The rationing of care: Valuing public services is not, and should never be, an exercise in accountancy

A recent BMJ study showed that reducing cost through shedding or not replacing frontline nursing staff impacts negatively on the quality and safety of care which, in turn, is detrimental to not only on patient outcomes but also on the financial costs of the health and social care system. Chih Hoong Sin argues that the NHS needs to adopt a whole-system and outcomes-focused approach that illuminates the true costs of various services and staff, as well as the range of direct and indirect benefits

The politics of ethnic integration in Singapore: Malay 'regrouping' as an ideological construct

Research on ethnic residential patterns is overwhelmingly empiricist in focus. The discursive context surrounding the socio-spatial phenomenon needs to be acknowledged since it can have concrete impacts on the practice of urban social planning as well as the spatial behaviour of individuals and groups. Using Henri Lefebvre's insights into the production of social space, this article looks at how a dominant representation of space is constructed, with its implications for 'lived' spaces and the spatial practices which circumscribe them. The case of Singapore is examined, where the government has appropriated the discourse surrounding 'ethnic regrouping' in an attempt to legitimize the unpopular policy of ethnic quotas in public housing. Alleging that 'ethnic regrouping' had been taking place during the 1980s, this was portrayed as undesirable and contrary to the ideal of integration. The imposition of ethnic quotas was thus justified as necessary and appropriate. Systematic analysis using the index of dissimilarity, however, problematizes this representation of space. The rhetoric surrounding ethnic regrouping is revealed to be a means of social discipline whereby the government imposes a particular representation of space and seeks to manipulate the social landscape via technocratic means. Copyright Joint Editors and Blackwell Publishing Ltd 2003.

Economic assessment of a workplace cognitive behaviour therapy service

This article presents a pragmatic economic assessment of an innovative service providing cognitive behaviour therapy (CBT) in the workplace to employees who are experiencing stress, anxiety and depression. The economic assessment tool used was designed to enable front line practitioners to demonstrate the value of their service innovations. Presenting the value of providing a CBT service in the workplace in this way is arguably compelling. This case study serves to illustrate the potential that can be realised by augmenting the skillset of front line practitioners who already have the clinical and service know-how with the skills to demonstrate economic value. These practitioners are equipped to lead service transformation that is not only clinically effective, but economically sound