'Subcontracting by Stealth' in London's Hotels: Impacts and Implications for Labour Organising

This paper examines the dynamics of change in employment relations in London's hotels. The industry has traditionally used employment agencies to meet short-term labour shortages, but more recently it has turned to agency workers on a 'permanent' basis to cut costs. Drawing on survey data and in-depth interviews with hotel workers in London, we examine the effects of this on labour, documenting changes in pay, and terms and conditions of employment. Our research confirms a trend towards the casualisation of employment in hotels, and highlights the emergence of 'subcontracting by stealth', whereby increasing numbers of staff are employed by agencies with lower wages and poorer working conditions than in-house staff. Given low union-density in the sector, we argue that the Living Wage Campaign, which has been successfully implemented in other sectors of the London economy, might prove an effective means to counter the negative impacts of subcontracting on hotel workers

Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American society of interventional pain physicians (ASIPP) guidelines

Background: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl. Contrary to scientific evidence of efficacy and negative recommendations, a significant proportion of physicians and patients (92%) believe that opioids reduce pain and a smaller proportion (57%) report better quality of life. In preparation of the current guidelines, we have focused on the means to reduce the abuse and diversion of opioids without jeopardizing access for those patients suffering from non-cancer pain who have an appropriate medical indication for opioid use. Objectives: To provide guidance for the prescription of opioids for the management of chronic non-cancer pain, to develop a consistent philosophy among the many diverse groups with an interest in opioid use as to how appropriately prescribe opioids, to improve the treatment of chronic non-cancer pain and to reduce the likelihood of drug abuse and diversion. These guidelines are intended to provide a systematic and standardized approach to this complex and difficult arena of practice, while recognizing that every clinical situation is unique. Methods: The methodology utilized included the development of objectives and key questions. The methodology also utilized trustworthy standards, appropriate disclosures of conflicts of interest, as well as a panel of experts from various specialties and groups. The literature pertaining to opioid use, abuse, effectiveness, and adverse consequences was reviewed, with a best evidence synthesis of the available literature, and utilized grading for recommendation as described by the Agency for Healthcare Research and Quality (AHRQ)

Enabling markets to work?: housing policy in the 'new' South Africa

The principles and achievements of housing policy during the government of President Nelson Mandela are assessed. In order to make the assessment, the specific meter of a World Bank list of policy 'do's' and 'don'ts' that are part of a strategy to enable markets to work is employed. It is argued that while the government conformed to the list in principle, the technical way in which policy was formulated set up tensions to housing delivery. Using the South Africa experience, a series of important challenges to the World Bank list is outlined

Housing and finance in developing countries: invisible issues on research and policy agendas

Housing finance has risen to the top of research and policy agendas in recent years. Yet, although our understanding of the formal delivery of housing finance has improved considerably, we know far less about households’ use and production of housing finance. This is particularly apparent in the case of four ‘invisible’ issues: land markets, rental housing, the role of savings and residential mobility. Drawing upon evidence from Botswana and Mexico, this paper considers the relationship between finance and the livelihood strategies that households adopt in order to fulfil their housing needs. On the basis of this discussion, the paper concludes by advocating a broader focus for housing finance-related research