The restructuring and privatisation of British Rail: Was it really that bad?

This paper uses a social cost-benefit analysis (SCBA) framework to assess whether rail privatisation in Britain has produced savings in operating costs. The paper shows that major efficiencies have been achieved, consumers have benefited through lower prices, whilst the increased government subsidy has been largely recouped through privatisation proceeds. We also find that output quality is no lower (and is probably better) than under the counterfactual scenario of public ownership (pre-Hatfield). The achievement of further savings is key to delivering improved rail services in the future. This paper finds that a privatised structure, where shareholders demand a return on their investment, has led to significant improvements in operating efficiency - it remains to be seen whether the new regime, with a not-for-profit infrastructure owner, will deliver the same efficiency improvements

Patient safety in acute care: are we going around in circles?

This article provides a critical discussion examining why adult patients continue to unnecessarily deteriorate and die despite repeated healthcare policy initiatives. After considering the policy background and reviewing current trends in the data, it proposes some solutions that, if enacted, would, the authors believe, have a direct impact on survival rates. Health professionals working in hospitals are failing to recognise signs of physiological deterioration. As a result, adult patients are dying unnecessarily, estimated to be in the region of 1000 a month. This is despite international healthcare policy requiring practitioners to be appropriately trained to recognise the deteriorating adult patient and to intervene. A literature review centred on health policy for England from 1999 to 2015 was undertaken, with reference to international policy and practice. This article also draws on the authors' combined clinical experience, which is underpinned by relevant research and theory. The implications for nursing could be significant. Change is urgently required otherwise people will continue to die unnecessarily. Health professionals, healthcare organisations and international governments working together can prevent unnecessary deaths from happening within acute hospitals

Fiscal decentralisation and local government efficiency: Does relative deprivation matter?

Fiscal decentralisation arguably improves government efficiency because it enhances responsiveness to local policy issues and incentivises fiscal discipline. However, critics suggest that central control over local spending is necessary to equalise fiscal outcomes between prosperous and deprived areas. Using a two-stage analysis, we investigate the validity of these arguments by analysing the separate and combined effects of fiscal decentralisation and socio-economic deprivation on the productive efficiency of English local governments during 2002?2008. The results suggest that decentralisation is positively related to productive efficiency and that there is a negative relationship between socio-economic deprivation and efficiency. Further analysis reveals that deprivation weakens the positive decentralisation-efficiency relationship, calling into question simplistic proposals for fiscal decentralisation

Building the next model for intervention and turnaround in poorly performing local authorities in England

This paper examines the design and implementation of the two recent models or strategies adopted for the intervention and turnaround of poorly performing local authorities in England in the two distinct periods of 2002–2008 and 2011–2015. The first was integral to the Comprehensive Performance Management regimes, while the second was developed under the Sector Led Improvement regime. The intention is not to determine which regime has, or had, the most merit or inadequacies, but rather to synthesise knowledge and identify areas that could be improved as policy and practice moves forward, particularly in the light of the recent general election in the UK. The paper finds that both models have merits as well as weaknesses, dependent upon context and policy priorities. It provides a review of when and where alternative models should be used, and a contribution to the development of the next regime. This, the authors contend, should have a greater emphasis on achieving more appropriate levels of public assurance than the current model is providing

The performance of local authority sports facilities in England during a period of recession and austerity

This paper examines how public sport facilities in England, which are dependent on subsidy from local authorities, have performed during a period of recession and austerity. Using data derived from Sport England's National Benchmarking Service (NBS), we track the changes in a series of key operational performance measures to investigate how local authority sports centres have fared between 2005/06 and 2015/16. Four dimensions of performance are analysed, namely: access; finance; utilisation; and, customer satisfaction. The study includes 1,116 sports centres in the time frame under review. Our results show that the overall financial efficiency of English public sport facilities has improved significantly in the face of a reduction in local authority expenditure on sport and leisure services. There appears to be a business model in the sector that includes outsourcing management and raising activity charges, which has been accompanied by higher levels of customer satisfaction with price-related service attributes and with the overall experience of using a facility. A possible explanation for these findings might be an improved quality of provision and greater customer orientation. At the same time, there appears to be a diminished focus on social inclusion objectives. We therefore conclude that promoting access to public sport facilities for hard-to-reach or disadvantaged groups has been compromised in exchange for the pursuit of financial stability. A key challenge is how to achieve market development whereby new and targeted customers are attracted to these existing facilities