Changing Midwifery: Working Conditions and the Quality of Care

Maternity units have been expected to achieve, within constrained resources, significant improvements in the quality and continuity of care as required by government policy. While significant advances have been made, these have been achieved by drawing upon the professionalism and vocational commitment of midwives, and at the expense of their working conditions and sense of wellbeing. While this approach has, in the short term, served the purpose of increasing midwifery output within existing resource constraints, the quality of care has suffered. The increasing problems of recruitment, retention, and falling morale within the profession suggest that it is not sustainable. In the longer term, if the improvements in care achieved thus far are to be sustained, there is a need to reform midwives' working conditions and working environment. This is not to imply that the answer to the ongoing dilemmas facing the maternity services lies solely in improvements in the pay levels or pay structure for midwives. The solution is also dependent on the extent to which midwives are afforded the enhanced status and autonomy recognised as necessary for the improvement of maternity services. Furthermore, strong representation of midwives, alongside improvements in management structures and systems of communication in NHS trusts, are necessary if midwives are to be enabled to participate in decision-making and thereby effectively contribute to improvements in the quality of care.

Partnership in Practice

This paper examines human resource management practices adopted in a group of eight case study firms and their tendencies towards versus away from partnership. The analysis is based on data collected during interviews with 124 employees (75 in organisations tending towards partnership and 49 in organisations tending away from partnership) and senior managers, conducted in 1997-1998 for the Job Insecurity and Work Intensification Survey (JIWIS). Drawing on the perspectives of senior managers and employees, we examine the tendency of firms towards and away from partnership in employment relations; and in keeping with the JIWIS methodology (Burchell et.al., 2001) we combine quantitative and qualitative evidence in our analysis. Specifically, we are interested in what partnership looks like in these different contexts, the reasons it is pursued (or not), the degree to which companies have been successful in achieving their partnership objectives (from the perspective of both management and employees), and the conditions that have either facilitated or impeded partnership in relationships with employees.industrial partnership, corporate governance, cooperation

Work Intensification and Employment Insecurity in Professional Work

Professional work is a category of employment that has traditionally been associated with high levels of worker autonomy, economic and social status. During the past decade, changes in customer expectations, government policy and technology have generated pressures resulting in enhancement of the quality and efficiency of service provision, expansion in task requirements and a need for higher levels of discretion. In this sense, professional work has been upgraded. However, the changes have also led to a deterioration in the economic and social status of professional work, adversely impacting on the social and psychological well-being of professional workers. This paper examines these developments in five professions including two established professions (lawyers and pharmacists), one aspiring profession (midwives) and two emerging professions (counselling psychologists and human resource managers). The empirical findings are based on a survey of 1270 professional workers conducted in 2000 and 2001.Professional work, counseling psychologists, human resource managers, lawyers, midwives, pharmacists, job satisfaction and morale.

Corporate Governance and Employment Relations

Using the 2004 United Kingdom Workplace Employment Relations Survey (WERS 2004), this paper examines the impact of corporate governance on HRM practices and employment relations outcomes within organizations in the UK. The analysis suggests that when a remote external stake-holder is assigned dominance, particularly in the case where their liability is limited and the organization is large, the conditioning of managerial commitments on the requirements of the dominant stake-holder has the potential to undermine the effectiveness of the HRM system in achieving its objectives.Corporate governance, human resource management, stakeholding, employment relations, work and employment relations survey

Anglo-American corporate governance and the employment relationship: a case to answer?

The corporate governance environment in the UK and US is generally thought to be hostile to the emergence of cooperative employment relations of the kind exemplified by labour-management partnerships. We discuss case study evidence from the UK which suggests that, contrary to this widespread perception, enduring and proactive partnerships may develop, in conditions where management can convince shareholders of the long-term gains from this approach, and where other regulatory factors operate to extend the time-horizon for financial returns. We conclude that there is more scope than is commonly allowed for measures which could reconcile liquidity in capital markets with cooperation in labour relations competition rather than EC legislationcorporate governance, labour-management partnerships, stakeholding

Regional collective learning processes, innovation and growth of high technology SMEs: The case of the Cambridge region

Recent theoretical research on the technological development of dynamic European regions has drawn attention to the supposedly key role of "untraded interdependencies" between local firms and other organisations (Storper, 1995), involving informal inter-firm networking (Yeung, 1994) and processes of "collective learning" (Camagni, 1991, Lorenz, 1992). These processes, which involve exchange and development of technological expertise, are seen as being based on relationships of trust and reciprocity, while the networks and processes themselves are viewed as influential in the recent evolution of dynamic regional clusters of innovative small and medium sized enterprises. The paper will attempt to assess the extent, importance and nature of collective learning processes in the specific caseof technology-intensive firms in the Cambridge region recenty descried as the "nearest thing in Europe to Silicon Valley" (Martin 1996). Based on an original interview survey of technology-based enterprises, the paper will asses the role of technology firm spin-off and acquistion, inter-firm research and technology collaboration, and scientific and professional labour market recruitment, in the development of local technological competencies and collective learning capabilities. Alltention will also be paid to the role of key local instiutions and supporting business services in this regard. The paper will conclude by condsidering implications for policy.

Corporate governance, stake-holding and the nature of employment relations within the firm

This paper investigates the effect of different forms of corporate governance on the structure and nature of stakeholder relationships within organizations and the consequent impact on employment relations within the firm. In this, HRM assumes a dual role in delivering improvements in production efficiency and in fostering employee commitment to the organization and its objectives. However, different forms of corporate governance prioritise stakeholder interests in ways that may bring these two objectives into conflict. To address these questions, we examine the interrelationship between corporate governance, HRM practices and HRM outcomes in a comparative analysis of companies operating under alternative forms of governance, including private sector, public sector and family-owned firms. The empirical analysis is based on the UK Work and Employment Relations Survey (WERS98).corporate governance, human resource management, stakeholding, employment, relations and Work and Employment Relations Survey

Productive Systems and the Structuring Role of Economic and Social Theories

The institutions of productive systems are structured by mutual interests and relative power. Securing mutually beneficial cooperation in production requires resolving distributional differences. These objectives are secured in liberal economic theory by the working of markets which mediate the power of individuals and reward individual success. The centrality of individuals and hierarchies in market theory contrasts with developments in labour management theory which identifies group activity and decentralised responsibility as productive factors and organisations as unitary. This neglects the separate interest that productive partners have and the role of institutions in resolving conflicts in productive systems to secure productive co-operation.Productive systems, co-operation, liberal economics, industrial psychology, industrial sociology, collective bargaining and labour standards.

NHS Reforms and the Working Lives of Midwives and Physiotherapists

From 2000 the NHS was subjected to a series of far reaching reforms, the purposes of which were to increase the role of the primary care sector in commissioning and providing services, promote healthier life styles, reduce health inequality, and improve service standards. These were seen as requiring a greater leadership role from health professionals, closer and more cooperative working between health professionals, and between health professionals, social services, and community and other service providers. The project surveyed a random sample of midwives and physiotherapists to investigate their perceptions of the effectiveness of the reforms, and their effects on working lives. The predominant perception was that NHS reforms had negatively affected the funding of their services; and had done little to improve service quality, delivery or organisation. Although the potential existed for the reforms to improve services, the necessary resources and required staffing were not made available and the objectives of the reforms were only partially secured by intensifying of work. The downside of this was a deterioration of the socio-psychological wellbeing of midwives and physiotherapists, especially the former, exacerbating the shortage of skilled and experienced. Shortage of staff and the associated increased work burdens were demoralising and demotivating; morale and job satisfaction declined, and job insecurity and labour turnover increased.Professional work, midwives, physiotherapists, Britain, public sector reforms, job satisfaction and morale

The Influence of Stock Market Listing on Human Resource Managment: Evidence for France and Britain

We use data from REPONSE 2004 and WERS 2004 to analyse whether approaches to HRM differ according to whether an establishment is part of a company with a stock exchange listing. In both countries we find that listing is positively associated with teamworking and performance-related pay, while in France, but not in Britain, it is also linked to worker autonomy and training. Our findings are inconsistent with the claim that shareholder pressure operates as a constraint on the adoption of high-performance workplace practices. The pattern is similar in the two countries, but with a slightly stronger tendency for listing to be associated with high-performance workplace practices in France.corporate governance, human resource management, employment relations