doctor finishes a consultation. We apply our methods for a range of distributions and parameters and to a case study in a medium-sized general hospital that inspired this research

Integrable Generalisations of the 2-dimensional Born Infeld Equation

The Born-Infeld equation in two dimensions is generalised to higher dimensions whilst retaining Lorentz Invariance and complete integrability. This generalisation retains homogeneity in second derivatives of the field.Comment: 11 pages, Latex, DTP/93/3

The Introduction of Diphtheria-Tetanus-Pertussis and Oral Polio Vaccine Among Young Infants in an Urban African Community:A Natural Experiment

Background: We examined the introduction of diphtheria-tetanus-pertussis (DTP) and oral polio vaccine (OPV) in an urban community in Guinea-Bissau in the early 1980s. Methods: The child population had been followed with 3-monthly nutritional weighing sessions since 1978. From June 1981 DTP and OPV were offered from 3 months of age at these sessions. Due to the 3-monthly intervals between sessions, the children were allocated by birthday in a ‘natural experiment’ to receive vaccinations early or late between 3 and 5 months of age. We included children who were <6 months of age when vaccinations started and children born until the end of December 1983. We compared mortality between 3 and 5 months of age of DTP-vaccinated and not-yet-DTP-vaccinated children in Cox proportional hazard models. Results: Among 3–5-month-old children, having received DTP (±OPV) was associated with a mortality hazard ratio (HR) of 5.00 (95% CI 1.53–16.3) compared with not-yet-DTP-vaccinated children. Differences in background factors did not explain the effect. The negative effect was particularly strong for children who had received DTP-only and no OPV (HR = 10.0 (2.61–38.6)). All-cause infant mortality after 3 months of age increased after the introduction of these vaccines (HR = 2.12 (1.07–4.19)). Conclusion: DTP was associated with increased mortality; OPV may modify the effect of DTP

Estimasi Pengaruh Vaksin DPT pada Kematian Anak: Analisis Diskritif Data Surveilan Demografi dan Kesehatan di Kabupaten Purworejo

Background: Recent controversial reports suggest that recipients of one dose of DTP vaccine have higher mortality than children who have received no DTP vaccine. Those reports were mainly derived from African countries where mortality and malnutrion were higher than Indonesia.Objectives: To describe specific and non-specific effects of DTP vaccination on child mortality age 1-24 months under routine vaccination program in Indonesia.Methods: During period of January 1 1995 to August 31, 2001 our longitudinal surveillance data at Purworejo district provided information on 5647 children below 24 months of age who received DTP and other vaccinations. The main outcome measure was all-cause mortality. Vaccination status on DTP, BCG, and measles were collected every 90 days and recorded its time at vaccination. Confounding factors associated with mortality were also collected. This first report used descriptive analysis and a survival curve (Kaplan-Meier) to examine the differential of mortality according to sex of the children and among vaccinated and non-vaccinated children with DTP, BCG, and measles vaccines. The second report will use survival analysis to estimate specific and non-sprecific effects of DTP by considering time at vaccination and other counfounding factors.Results: There is no sex differential of mortality among children in Purworejo. A probability of dying was lower in the children vaccinated with DTP vaccine compared with those not vaccinated DTP. Simmilarly, vaccinated children with BCG and measles have lower mortality compared to unvaccinated children. There is strong indication that BCG and measles have stronger protected effects to risk of dying than DTP.Conclusion: The study showed lower mortality among children who received DTP, BCG, and measles vaccines compared those unvaccinated. There were not enough evidences to change current vaccination policy because DTP was not associated with any harmful effect among girls

Brain damage following whooping cough vaccination : is it time to lay the myth to rest?

Whooping cough causes significant morbidity and mortality, especially in early infancy. Although an effective vaccine exists, vaccine uptake in Malta was previously disappointing due to the general public’s and the medical community’s doubts regarding vaccine efficacy and safety. The aim of this study was to review population-based studies which have analysed the potential short and long term neurological sequelae following pertussis and pertussis vaccination, to describe vaccine uptake globally and in Malta over the past 15 years, and to analyse the effect of vaccine uptake on pertussis epidemics in Malta. This study found that pertussis vaccine uptake has only become satisfactory in recent years, with a resulting attenuation in the most recent pertussis outbreak. Uptake has increased progressively all over the world, and no study has ever incriminated pertussis vaccination as a cause of permanent neurological disability, both locally and abroad. This should encourage the present continuing trend of pertussis uptake.peer-reviewe