The Dilemma of Privatized Public Services: Philosophical Frames in Understanding Failure and Managing Partnership Terminations

This paper uses social theory to explicate the competing perspectives on the on-going and, increasing, privatization of public services in the U.K. It suggests that if business ignores these perspectives then political imperatives will come into play that will inevitably turn privatization initiatives commercially sour.Contrary to political rhetoric, public/private partnerships (PPPs) constitute a more strategic form and process of out-sourcing, demanding that wherever public funding flows, private rent-seeking opportunities be created for the private sector. Seen in these terms, managerial elites will need to understand and anticipate conditions under which the state would seek to terminate lucrative partnering arrangements in the public interest.Political–administrative dialogue on partnerships can involve an unresponsive discourse or a dialogue of the deaf, both constituting a threat to business through the imposition of undefined community service obligations or hostile and unprofitable terminations by the state. Performance required of PPPs goes beyond market success and requires co-optation of strategic stakeholders, raising significant issues about corporate governance directions. Business leaders will need to develop communicative rationalities that build pluralized decision structures and implementation capacities. The paper concludes by outlining design features of more effective regulatory regimes to avoid hostile and unprofitable terminations of increasingly contested PPPs. The conclusion is less sanguine about the ability, or even the wish, of governments to do so.     

Assessing the local need for family and child care services: a small area utilization analysis

This article reports the findings of a study to develop a new method for allocating resources to family and child care services within Northern Ireland. Downloads from financial and client databases, together with a survey of social worker case activity, were used to estimate utilization costs across 500 local areas. Regression techniques were then used to account for variations in these costs in terms of local socioeconomic conditions. The resultant needs index represents a fair and equitable means of allocating central family and child care budgets to local units of management and service delivery.     

The Financing of the Proposed Australian Health Insurance Programme

The Australian Labor Government has outlined how it intends to finance the proposed Health Insurance Programme in its recent white paper on Health Insurance, whilst the specific details are provided in the earlier Deeble Report. From these documents two important conclusions emerge. Firstly, the Government does not really know how much the scheme will cost. Secondly, the proposed methods of financing has a number of contentious aspects. It is with these two matters that this paper is concerned.     

Hunger strikes: preventing harm to students.

When the health center encountered a student hunger strike, an initial search for medical information regarding fasting provided very little on which to build management decisions. The result of a more thorough evaluation of starvation literature is presented, along with survey responses from students who fasted. Starvation may produce many adverse events, including death. Yet, according to reports, acaloric fasts that include full water intake seem to be readily tolerated for 2 weeks in young, healthy adults. Our students included juice, sports drinks, and vitamins in their diets and completed their strike without major problems. Supplementation with carbohydrates and vitamins may improve the safety or comfort of a hunger striker, but clear proof of this effect does not exist.     

Adolescent crisis and suicidal behavior: Dynamics and treatment

Suicide among adolescents is increasing. Three interacting factors—the crisis of adolescent development, family dysfunctioning, and social factors—create vulnerability to feelings of rejection and worthlessness among suicidal adolescents. Long-term family problems that are not openly acknowledged but for which the adolescent feels responsible are particularly relevant. The authors recommend a multiple approach to assessment and treatment in which crisis intervention is employed initially; and individual treatment for the adolescent and family therapy are utilized concurrently on a long-term basis.