"Fiscal Policy in a Monetary Union: The Case of Ireland"

qec

Options for finance in primary care in Australia

A number of policy initiatives aimed at reform of primary health care financing are currently either being debated nationally, or trialled in different jurisdictions. Commonwealth Government austerity and an interest from a wide range of stakeholders to mobilise capital from different parts of the economy have provided an incentive to explore new finance policy options for primary health care. However, recent reviews of primary health care finance have focused on contrasting the different payment systems, rather than the financing of primary health care in a more systemic sense. Finance is more than just an approach to payment, reflecting the flows of capital that structure service. Debates centred on payment systems (such as fee-for-service, salaries, capitation, pay for performance and activity–based funding) tend to eclipse the conceptual underpinnings of primary health care finance. This issues brief explores policy options that move beyond payment systems. It approaches primary health care from a deeper perspective with a focus on how to link objectives to outcomes through different financing approaches. For example, the separation of primary health care payment systems (mostly fee for service) from hospital payment systems (activity-based funding) creates numerous boundaries between parts of the sector. Although different payment systems separate health care into discrete segments, the lived reality for many people managing their health care is that they need to move across these fragmented elements of the system, with little overall sense of outcome. This issues brief will identify ways to consider primary health care finance policy options, by focusing on the objectives of different financing systems, how they connect to financial tools (such as impact investing), with a focus on health outcomes. It aims to broaden and deepen debate about primary health care finance. It is anticipated that the issues brief will also be a starting point for a structured debate through policy engagement events between policy makers, academics and practitioners about new models of finance for primary health

“Just do it” – making and measuring social impact

This lecture examines the pressure on philanthropic organisations to provide quantifiable short-term impact measurements.It is often said of private donors and non-profit actors that social impact is not something they set out to measure –– it’s something they set out to make. Along the way to making a difference, social investors often face questions about the alignment between their activities, missions and strategies, about the progress of the work that is funded through investments and grants, about possible course adjustments, and perhaps taking advantage of emergent opportunities. And of course all need to report to stakeholders and the public. So they inevitably end up monitoring, measuring, and evaluating programs and projects simply to generate the impact they want to make. For private donors and non-profit actors, measuring impact is not an end in itself. That said, when tailored to a purpose and demonstrably benefitting the communities we seek to serve, monitoring and evaluation and learning can play a crucially important part in effective philanthropy and social investment.There are many good reasons for measuring and evaluating social outcomes and impact, each calling for a distinctive approach and possibly for different measurement tools. In a start-up social enterprise, for example, the chief aim could be to develop a viable business plan ensuring the growth and survival of the enterprise by monitoring costs, income, benefits, and outcomes. For a large mature organization, a robust impact measurement system could provide a helpful management tool for aligning activities with mission and strategy, and guiding internal resource allocations to the best intermediate users. For other organizations, it could serve chiefly as a learning tool, helping to improve practice by adjusting methods and activities to take full account of the lessons coming out of measurement. For others again, it could help to flesh out communications strategies by identifying the success stories that boards and the public appreciate.The least good reason for measuring social impact is to meet the expectations of donors and funding agencies. And yet, in Australia, the strongest incentive for measuring social impact among service organizations today appears to be a perceived need to meet increasingly shrill demands from funding agencies and donors for quantifiable impact measurements as a condition of further funding. To complicate matters, in fields of community engagement where cooperation among service providers is a precondition for enduring social impact, funders’ demands for impact measurement stimulate competition among providers to beggar their neighbours.Non-profit service providers are under pressure to demonstrate their impact from several quarters including public pressure for greater accountability, government fiscal pressures to “squeeze more out of existing dollars,” and new pressures from the new social finance market to show social returns on investments

European Works Councils on the Periphery? A Case Study of a 'Global Economic Outpost'

European Works Councils (EWCs) are now an established part of industrial relations structures in approaching 600 multinational companies with potentially 10,000 or more employee participants(EIRR 2000). They have become the object of considerable expectation as, variously, vehicles for the development of a European industrial relations system, corporate communication networks or the basis for international trade union solidarity. They are equally the focus of wide ranging academic speculation, case study analysis and survey research. The empirical data that has been generated has served to support the development of a series of ‘models’ of EWCs that are commonly related to the initial expectations to their role