This Cambridge Elements on Global Development Studies volume applies the lens of 'investor state' to a pattern of cross-border activities emerging at the end of aid. Using a series of case studies, the volume examines the growth of a trend where states operate as, with and for investors in the healthcare provision sectors of other nations. It sheds light on an evolving institutional landscape for global health in which state-owned development finance institutions, national development banks and sovereign wealth funds are becoming key financial stakeholders in healthcare systems. The trend has been gathering pace in the past 10-15 years in contexts of growing diversity for development financing and is driving the expansion of corporate-oriented models for healthcare provision that are liable to undermine already-strained progress towards achieving equitable access in healthcare globally.
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1. The challenge of white-collar offenders' desistance -- 2. Searching for the self -- 3. Autobiography and the search for 'truth' -- 4. Imprisonment and the assault on the self -- 5. Who am I? Self and identity in the post punishment world -- 6. The journey to self : success, failure and change -- 7. Becoming who one was : professional-ex roles -- 8. Becoming who one is : religious conversion narratives and desistance -- 9. An existentially informed understanding of desistance.
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The MPs' expenses scandal in England and Wales and the international banking crisis have both brought into focus a concern about 'elite' individuals and their treatment by criminal justice systems. This interest intersects with a well-established concern within criminology for the transgressions of such offenders. However, up until now there has been little sustained consideration of what happens to such offenders following conviction and little discussion of how they attempt to avoid reoffending in the wake of their punishment. This study rectifies this omission by drawing upon white-collar offenders' own accounts of their punishment and their attempts to make new lives in the aftermath of it. Detailing the impact of imprisonment on white-collar offenders, their release from prison and efforts to be successful again, this book outlines the particular strategies white-collar offenders used to cope with the difficulties they encountered and also analyses the ways they tried to work out 'who they were' in the post-release worlds they found themselves in. Representing the first sustained qualitative study of white-collar offenders and desistance from crime, this book will be of interest to academics and students engaged in the study of white-collar crime, desistance from crime and prison. The insights it offers into a particular group of offenders' experience of criminal justice would also make it useful for criminal justice practitioners and anyone who wishes to understand the challenges faced by a group of offenders who are assumed to have many advantages when it comes to desisting from crime.
In: Hunter , B M 2018 , ' Brokerage in commercialised healthcare systems : A conceptual framework and empirical evidence from Uttar Pradesh ' , Social Science & Medicine , vol. 202 , pp. 128–135 . https://doi.org/10.1016/j.socscimed.2018.03.004
In many contexts there are a range of individuals and organisations offering healthcare services that differ widely in cost, quality and outcomes. This complexity is exacerbated by processes of healthcare commercialisation. Yet reliable information on healthcare provision is often limited, and progress to and through the healthcare system may depend on knowledge drawn from prior experiences, social networks and the providers themselves. It is in these contexts that healthcare brokerage emerges and third-party actors facilitate access to healthcare. This article presents a novel framework for studying brokerage of access to healthcare, and empirical evidence on healthcare brokerage in urban slums in Lucknow, Uttar Pradesh. The framework comprises six areas of interest that have been derived from sociological and political science literature on brokerage. A framework approach was used to group observational and interview data into six framework charts (one for each area of interest) to facilitate close thematic analysis. A cadre of women in Lucknow's urban slums performed healthcare brokerage by encouraging use of particular healthcare services, organising travel, and mediating communications and fee negotiations with providers. The women emphasised their personal role in facilitating access to care and encouraged dependency on their services by withholding information from users. They received commission payments from healthcare programmes, and sometimes from users and hospitals as well, but were blamed for issues beyond their control. Disruption to their ability to facilitate low-cost healthcare meant some women lost their positions as brokers, while others adapted by leveraging old and new relationships with hospital managers. Brokerage analysis reveals how people capitalise on the complexity of healthcare systems by positioning themselves as intermediaries. Commercialised healthcare systems offer a fertile environment for such behaviours, which can undermine attainment of healthcare entitlements and exacerbate inequities in healthcare access.
In many contexts there are a range of individuals and organisations offering healthcare services that differ widely in cost, quality and outcomes. This complexity is exacerbated by processes of healthcare commercialisation. Yet reliable information on healthcare provision is often limited, and progress to and through the healthcare system may depend on knowledge drawn from prior experiences, social networks and the providers themselves. It is in these contexts that healthcare brokerage emerges and third-party actors facilitate access to healthcare. This article presents a novel framework for studying brokerage of access to healthcare, and empirical evidence on healthcare brokerage in urban slums in Lucknow, Uttar Pradesh. The framework comprises six areas of interest that have been derived from sociological and political science literature on brokerage. A framework approach was used to group observational and interview data into six framework charts (one for each area of interest) to facilitate close thematic analysis. A cadre of women in Lucknow's urban slums performed healthcare brokerage by encouraging use of particular healthcare services, organising travel, and mediating communications and fee negotiations with providers. The women emphasised their personal role in facilitating access to care and encouraged dependency on their services by withholding information from users. They received commission payments from healthcare programmes, and sometimes from users and hospitals as well, but were blamed for issues beyond their control. Disruption to their ability to facilitate low-cost healthcare meant some women lost their positions as brokers, while others adapted by leveraging old and new relationships with hospital managers. Brokerage analysis reveals how people capitalise on the complexity of healthcare systems by positioning themselves as intermediaries. Commercialised healthcare systems offer a fertile environment for such behaviours, which can undermine attainment of healthcare entitlements and exacerbate inequities in healthcare access.
Abstract University and campus public safety departments deal with a wide range of planned events and incidents from felonious crimes, chemical spills, and other emergent incidents to routine activities that require consistent reviews like commencement ceremonies. After-Action reviews (AARs) are a standard process in several industries including public safety, yet there is little empirical research when it comes to how AARs are applied to campus public safety entities and their outcomes. The Indiana University Public Safety Department (IUPS) reviewed 153 AAR reports, from 2017 through 2020, across seven Indiana University campuses and two academic centres. We highlight the key empirical findings from that review and how they influenced policy and practice at IUPS. We also highlight the role of the researcher–practitioner partnership in the process. We present lessons learned from the project along with suggestions for agencies interested in implementing a robust AAR process.
AbstractThe public call for transparency around police use-of-force incidents and incident data must be answered. Campus police departments are no exception. Yet while the fundamentals of policing are universal, campus policing poses unique challenges for officers, and there is little empirical research informing campus policing policy and practice. In this article, we analyse use-of-force incident records and police officer focus group data involving the Indiana University Police Department over a 3-year period. The data reveal that use-of-force incidents most commonly occurred off-campus; most subjects were males not affiliated with the university; and alcohol was usually a factor. Subject resistance actions and officer use of force are discussed. The article concludes with examples of real-world policy applications, presenting an opportunity for urban police departments to look to campus policing as a model of transparency around use-of-force incidents.
This article examines an attempt to reconstitute global development governance in a context of growing influence for private finance. We focus on the World Bank's Human Capital Project (HCP) and Human Capital Index (HCI), which have stated aims of promoting economic growth and accelerating progress towards achievement of the Sustainable Development Goals. Informed by a review of publicly available World Bank materials, we argue that, through its HCP and HCI, the World Bank is responding to its own institutional sidelining in development financing and governance with a strategy of reintermediation. Its leaders have pursued a system of governance in which the World Bank creates and instrumentalises knowledge on human capital – an asset to be accumulated through judicious investments in markets for self-betterment. Through its HCI the World Bank has expanded its global benchmarking practices, encompassing new domains and quantified predictions of future productivity, in the hope of shaping domestic policy processes. Its leaders propose to use HCI scores to signal risk to investors and political leaders, triggering political shocks that will spur policy reform. Crucially, these efforts seek to reassert the World Bank's epistemic authority and financing clout as the influence of its own lending wanes.
ABSTRACTFinancialization is promoted by alliances of multilateral 'development' organizations, national governments and owners and institutions of private capital. In the healthcare sector, the leveraging of private sources of finance is widely argued as necessary to achieve the Sustainable Development Goal 3 target of universal health coverage. Employing social science perspectives on financialization, the authors of this article contend that this is a new phase of capital formation. The article traces the antecedents, institutions, instruments and ideas that facilitated the penetration of private capital in this sector, and the emergence of new asset classes that distinguish it. The authors argue that this deepening of financialization represents a fundamental shift in the organizing principles for healthcare systems, with negative implications for health and equality.
Financialization is promoted by alliances of multilateral 'development' organisations, national governments, and owners and institutions of private capital. In the healthcare sector, the leveraging of private sources of finance is widely argued as necessary to achieve the Sustainable Development Goal 3 target of universal health coverage. Employing social science perspectives on financialization, we contend that this is a new phase of capital formation. We trace the antecedents, institutions, instruments and ideas that facilitated the penetration of private capital in this sector, and the emergence of new asset classes that distinguish it. We argue that this deepening of financialization represents a fundamental shift in the organizing principles for healthcare systems, with negative implications for health and equality.
In order to progress towards more equitable social welfare systems we need an improved understanding of regulation in social sectors such as health and education. However, research to date has tended to focus on roles for governments and professions, overlooking the broader range of regulatory systems that emerge in contexts of market-based provisioning and partial state regulation. In this article we examine the regulation of private healthcare in India using an analytical approach informed by 'decentred' and 'regulatory capitalism' perspectives. We apply these ideas to qualitative data on private healthcare and its regulation in Maharashtra (review of press media, semi-structured interviews with 43 respondents, and three witness seminars), in order to describe the range of state and non-state actors involved in setting rules and norms in this context, whose interests are represented by these activities, and what problems arise. We show an eclectic set of regulatory systems in operation. Government and statutory councils do perform limited and sporadic regulatory roles, typically organised around legislation, licensing and inspections, and often prompted by the judicial arm of the state. But a range of industry-level actors, private organisations and public insurers are involved too, promoting their own interests in the sector via the offices of regulatory capitalism: accreditation companies, insurers, platform operators and consumer courts. Rules and norms are extensive but diffuse. These are produced not just through laws, licensing and professional codes of conduct, but also through industry influence over standards, practices and market organisation, and through individualised attempts to negotiate exceptions and redressal. Our findings demonstrate regulation in a marketised social sector to be partial, disjointed and decentred to multiple loci, actively representing differing interests. Greater understanding of the different actors and processes at play in such contexts can inform future progress towards universal systems for social welfare.
In: Marathe , S , Hunter , B , Chakravarthi , I , Shukla , A & Murray , S F 2020 , ' The impacts of corporatisation of healthcare on medical practice and professionals in Maharashtra, India ' , BMJ Global Health , vol. 5 , no. 2 , e002026 , pp. 1-9 . https://doi.org/10.1136/bmjgh-2019-002026
A heterogeneous private sector dominates healthcare provision in many middle-income countries. In India, the contemporary period has seen this sector undergo corporatisation processes characterised by emergence of large private hospitals and the takeover of medium-sized and charitable hospitals by corporate entities. Little is known about the operations of these private providers and the effects on healthcare professions as employment shifts from practitioner-owned small and medium hospitals to larger corporate settings. This article uses data from a mixed-methods study in two large cities in Maharashtra, India, to consider the implications of these contemporary changes for the medical profession. Data were collected from semistructured interviews with 43 respondents who have detailed knowledge of healthcare in Maharashtra and from a witness seminar on the topic of transformation in Maharashtra's healthcare system. Transcripts from the interviews and witness seminar were analysed thematically through a combination of deductive and inductive approaches. Our findings point to a restructuring of medical practice in Maharashtra as training shifts towards private education and employment to those corporate hospitals. The latter is fuelled by substantial personal indebtedness, dwindling appeal of government employment, reduced opportunities to work in smaller private facilities and the perceived benefits of work in larger providers. We describe a ⠀ reprofessionalisation' of medicine encompassing changes in employment relations, performance targets and constraints placed on professional autonomy within the private healthcare sector that is accompanied by trends in cost inflation, medical malpractice, and distrust in doctor-patient relationships. The accompanying ⠀ restratification' within this part of the profession affords prestige and influence to ⠀ star doctors' while eroding the status and opportunity for young and early career doctors. The research raises important questions about the role that government and medical professionals' bodies can, and should, play in contemporary transformation of private healthcare and the implications of these trends for health systems more broadly.