Bus Company JMB: Fare Increase Causes

Bus Company JMB: Fare Increase Causes JMB TRAVEL GRADED UNIT 2 REPORT DEVELOPMENT STAGE EXECUTIVE SUMMARY This report is about primary and secondary research that was carried out on the bus company JMB. Increase in fares within the company JMB. Looking at the reasons for the increase in fares and the economic implications of this and the advantages that the improvements that the company has been able to make due to the increase in fares and the external factors that have also determined the price increase. The impact this has had on the passengers and exactly what they think about the increase and how it has affected their daily life commuting back and forth to their destinations and to find out what effect this has had on demand for this service. Evaluating the impact this has had on the company and its employees and how this has effected employee motivation within the company and what external factors have affected the company. Looking at the government subsidies that are available to the bus companies and what rules they have in place for a transport company to receive this grant. 1.1 REASONS FOR PRICE INCREASE Investigations have found that when the company first started operating they used an introductory price so customer would use the services, so customer would be able to see what a reliable and flexible bus service they provided. As there was only one other bus competitor running in that area First Buses that only run services to and from Glasgow but didnt have the direct routes that JMB were providing and the reliability that the service would run every 15 minutes from Lanark to Hamilton and returning which made the demand for their service greater than the other bus service run by First Buses. This would be known as price elasticity where the price of fares had risen but demand for the bus services stays the same as there is no direct competitive competition to stop them from implementing there 40% fare increase as they seem to have the biggest percentage of market share in this area. Other reasons for the increase is so they can could run a reliable service for customers in the Lanark to Hamilton route which allowed them to employ more staff to make the company run efficiently as possible. The company spoke of the expansion that is being planned which would allow more child friendly buses to be available for buggy and pram access, wider bus aisles and ramps that can be moved up and down for easy manoeuvring for wheelchairs and prams. School contract service available which would be run on a large scale to help build up their customer base and the company would be able to operate services to a lot of schools within south and north Lanarkshire. Due to the expansion of the company had decided to run bus services in other areas to expand their space in the travel network so that this would bring in more revenue for the company although the company would not allow any revenue figures to be published and management were very specific on this. Luxury coaches have also been introduced that are available for coach trips, private functions and other outings which brings in a great deal of revenue which could lead to further expansion within the Travel network. Revenue figures or any other figures relating to the company was not available. It was seen the actual number of passengers on the gov.scot website published these figures over the past three years seen in (appendix 1) has increased which would allow JMB to consider branching into other areas in Scotland as demand for bus services is on the rise and would enable them to expand their market share in the travel network, which would allow customer to have a preference on who they would want to travel with every day. 1.2 External Factors External factors affecting this price increase is due to the price increase this year because The Scottish Governments flagship concessionary travel scheme for the over 60s and disabled people has run out of money to fund this The Confederation of Passenger Transport UK which is representing 1000 bus and coach firms said fare hikes and cuts in services were on the cards as members could no longer afford the losses (Herald, 2016) which means that the bus companies are going to have to make their contribution towards the concessionary fares for the over 60s and disabled customers. 1.2.1 Congestion Congestion on the roads is a big factor as drivers are not able to reach punctuality targets which could mean Higher operating costs and higher fares Higher in Vehicle times Deteriorating reliability and being punctual to fit with scheduled time tables 1.3 Conclusion Investigations found that the company started with an introductory price of  £2.50 for return tickets from Lanark to Hamilton but in order the company to flourish and extend their market share in the travel industry they had to increase their fares to  £3.50, although the company is flourishing it did need to overcome external factors concerning concessionary fares for over 60s and disabled customers as they now pay into this scheme which also triggered the price increase. Studies also showed that congestion is on the roads is a huge issue on the price increase as this causes higher operating which results in higher fares and cause problems with the service being provided which would cause the company to lose revenue. 2.0 IMPACT ON PASSENGERS A Social Media Survey was carried out with 30 customers in the Lanark to Hamilton area to find out what they felt about the increase in fares and if they still used the services provided by JMB due to increase in price. It was found that a large percentage of customer that used the bus service were not impressed by the increase in fares but still used the services regardless as it was their only reliable means of transport to travel back and forward to their desired destination as mostly every customer commented that rail services are not reliable in these areas so they used the bus services as more of a necessity, where as a small percentage said they used the bus services because it was reliable and friendly. (Appendix 2) illustrates these results. Customer stated that the service that JMB provided was very reliable and the staff were always friendly and on hand to helpful, while other customer said that they pay this amount for fares as it was the only bus service available to them to commute back and forth to work on a day to day basis where as other people used this service for leisure use. As porters five forces suggests see (appendix 3) customers have no other means of getting to their destination as there is no competitive choice in this area. JMB can put prices up as this is their only means of getting to their desired destination because theyre very little choice customers cannot change to another bus company and it seems that now there is not any new entrants in this area in the travel industry. This would suggest that customer that use the JMB services are more than happy to pay the fares as it is there only means of getting to and from their destination with the minimum of time and fuss and because this is a reliable, friendly and well known Travel provider. Although if there was any other means of transport in this area they would consider using it. 2.1 Other factors that determine if customers are receiving good service (1) Public transport needs to be clean and tidy at during operations as it could be a danger to the public health if Health and Safety rules are not adhered to. (2) Making sure that customers perceptions of the service meet their expectations to make sure that the customers completely satisfied with the service being provided. (3) Making sure that bus stops are accessible for customers as you dont want customer having to walk a long distance to the nearest bus stop, the perceived distance that is accessible is a 10 to15 minute walk away from the customers residency or location that the customer might be in at that time. 2.2 Conclusions Conclusions raised were that customer will pay the fare because the train services are not available in this area as it is a necessity to use them but if any other services were to be provided in this area they would probably consider trying a different bus service to commute also other factors such as cleanliness, accessibility and reliability are the key elements that customer look for in a transport services. 3.0 IMPACT ON THE COMPANY A Swot analysis was carried out on JMB to see what its strengths, weaknesses opportunities and threats were to the company. It was found that JMB had a lot of strengths as they were a well- known company with a well-known service provided to the public. JMB also have an advantage over their competitors as the journey routes that they operate are different from their competitors as they over a varied selection of bus routes and over a friendly helpful service to their customer. In the two years the company has been operating they have managed to secure different school contracts and have run a luxury coach service for the public for functions and other private events. The introduction of the Alexander Dennis Enviro 200 bus that was introduced in 2016 is this is fuel efficient and has great manoeuvrability that gives customers a luxury driving experience which makes them miles ahead of their competitors. The weaknesses that they have are being able to keep their services running smoothly day to day basis to keep their customers happy as customers are their customers are everything to the company. Being able to keep their fares to a minimum so that customers are not paying too much for the customers will not be able to afford their fares. Opportunities that the company has is they will be able to expand into new areas with the business such as providing services for different areas out with south and north Lanarkshire for example rural areas as they dont have a lot of transport operating in these areas by offering competitive prices so they can phase out their competitors. Threats that may affect them are If new competitors were to run a new bus service in their areas which would affect their business over a better price and service for the public. If the government cut funding that would enable them to run a reliable transport service. 3.1 Employee Motivation As staff are important to JMBs business morale is a big issue in their business because happy workers mean happy customers. Maslow motivational theory as executed in this company as Maslow talks about the five stages of hierarchy of needs these stages include see (appendix 4) for illustration. JMB has implemented this theory because they have provided their staff with good working conditions and a satisfactory salary for all. JMB have also employed more driver to deal with the demand for their bus services and has enough staff to delegate to different journeys and on different services everyday which allows their workers to get the time off for holidays or appointment or any other time they may need off without the minimum of fuss. The company also has good safety elements implemented as the drivers have direct contact with the depot in Wishaw in case there is any emergencies such as buses breaking down or if there was a medical issue with customer or a customer attacking another commuting on the bus or worst case scenario attacking one of the company bus drivers. Staff that work for the company also have works night out on a regular basis where they can bring their partner along to join in and they also have a Christmas party every year at different venues across Scotland. Mostly all the job vacancies within the company are all internal which means if people have the right credentials to apply for jobs they are urged to do so they are promoted for a job well done as one of the staff in the company was recently promoted to inspector for his outstanding contribution and commitment as a bus driver. 3.2 External factors affecting the business 3.2.1 CO2 Emissions A PESTLE analysis was done on the issue of CO2 emissions which outlined Political, Economic, Sociological, Technological, Legal and Environmental impact on the need to reduce CO2 emissions Political The government have set out clear guidelines for these CO2 emissions to be cut which could affect the company as these guidelines put in place need to be adhered to. Economic In 2010 there was an initiative put in place for all bus services called carbon reduction commitment which meant that bus companies had to buy carbon credits which would permit JMB to generate specific qualities of carbon emissions. In 2010 the company had to put in place a budget and set out very clear plans to measure how much CO2 emissions will be produced going forward. Which could affect the company as if they were to produce more emissions than stated in their plan then this could be an expense for the company which means it may lead to an increase in fares for customers. Sociological If the company does not abide by the guide lines, then the public could lose all expectations of the company at what it stands for. Technological The company may have to get another system built into the buses so they can monitor the CO2 emissions so they know what is being used every day. Legal If the company do not commit to the initiative to reduce emission they may find themselves with a hefty fine or worst case scenario they could lose grant which means they wouldnt be able to operate their business to its full potential. Environmental CO2 emissions are dangerous to the environment and the planet and is one of the biggest problems causing greenhouse gas that is destroying our planet today. 3.3 Steps JMB are taking to comply with the emissions initiative As CO2 emissions are a short and long term problem for JMB and have put in place a plan to reduce these emissions by 2020 from 25% to 20% and the introduction of the envir0 200 bus which would give them a clearer advantage over the competition. 3.4 Conclusion Although a SWOT was performed the results were positive on the company as the company has grown from strength to strength over the last 2 years as it is now able to provide transport to other areas in the North and South Lanarkshire area which has created more jobs for the population of North and South Lanarkshire which has made them able to strengthen the economy by creating jobs such as bus drivers, school escorts and other depot staff. The way the company is fair to their staff and give them the motivation to perform their jobs daily to a high standard that benefits their customers. Other aspects JMB are how user friendly the buses are to the environment because of fuel emission that could be a danger to the environment and could have legal implications if this was not rectified and the guidelines for emissions set by the government followed in the best interests of the company. 4.0 GOVERNMENT SUBSIDES Government subsidies are the main source of funding for JMB Travels business as they receive a (BSOG) Bus Services Operators Grant Scheme this is a discretionary grant paid under section 38 of The Transport Scotland Act 2001 which is regulated by the (DFT) Department for Transport to get this you need to adhere to certain terms and conditions. These conditions include the company needs to maintain adequate records of the mileage and distances that the bus service runs on a day to day basis. Checks are also performed by Transport Scotland to see that all the necessary requirements under the Transport Scotland Act have been fulfilled. DFT provide these grants to keep customers fares to a minimum and the distances the bus services to travel. This (BSOG) is applied for every year and consists of 4 quarterly payments that are paid directly into the company bank account. JMB also receive money from the government for their school contracts which has a great impact on their business and brings in a great deal of revenue. 4.1 Reforms to the (BSOG) Reforming the (BSOG) will create better incentives for local authorities and bus operators to work with one another to provide a better service for commuters and help with keeping the environment safe to provide value. Investing in fuel efficient buses to improve services for customers and to minimise regulatory burdens and reduce the cost of administration. Although these reforms to this policy are in place it will impact in different ways as no measure will completely deliver the objectives highlighted in this reform. Even though the objectives highlighted in this reform will ensure improvement in the value from the bus subsidy thats paid to the company every year. 4.2 Conclusion Investigations show that government subsidies are the main source of funding and keeping to the terms and conditions set for the public transport sector are followed then they will be able to continue receiving this grant and can provide the best service expected of them by their customers. Reforms that have been put in place by (BSOG) are going to benefit the operation of the service because as well as providing a good service to customers they will be able to see that JMB cares about what happens to our planet. APPENDIX Appendix 1 Appendix 2 Appendix 3 Porters 5 Forces   Ã‚   BIBLIOGRAPHY http://www.heraldscotland.com/news/13052185.Bus_fares_going_up_to_pay_for_free_OAP_travel/ http://www.transport.gov.scot/report/j415388-05.htm Arline, Katherine (2015) Porters five forces analysing the competition. Available at: http://www.businessnewsdaily.com/5446-porters-five-forces.html (Accessed: 19 January 2017). Boddy, D. and Paton, R. (2002) Management: An introduction. New York: Prentice Hall Europe. begg, prof david (2016) Congestion. Available at: http://www.greenerjourneys.com//2016//Prof-David-Begg-The-Impact-of- (Accessed: 20 January 2017). abstracts.aetransport.org/paper/download/id/3735 http://businesscasestudies.co.uk/first-group/managing-external-influences http://www.businessballs.com/maslow.htm https://www.gov.uk/government/uploads//impact-assessment.pdf Activity Log DATE DURATION ACTIVITY RESOURCES USED 2ND November 2016 20 mins Phoned to arrange interview with manager from JMB Mobile, Paper, Pen 9th November 2016 2 hours Compiled questionnaire to ask manager from JMB Pen, paper, computer, printer 11th November 2016 3 hours Travelled to JMB depot to interview Martin Bell a manager from JMB asked him question to help with primary research for report Money, pen, paper 18th November 2016 2 hours Looked at the results from questionnaires on face book and recorded the information Face book page, computer, pen, paper 22nd November 2016 1 hour Went to college library to get reference books on economics and business strategy for secondary research for my report Library, books, student card 27th December 2016 3 hours Compiled information and put this into some sort of order and used planning stage to see aims and objectives Planning stage of report, reference books, notes, pen, paper, computer 6th December 2016 2 hours Started typing up my findings for 1st aim and objective relating to price Notes, paper, computer, pen, printer, reference books 13th November 2016 3 hours Compiled information on my 1st aim and objective. Notes, paper, computer, pen, printer, reference books 20th December 2016 3 hours Started compiling information for my 2nd aim of how customer feel about the increase Notes, paper, computer, pen, printer, reference books 17th January 20177 3 hours Typed up my findings for 1st aim and objective started to put this into report format Notes, paper, computer reference books, hard drive to save 18th January 2017 2 hours 30 mins Typed findings for first aim and objective Notes, paper, computer reference books, hard drive to save 19th January 2017 4 hours Collated all my information and started typing up 2nd aim into report format Notes, paper, pen, computer reference books, hard drive to save 20th January 2017 7 hours Typed up data for 2nd aim of report. Started collating information for my 3rd aim of my report Notes, paper, computer reference books, hard drive to save 21st January 2017 6 hours Typed up 3rd aim of my report. Started working on data for my 4th aim of report Notes, paper, computer reference books, hard drive to save 22nd January 2017 6 hours Typed up findings for 4th sim of report Notes, paper, computer reference books, hard drive to save 23rd January 2017 5 hours Wrote my acknowledgements, Executive summary and contents page and Activity log for report Notes, paper, computer reference books, hard drive to save, planning stage of report 24th January 2017 1 hour Checked over my report, sent report through turn tin Computer, report, college email and access to turn tin

The international evidence base for healthcare commissioning

The international evidence base for healthcare commissioning According to the Department of Health (2006) healthcare commissioning is more than just procurement of services. Effective commissioning is about care that adds maximum value for patients in a system that promotes fairness, inclusion and respect from all the sections of the society. The following essay focuses on the international evidence base for healthcare commissioning, explaining the healthcare commissioning of Finland, Sweden, Europe, New Zealand, Arizona and United States and the challenges for healthcare commissioning within the context of economic recession and the ways in which these challenges might be addressed. The fundamental aims of healthcare commissioning includes service improvement, decreasing costs wherever feasible, better patient outcomes, and NHS priorities should be taken into account for all commissioning activities (InPharm, 2010). The cycle of commissioning is fragmented into 3 segments: Strategic planning (the beginning of the cycle), procuring services and monitoring and evaluation. Various NHS tools for supporting the PCTs are available like Better Care Better Value indicators, NHS indicators etc. By restructuring the patient pathway at the first time, we improve clinical quality, decrease expensive readmissions, better staff and patient satisfaction and in turn generate savings which can be used for various services (Peskett, 2009). After the NHS reforms in England, the PCT were considered as the main commissioners of healthcare (Peskett, 2009).. In addition to the NHS providers and NHS Foundation Trusts (FTs), the independent and third sectors were also considered as the main healthcare commissioners. The Operating Framework (Department of Health, 2007a) of 2008/2009 focused mainly on world class commissioning which defines the commissioners skills and competencies for commissioning healthcare successfully from a variety of providers. According to Ham (2009) market like mechanisms has been applied to the health reforms in England. In the emerging market it will be of critical importance for the commissioners of care to manage equivalent with the providers. The government has laid down plans for establishing world class commissioning but evidence shows that commissioning is not done consistently in any of the systems. World class commissioning if developed might not be successful because of lack of potential in absence of other modifications in the making of reforms like payment modes and autonomous providers. An alternative to this would be to develop competing integrated systems. World class commissioning (WCC) is metamorphosing the means through which services are commissioned, resulting in improved health consequences and reducing health inequalities adding life to years and years to life (NHS: Department of Health, 2009). The Department of Health along with the NHS launched WCC in December 2007 which aims to d evelop World class commissioners of NHS-funded services. The NHS in England had designed a 10 year program of reform to handle long standing weaknesses in performance which they are halfway through (Ham, 2008). The commissioners of care play a critical role in negotiating similar terms with providers and use the resources efficiently for improving the health and performance of health services. In the early 1990s commissioning was a weak link in the internal market and it is risky if the history is repeated again. Many countries worldwide have drawn attention towards healthcare commissioning for bringing reforms. The traditional systems which have integrated financing and planning of healthcare (eg the UK, New Zealand and Sweden) have experienced the detachment of commissioning from provision since the early 1990s. The roles of insurers and providers have been strengthened due to traditional partition like Germany, Netherlands and US. Experience of commissioning in Europe: (Ham, 2008) It was found that commissioning in Europe had substantial diversity in context to organization that do purchasing. The type of organization like the central or regional government, municipalities that can act as purchaser, market concentrations and the way of interaction differs from country to country. Variations are also observed in their funding sources and jurisdictions. The function of the purchasers was merely carried out in the challenging surrounding despite of the tangled European health policy debates because of the market based reforms. Figureas and colleagues stressed that a fundamental lesson from European experience is that a broad systems approach for purchasing and various components are required by policy makers. Experience of commissioning in Finland: The Healthcare Commissioning system in Finland is micro level, non-competitive and within the local government (Benson, 2011). For an average of 11,000 populations there are about 448 municipal councils which are responsible for purchasing. Each of these 448 councils is valid for a period of 4 years and an executive board is appointed which leads to democratic linkage between the citizens and health commissioners. The councils are authorized to commission secondary or tertiary services of their choice themselves or by merging with other councils. Experience of commissioning in Sweden: The Swedish healthcare system comprises of 3 levels of government: the central government, county councils and municipalities (The Commonwealth Fund, 2010). The local government is responsible for the ways in which services are delivered considering the local conditions and precedence whereas the central government accounts for the overall goals and regulations of the healthcare system. Thus at local level the delivery system varies because of this decentralization. The central and local taxation is held responsible for public funding of healthcare services. The financing of prescription drug subsidies is provided by the central government. It also provides funding by grants apportioned using a risk adjusted capitation pattern to county councils and municipalities. Financing of primary and mental healthcare and specialist services is provided by the 21 county councils whereas home care and services and nursing home care services are provided by the 289 municipalities. The private sector covers about 5% of the population and it provides easy access to care for patients. The 21 county councils are responsible for the organization of primary care services. For residents within a devoted geographical area, the primary care is provided by the health centers. But there have been significant changes in the model and now the residents can choose their provider and physician. A new law holding an alternative for the population and primary care privatization has been implemented from January 2010. The various modes for payment of private primary care providers are taxation, topped up with fee-for-service and targeted payments. The residents can now directly go to the hospitals or the private specialists. Experience of commissioning in New Zealand: There was a separation of purchaser and provider roles in New Zealands healthcare system from 1993 to 2000 (Ham, 2008). From a recent study both the positive and negative side of purchasing and contracting in New Zealand were highlighted. The drawback was that it was difficult to co-relate providers performance and negotiate contracts because of insufficient data on cost, volume and quality. An antagonistic environment was appreciated because of legalistic approach to contracting. It was difficult to sustain long term contracts or conjunctive relationships because the competition law concerns were not even whereas on the positive side because of purchasing the purchasers and providers focused more on costs and volumes of services and specified the categories and levels of services supplied. According to the providers written contracts would encourage them to focus on improvement of quality of care. Ashton and colleagues have summarized the New Zealand healthcare as: contracting has amended the providers direction on costs and volumes, increased the clarity of services and greater emphasis on methods for improving quality. New Zealands healthcare faces the challenge whether the profit of contracting maintained with simultaneously declining the transaction costs. Experience of commissioning in United States: In United States, indemnity insurance was used for financing and delivery of healthcare (Ham, 2008). Patients selected their providers and the providers charged the insurers by paying fees for services. Hence the patient had a flexible choice and the providers prevailed. Because of increase in healthcare managed care approach was developed in the US in the 1980s and 1990s which was based on the funding authority playing a significant role as commissioners. Evidence suggests that managed care temporarily curbed the increasing healthcare costs in the US. But managed care led to fee-for-service providers. In spite of the evidence, a reinvention movement known as consumer directed healthcare movement took place in the health insurance industry. Experience of commissioning in Arizona: The healthcare commissioning system in Arizona (USA) known as Arizona Healthcare Cost Containment System (AHCCCS) was launched in 1982 (Benson, 2011). Arizona had two tier arrangements: AHCCCS covers about million Medicare and Medicaid from a number of purchasers. The purchasers are liable to commission health services operationally for 35,000 to 200,000 people known as members or lives and they purchase services from various providers. In order to sustain the contract or win, the AHCCCS has to produce detailed bids every 5 years and not all the health plans covered under AHCCCS are for profit organizations. The Department of Healths (2007d) recently published documents suggests that the world class commissioners will (Peskett, 2009): Run the NHS locally Function along with the community partners Both patient and public involvement will be there Merge with clinicians Organize and assess knowledge and needs respectively Accelerate the market Enhance innovation and improvement Draw upon some sound financial investment Supervise the local health system One of the ways of addressing one end of the spectrum is PBC which challenges the PCTs for having the proper governance arrangements and bringing awareness about absolute clarity between responsibilities and boundaries. CHALLENGES FOR HEALTHCARE COMMISSIONING: According to Le Grand (1999), commissioning problems were due to very weak incentives and very strong constraints (NHS CONFEDERATION, 2010). History says that commissioning had failed in the internal market in the 1990s and hence there is risk if repeated again (Ham 2008). Weak commissioning is because of the tendency to focus less on PCTs and PBC and giving importance to national, specialized and joint commissioning. Healthcare commissioning has become weak because of the following reasons: In publicly financed systems purchasing of health services is quite difficult Inability to control the referrals and activity of GPs in general Insufficient power against the number of providers, especially the Foundation Trusts (FTs) for shaping the market Curtailment of clinical engagement and base for decisions related to healthcare commissioning Lack of ability to comprehend an issue and perform in analysis of requirement and demand, managing budget, risk taking etc. There is hardly any evidence which suggests that commissioning has made a symbolic or strategic impact in secondary care services (Smith, et al., 2004). Healthcare commissioning is perplexed and postulating and requires both technical as well as managerial skills (Peskett, 2009). Ham (2008), quoting Mays and Hands (2000) defines Healthcare commissioning as complicated, unclear, not exhibiting information symmetry between buyer and seller, lengthy training mandatory and is based on long term relationships between patients and professionals. Often there is misunderstanding among the commissioners and providers, clinicians and managers, and sometimes between the primary and secondary care commissioners which builds up stress, hence a prominent degree of competence and communication skill is mandatory. The challenges for healthcare commissioning were revealed by the UKs Department of Health Independent Sector Program, particularly for assessment of governance arrangements and identification of high standards of healthcare providers (Peskett, 2009). A successful care pathway commissioning requires an acquaintance and proficiency of the clinical intakes, turnouts and consequences as well as organizational skills for process management and patient journey. Pertinent inter and intra-organizational governance arrangements should be verified. Evidence suggests that healthcare commissioners will need not only time but also stability and persistence of management and organization, if a sustainable progress is required for betterment of local services (Smith, et al., 2005). The recently developed primary care commissioning organizations focuses internally in their initial stages and in future with the secondary care and other providers. The factors which facilitate effective commissioning may also pose to be the greatest challenge. One of these includes for engaging the GPs a set of incentives is created, for patient with long term conditions new forms of seamless services being developed and eventually making an absolute effect on the broader healthcare system, which was difficult for the primary care commissioning to achieve. From a survey conducted recently a conclusion was drawn that about 50% of GPs did not show interest in commissioning budget (Smith, et al., 2005). The GPs would thus have power and would play the role of managers but the power was not distributed equally among the doctors. It has been suggested that an important incentive within fund holding and total purchasing would lead to changes and might improve the services as well, if there were profits during the practice process. In order to engage all the GPs into budget commissioning more strident incentives would be required. If a new NHS market is developed then it will offer sharper incentives so that the GPs and nurses can become practice based commissioners. Hence services could be purchased from new providers of primary care and diagnostics by a commissioning budget. For the non NHS providers, there arises a possibility that the primary care should demand increasingly for budget commissioning and thus become equivalent to the NHS GP s and nurses. (Peskett, 2009) Separation of managerial and clinical goals led to failure with no clinical leadership. Negative targets had detrimental consequences and if the financial flow encouraged efficiency and not effectiveness it leads to failure of service. A culture of collaboration would be helpful rather than competition with command and control ethos. The managers and the organization should be responsible enough to provide commercial expertise, infrastructure and information and the clinicians should provide specialist and knowledge related to healthcare. Weak and ineffective engagement of clinicians of primary and secondary care would lead to crucial Primary Care Trust Commissioning. Commissioning fails if there is lack of resources, capacity and capability and an ability to sustain long duration relationship. Commissioning organizations also require robust governance system in business transactions for ensuring no conflicts of interests. Lack of time, personnel, resources and diffic ult long term relationship were the challenges that Healthcare commissioning had faced (Checkaland, et al., 2009). The four major challenges faced by healthcare commissioning are (Boyd, 2010): Ameliorating the health of the patients Assuring a high quality standard of care in healthcare arena Supervising costs and savings. It includes preventing and managing falls, assessment of risk and saving tax payers money. Managing the transition to clinical commissioning (Boyd, 2010)The key responsibilities of healthcare commissioning includes buying high quality services throughout the care pathway in order to meet the needs of common people and making decisions for not purchasing services. The detailed information regarding organizations engaged in pathway, from primary care to tertiary care is available to the commissioning team and their aim is to fit together all the parts of care pathway to provide a holistic care. Foundations for effective commissioning are as follows: improving outcomes, patient empowerment, evidence based practice, community mobilization and sustainability (Royal College of General Practitioners, n.d.). If these foundations are not taken into consideration carefully then it might lead to difficulty in commissioning health services. Payment by Results (PBR) plays a massive role for achieving efficiency gains in commissioning decisions (InPharm, 2010). A key challenge to an efficacious healthcare commissioning is that there is an absence of general/global, apparent/definite commissioning procedure for the NHS. Several factors are taken into consideration for establishing a business case and introducing it to the decision makers for authorization. These factors includes financing the services, route of commissioning whether the prevailed services be improved or put a tender, assessment of both the NHS and patient needs and views of patient. According to Baird, et al. (2010) one of the various challenges that the healthcare commissioning had was the size and performance in commissioning organizations, both in the NHS as well as internationally. It was concluded that small commissioning organizations would struggle more if they took the responsibility of commissioning the entire spectrum of healthcare and there was negligible relationship between performance and size of commissioners. The providers would also face a number of challenges (NHS CONFEDERATION, 2010). These include: Handling the PCTSs during their transition phase Making commitments for the next 2-3 years about services and financial plans Understanding the new GP consortia and their managers Making arrangements for contract with multiple consortia behaving individually and in networks Ascertaining that the PCTs vital statutory activities are being taken into account even during a major organizational transition. The challenges of Healthcare commissioning might be addressed by focusing more on clinical leadership (NHS CONFEDERATION, 2010). For the local needs and services, the consortia will develop a real, risk adjusted, capital budget. The consortia will be held responsible for economic risk, service execution and health outcomes. Amongst the local system, the consortia will have an outstanding position. Therefore it should be capable of attracting a powerful management and have clout. Gray (2001) says that these challenges are difficult to address because it is not possible to decrease hospital care expenses and divert it into budgets of primary care drugs. Accessibility to diagnostic service costs might be prohibited which is subjected internally within the provider unit and not to external contracts. Savings within the hospital can be redirected to hospital care by professionals in any other service. Conclusion: Healthcare commissioning personifies the improvement in quality of healthcare and it is responsible for publicizing the national healthcare standards, assessing the organizations performance and comparing it with other organizations, solving the problems when it is not possible to resolve it locally and looking into severe service failure. According to Sobanja (2009) commissioning is defined as the act of committing resources, particularly but not limited to the health and social care sectors, with the aim of improving health, reducing inequalities, and enhancing patient experience. Many countries throughout the world are now concentrating on healthcare commissioning. Experience and evidence available from Europe, United States and New Zealand suggests that commissioning is not done systematically in any of the systems. There have been innovations in all the systems but again there are illustrations of barriers and limitations of effective commissioning. Commissioning tends to be dif ficult may be due to the nature of healthcare and the expectation of the healthcare commissioners to have a high level of technical and managerial skills. Payment system, incentive, market organization and regulation influence the impact of commissioners. The concluding point to stress is that there is only one element called commissioning in the health reforms and its impact will be affected by how different elements are carried forward. Hence it can be concluded that even if world class commissioning is enhanced it may not reach the standards and fall short of its potential due to lack of variations in system design.

The Federal Reserve Bank and the Decline of the U.S. Economy Essay

There is perhaps no other political issue in our contemporary society that is more pertinent, pervasive, and encompassing than a nation’s economy. From the first coins used in Greece and the Asia Minor in the 7th century BCE, to the earliest uses of paper money, history has proven time and time again that the control of a region’s economy is absolutely crucial to maintaining social stability and prosperity. Yet, for over a century scholars have continued to speculate why the United States, one of the world’s strongest and most influential countries, has one of the most unstable economies. Although the causes of this economic instability can be attributed to multiple factors, nearly all economists agree that they have a common ancestor: the Federal Reserve Bank – the official central bank of the United States. Throughout the course of this paper, I will attempt to determine whether or not there is a causal relationship between the Federal Reserve Ba nk’s monetary policies and the decline of the U.S. economy. I will do this through a brief analysis of the history and role of this institution, in addition to the central banking system in general. In turn, I will argue that the reckless and intentional manipulation of the economy by the Federal Reserve Bank, through inflation and the abolishment of the gold standard, has led to the current economic crisis in the United States. Before we begin our investigation, it is imperative that we understand the historical role of the central bank in the United States. Examining the traditional motives of this institution over time will help the reader observe a direct correlation between it and its ability to manipulate an economy. To start, I will examine one of its central policies... ...iew 26.4: 683-690. JSTOR Database. Web. 18 Nov. 2010. Sprague, O.M.W. â€Å"The Federal Reserve Act of 1913.† The MIT Press 28.2 (1914): 213-254. JSTOR Database. Web. 18 Nov. 2010. Sproul, Allan. "The Gold Question." Vital Speeches of the Day 16.4 (1949): 108. Academic Search Complete. EBSCO. Web. 18 Nov. 2010. United States. Federal Reserve Bank. Frequently Asked Questions. Mar. 2007. The Federal Reserve Board. Web. 13 Dec. 2010. United States. U.S. Department of the Treasury. Historical Debt Outstanding – Annual 1791 – 1849. Aug. 2008. Treasury Direct. Web. 13 Dec. 2010. United States Constitution. Amendment 10. USdebtclock.org. U.S. National Debt Clock, 2010. Web. 13 Dec. 2010.

Response to Bell Hooks Keeping Close to Home :: Family Values College

Strong Family Values In Bell Hooks’s essay, "Keeping Close to Home," she suggests that the American educational system forces students to hide, change, or mask the values that they have when they first enter college. While this might be true for some students, this line of thinking does not hold true for me personally. I do not agree with her assertion for, and I have not changed since entering the University of Georgia. The University of Georgia has not placed any pressure on me to change my values due to the fact that I had very strong values when I entered the University, and those same values hold true to me today. The values that I learned from my parents as an infant, child, adolescent, and, most recently, as an adult, are continually enforced and taught to me today. It is because of this strong family support that I have stayed the same as I was before entering college. My family has always preached strong family values that will be with me for the rest of my life, and will be passed on to my children and grandchildren. Some of the family values that I have learned from my family are to always respect my elders and to have good manners no matter what. I believe that values are taught and learned at an early age. If the teaching is successful, as it was in my case, the student should hold true to the values that he or she was raised with. Everybody is raised with different values, whether the difference is religious, moral, or social, and they should all be respected by others. I will not change or alter my values because they are very important to both my family and me, and I firmly believe in them. There are many different types of people on the University of Georgia campus, whether they come from the same or different background than I. There are people of different skin color, religion, ethnicity, and many other different backgrounds. Therefore, there are also many different beliefs in faith and values. At an institution of higher learning, such as the University of Georgia, there is respect for and interest in other people’s beliefs. There is never a push to "change" someone. Some students might alter their beliefs and values, but as for myself I will learn of others, but never change.

Racism and Racial Profiling are Better than Political Correctness :: Sociology Racism Prejudice Essays

Racism and Racial Profiling are Preferred Over Political Correctness I am beginning to detest political correctness! Perhaps I just want to know how people really feel. It's not that negative opinions don't hurt - of course they do. But I would take a cross-burning-hate-spouting-hood-wearing Ku Klux Klan member over a person who thought the same things, but never dared to express those thoughts until sometime in the future when it could hurt me more (i.e. job hiring). At least with the KKK member, I know what I am getting. As a black female born and raised in the South, I have dealt with racism and discrimination all of my life. But I expected (or hoped for) a little more from our university. Yet what is the first thing that happens when I come to campus? The "ghetto party!" What followed were anger, discussions and learning. But was anything really learned? Every year, there is another incident of some kind: the "luau party," Jewish hate mail, vandalism on the door of Asian students, and most recently, the incident at the fraternity, just to name a few.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   So I have a new idea. If the university wants to strengthen community, it does not need to just have discussions where people learn what not to say or do. People need to feel the effects of their words and actions. So I propose we build a machine that transforms the "offender" into the "offended." Instead of hearing how their words and actions hurt someone else, let them walk in that person's shoes.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Think you know someone who is racist? Put her in the machine and let her know how it feels to be a person of color for a lifetime. As part of the experience, she will be followed in stores as if she's about to steal something. As a child, instead of having teachers help her in school, they will write her off as a lost cause, label her a delinquent, or prematurely put her in a special education class. Or when she does not understand, people will act surprised and say, "Aren't all of you good in math?" When people insult her race, her objections will be judged as over-sensitivity (considered a common attribute of people like her). Her success will be seen as a threat to others. When she tries to show pride in or help others have pride in their race, she will be labeled

Internal Control Essay

(1) If the LJB Company should decide to become a publicly traded company, a few internal controls should be implemented to comply with the Sarbanes-Oxley Act (SOX). * Management will need to provide periodic quarterly reports to evaluate the effectiveness and reliability of LJB’s internal controls over financial reporting procedures. * Management should certify the accuracy and fairness of presentation of their financial statements. * Independent auditor(s) outside of LJB will need to attest to management’s assessment of said internal controls. Additionally, non-audit services between these two parties (LJB and said independent auditor) are prohibited. (2) There are a few internal control measures that LJB already has in effect and are better for it: the use of pre-numbered invoices by the accountant and your (the President’s) involvement in the approval and hiring process of new employees. I also recommend the purchase of the indelible ink machine as per the accountant’s request. As this applies to the Internal Control Principle of Physical Control, future check fraud will be more difficult to be accomplished. 3) There are several internal control weaknesses that I assess LJB currently has. Following each weakness I list below is a recommendation from myself to rectify these internal control weaknesses. * One is risk is the accountant who serves as Treasurer and Controller. Although I understand this is to streamline many processes, it possesses a risk where an opportunity is created for this employee to commit fraud. This also violates the Segregation of Duties Principle of Internal Control Principles. I recommend that these two responsibilities be segregated 2 different employees. * When the accountant in charge of payroll leaves employees’ checks in his office unsupervised and unsecured, it presents an opportunity for theft. This violates the Internal Control Principle of Physical Control, as though checks are not constantly kept in the accountant’s office safe prior to pick up. I recommend that these checks remain physically secured at all times (by the accountant, or by delaying delivery to the accountant until he reaches his office). Due to the unorthodox honor system of dealing with petty cash, any single employee can withdraw a substantial amount of petty cash in relative anonymity. This violates two Internal Control Principles: Physical Control and Establishment of Responsibility. It violates the Physical Control Principle because the petty cash is easily accessible with no form of physical protection of theft, and it violates the Establishment of Responsibility Principle because no single person is in charge of the Petty Cash Fund (rather everyone is). This can be remedied by assigning a custodian to be responsible for the fund, as well as creating a secure area to store said funds. * These previous points additionally bring up another weakness, though not actually part of the Internal Control Principles. Though it seems to be LJB’s unofficial policy to trust long-term employees, when a desirable opportunity to commit fraud/theft arises, it becomes at the discretion of the employee to commit these acts for their personal benefit. Another weakness is LJB’s lack of individual passwords which allows personnel to anonymously use the company computers and databases. This lack of individual accountability will prevent most attempts to track suspicious employee activities on company computers and databases. This instance violates the Internal Control Principle of Physical Control. I recommend assigning employees individual accounts and passwords, as well as creating a form of digital control to prevent future unauthorized activities, such as viewing pornography on company computers. Lastly, because LGB unknowingly hired a convicted felon, it can be deduced that LGB’s Human Resource Department may be lacking, due to the fact that a background check should have caught his criminal history. This may violate the Human Resource Control Principle of the Internal Control Principles. I recommend that the Human Resource Department reevaluate their policies and staffing procedures to prevent future incidents from happening. Thank you for taking the time to read this letter and please consider my recommendations before going public with the LGB Company.

Behavioralism & Political Science

The field of Political Science is a field that is rich in issues and knowledge. It contains many issues that may be subject of inquiry. In this field, many queries have been made and many researches have been performed. The years have shown an evolution of research processes involving many different methods and approaches, targeting different goals, and focusing on different aspects of an issue.One of the most popular of these approaches is the behavioralist approach. The behavioralist approach has been used in many inquiries in Political Science and has been subject of analyses of many scholarly works pertaining to the field.In this essay, I will examine two of such works. The first of them is David Sanders â€Å"Behaviouralism†; and the second is Robert A Dahl’s â€Å"The Behavioral Approach in Political Science: Epitaph for a Monument to a Successful Protest†. David Sanders’ â€Å"Behaviouralism† is a quick look at some of the important concepts involved in behavioralist studies. This involves an examination of the core question â€Å"what do actors involved actually do and how can we best explain how they do it? † It emphasizes the quest of behavioralists for reliability and truth.This can be shown through the use of quantitative, in addition to qualitative, measures or statistical techniques, the attempt to explain all empirical evidence or at least a representative sample, and the requirement of falsifiability. It emphasizes on the criteria of being internally consistent, consistent with other theories explaining related phenomena and capable of generating empirical predictions. The article also delved on the criticisms thrown against behavioralism. Among these is the tendency to emphasize what can be easily measured and what can be easily observed.This results to a failure to comprehend the â€Å"big picture† because of the focus on smaller aspects of an issue that is capable of measurement. However, as th e Sanders wrote, this is not to say that â€Å"all examples of behavioral research are flawed†. Behavioral research has vast contributions to the understanding and explanation of social behavior.This strength, according to Sanders, is derived mainly from the â€Å"determination to pursue forms of analysis that are capable of replication†. On the other hand, Robert A. Dahl’s â€Å"The Behavioral Approach in Political Science: Epitaph for a Monument to a Successful Protest† is a historical and evolutionary account of the theory of behavioralism. It touches on the main concepts and ideas behind the theory, such as the main question involved in behavioral research, the scientific nature of its purpose, the goal of discovering uniformities and indicating the consequences of such patterns, and use of quantitative tools whenever possible (767). However, the article’s main focus is on how the approach has originated and evolved through time.According to Da hl, the behavioral approach was originally a â€Å"protest movement within political science†. It resulted from â€Å"a strong sense of dissatisfaction with the achievements of conventional political science†¦ and a belief that additional methods and approaches either existed or could be developed† (766). The article then goes on to discuss the reactions to the behavioral approach and its contributions in the field of research, especially in voting studies (769-770). It finished its discussion with a prediction of the future of behavioralism as a research approach in the field of political science.Dahl believes that, from being a movement of protest, the behavioralist approach will â€Å"slowly decay as a distinctive mood and outlook† and â€Å"will become, and in fact already is becoming, incorporated into the main body of the discipline,† thus marking its success as a research approach (p. 770). The introduction of behavioralism provided a good bri dge between the purely qualitative approach to social science research and the systematic, reliable and verifiable methodologies of quantitative research.It is undeniable fact that social science research is a complex arena where various actors, factors and circumstances interact to produce results that is often not uniform and regular, unlike in the field of hard science. Most factors are difficult to isolate and measure. Trends are difficult to establish and changes easy and research results have a higher margin of error. This is due to the fact that the subjects of social science research are mostly individuals or entities composed by individuals.This is why, for a very long time, most research methodologies in social science are too flexible and indefinite. The inherent difficulty of measuring social science phenomena prevented the field from developing a research methodology as rigid as that in the hard science. This difficulty is the reason why, despite the attempts to achieve the reliability of the scientific method, behavioralism remains to be mostly qualitative, thus using quantitative methods only when possible.While many people recognize the contribution of behavioralism in the field of political science, many people also throw criticism to its validity as a method. The main contribution of behavioralism that sets it apart from other approaches is also the source of these criticisms—measurability and verifiability. While these criticisms may actually true, they do not render behavioralism useless. The task of a researcher is not only to employ a research method and accept the results as it is. A good researcher knows that his data may be polluted or compounded.Due to the complexity of political science phenomena, a researcher should not only be able to identify and isolate the factors that should be measured, it should also know the other factors that may affect or even pollute the results of his research. He should know that his methods are not perfect and there is probability for mistakes. This is especially necessary in the field of political science where the possibility of compounding is high the opportunity to make a research that encompass all factors is low. Both Dahl’s and Sander’s articles are incomplete discussions of the Behavioralist approach.This is partly due to the fact they are only parts of a whole collection of articles in a book. Therefore, their goal is not actually to give a comprehensive discussion of behavioralism, but rather to give and discuss only a few of its aspects and main features. Their foci are only on certain aspects of the approach. Therefore, while the discussion may not be said to be exhaustive and comprehensive as regards behavioralism as the articles’ subject matter, they are exhaustive and comprehensive within their respective limits.First, Robert A. Dahl was able to provide a comprehensive presentation of the origin and development as an approach. He was abl e to identify the reason the approach was introduced and the factors that facilitated its growth. He was also able to note the changes that the approach has undertaken and some of its most notable contributions in research. It even provided a prediction of the future of behavioralism. On the other hand, David A. Sanders provided a very brief but complete discussion of the essence of behavioralism, including its strengths and weaknesses as a research approach.While the discussion is not too in-depth to the point of being technical, the discussion is sufficient for a person, even with a non-political science background to understand what behavioralism is and what sets it apart from other theories. The articles by both authors are well-supported. Dahl’s article was supported by specific facts in history that are cited to facilitate the discussion about the development of behavioralism. These facts and details show the quality of research that went into the work.Sanders’ a rticle, on the other hand, is supported by illustrations. Since the discussion is as regards relevant concepts, the approach is more of illustrating the dynamics of behavioral approach through the use of examples. As for the style of writing, Robert Dahl's article reaches more to the audience because of its style of writing. The use of the word â€Å"I† and the insertion of several personal insights while discussing hard facts contributed to the dynamic and smooth reading process that the reader may experience while reading the article.The paradox one may experience while reading is that, while the article tackles about development, something which may be done with just a recital of facts, Dahl was able to made the discussion something that is not a mere recital of facts, but an expression of his own insights. Therefore, the author avoided putting distance between him and his article and made the article his own. The audience of the article is those that belong to the field. This may be gleaned from the fact that the focus is on development and not on concepts.There is an assumption that the readers already have basic understanding of the theory of behavioralism, and can thus relate to what the author is saying. Such initial understanding of behavioralism is necessary for the reader to be able to relate to what the author is discussing and form a personal evaluation as regards the validity of the author's observation. Sanders' style of writing takes the opposite form of than of Dahl's. His is a more formal discussion of the concepts. His article is more appropriate for readers who are just being introduced to behavioralism.The discussion may be as formal as a discussion in political science may allow, but the language used is simple and easy to comprehend. It discussed behavioralism from its core concepts to the ideas which revolved around it such as scientific approach and quantitative research. Unlike Dahl, Sanders places a distance between him and hi s article by using a formal format in the discussion. Dahl and Sanders articles offer a comprehensive discussion of behavioralism. However, read apart, they are limited only as to their specific purposes—Dahl’s as to the development of behavioralism and Sanders’ as to the core concepts and ideas involved.All in all, both articles are satisfactory pieces about behavioralism. They are clear, concise and informative, without being too rigid and technical. They are straight to the point, elaborating only when needed. They are both useful, especially for new students of Political Science. References: Dahl, R. A. `The Behavioural Approach in Political Science: Epitaph for a Monument to a Successful Protest`, American Political Science Review, vol. 55, no. 4 (1961), pp 763-772.Sanders, David `Behaviouralism` in Marsh, David and Gerry Stoker, Theory and Methods in Political Science (Basingstoke: Palgrave, 2002) ch. 2..