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Do the poor gain more? The impact of secondary care expenditure on health inequality
Get PDFBackground: Quasi-experimental studies of mortality variation and trends among large administrative areas of England in the 2000s and early 2010s have suggested that more deprived populations gain larger mortality benefits from marginal increases in public expenditure on secondary care. Objective: To identify causal effects of marginal changes in expenditure on mortality variation in 2018 among 32,784 more and less deprived small areas of England, with a mean population of 1700, allowing more fine-grained measurements of deprivation and mortality. Methods: We used cross-sectional data on secondary-care funding allocated to 195 National Health Service administrative areas in England in 2018/19 and employed a well-established instrumental variable approach based on the “distance from target” component of the funding formula, which generates quasi-exogenous variation in funding based on historical factors unrelated to current need for secondary care. Results: We found an inverted U-shape pattern of mortality gains by deprivation group, whereby the middle group gained significantly more than others. However, we could not reject the null hypothesis that the two more deprived groups received the same mortality gain as the two less deprived groups. These findings were robust to extensive sensitivity analysis using different levels of analysis, control variables, mortality outcomes, functional forms, first-stage regression specifications, and exclusions, and our preferred specifications all satisfied standard instrumental variable diagnostic tests. Conclusions: We found that the poor do not always gain more from marginal increases in public expenditure on secondary care and, conversely, might not always bear the largest share of the health opportunity costs of cost-increasing programmes
Managing to stay: does line‐manager quality affect employees’ intention to quit in the NHS?
Get PDFThe English National Health Service (NHS) is one of the largest employers in the world. It is currently suffering from high employee turnover and rising numbers of job vacancies. This article uses five waves of NHS Staff Survey data (2018–2022) to try to understand the relationship between line manager quality and staff intention to quit. It estimates pooled cross‐sections with data on close to 400,000 individuals and approximately 130 NHS Trusts. The analysis adjusts for a wide variety of confounding variables, including hospital trust fixed effects. We also check for omitted variables and potential endogeneity. Our econometric estimates point to the important influence that line manager quality has on employees’ intentions to quit or stay. This study's novel results suggest that an increase in line manager quality by one unit (on a scale from 1 to 5) is associated with a substantial decrease in NHS employee quit intentions of 17 percentage points
Writing the history of the Pequot War, 1636-7
No full textIn this article I make three arguments. First, that the combination of direct personal experience and some twenty years of hindsight gives the ‘authorized version’ of the Brief History of the Pequot War by John Mason of Connecticut a uniquely valuable perspective on the notorious Mistick massacre. Second, that in other respects this version of the war, although largely relied on by modern historians, is highly misleading, spectacularly so in its delineation of the parts played by the colonists’ Indian allies, Mohegans and Narragansetts. Two other narratives, both embedded in later printed accounts, and one of them composed soon after the war’s end by John Mason himself, reward greater scrutiny than they have as yet received. Third, that Connecticut’s successful undermining of the wartime alliance between Massachusetts and the Narragansetts meant that the familiar version of Mason’s text was better attuned than all extant earlier narratives to the political constellation which emerged in New England in the aftermath of the Pequot war – a new alignment which remained in place up to and beyond the demolition of Narragansett independence in the war of 1675–6
Gateways, funnels, and stackers: how people hide property ownership through offshore structures
Get PDFHow do wealthy individuals use offshore financial structures like shell companies to protect personal assets? And how is such offshore wealth structuring itself variably organized? Moving beyond conceptualizations of offshore as concerning only individual tax havens, this article investigates offshore wealth structuring as a fundamentally relational practice to supply the first systematic image of the patterns between two key layers of offshore structures within a specific asset class. We analyze the overseas entities that hold expensive residential properties in the UK to make three contributions to debates around offshore. First, we identify a specific regional offshore circuit in its flows and magnitude by isolating two key layers, namely the entry layer, which is used to connect into the UK property market, and the action layer, which is used for the actual or projected appearance of managing the offshore structure. We next examine the interstices between these layers to reveal three patterns of offshore formations. These we term global funnel, selective gateway, and self‐stacker, and we discuss their implications. Finally, we offer indirect evidence of which jurisdictions people are more likely to choose for “brass plate” incorporation and which they employ for more complicated structuring, either in actuality or in appearance, which has implications for policymaking. By identifying significant variation in the interstitial patterns between jurisdictions, we not only pinpoint which jurisdictions are used in relation to others and to what extent, but also provide indirect evidence of how they are used differently and discuss why. Our findings supply a pioneering analysis of the scope, scale, and interstitial formations of the offshore structures that wealthy individuals use to hold personal property
Decoding regional dynamics: institutions, innovation, and regional development in the EU
Get PDFThe importance of institutions and innovation for regional development is well established. How these two factors interact under different historical legacies and urban-regional contexts remains, however, insufficiently understood. This paper identifies which combinations of institutional and innovation indicators most effectively classify regions into distinct developmental archetypes, revealing critical thresholds that redirect regional trajectories. Employing decision-tree analysis on 233 EU NUTS-2 regions, we analyse 15 indicators spanning institutional quality, technological readiness, business sophistication, and innovation. This methodology uncovers non-linear relationships that traditional approaches cannot capture. The findings demonstrate that institutional quality acts as a necessary condition for innovation-led growth. High-performing regions, predominantly in Western and Northern Europe, benefit from robust institutions and strong innovation outputs. Many lower-performing regions, particularly in Central and Eastern Europe, exhibit innovation potential but are constrained by governance deficits. By integrating institutional and innovation indicators within a single analytical framework, we underscore how addressing governance and innovation in tandem can result in balanced and sustainable growth across Europe
How institutions shape the economic returns to investment in European regions?
Get PDFMost studies of institutional quality and regional growth assume uniform effects across territories. However, this may mask crucial regional heterogeneity, with direct policy implications. We use a latent class framework applied to 230 EU regions over 2009-2017 to identify institution-driven regional parameter groups, and to examine both average effects and catching-up effects associated with changes in the institutional environment. We demonstrate that institutional quality generates highly variable returns to investment in physical capital and innovation. Nordic and Central European regions show highest returns to physical capital and R&D investment, whereas less-developed regions benefit most from education spending. Crucially, we find that improving government quality not only raises average returns but also promotes territorial cohesion. By contrast, regional autonomy shows limited impact on returns. Our findings challenge the one-size-fits-all approach to cohesion policy and indicate that cohesion policy should explicitly promote institutional improvements in addition to capital deployment
Industrial Relations, 1975 to 2025
No full textIn introducing his new book, A Concise Introduction to Employment Relations (Elger: 2005), Richard Hyman notes that if anyone were inventing the subject today, they would not think of calling it industrial relations, which does tend to imply manufacturing industry, whereas the world of work today primarily involves very different forms of productive activity, including much external to the boundaries of the contract of employment and large organizations. Offering a critical discussion of Polanyi is one of the themes Hyman uses to analyse the landscape of contemporary work, the sustained assault on workers living standards and collective organizations, and the possibilities for a counter-mobilization by workers to confront the challenges of Covid-19 and its aftermath, international politics and European war, and climate politics and the green transition
