Roy Carr-Hill - Academia.edu (original) (raw)
Papers by Roy Carr-Hill
a broad readership drawn from the academic community, professional health care staff and policy m... more a broad readership drawn from the academic community, professional health care staff and policy makers, both within the UK and internationally. Material published in DP form ranges from work in progress, to edited versions of completed project reports, from papers intended ultimately for journal publication, to those which seek to stimulate immediate debate. Hence the variation in length and complexity of DPs. In the past, DPs have been subject to a minimum of editorial revision, it being principally seen as the responsibility of individual authors to ensure that appropriate standards were met. Since June 1996, a more formal system of internal peer-review has been introduced to consolidate the high levels of quality that have been achieved in the past. That system involves the refereeing of DPs in draft form, with any recommended revisions being verified independently by a senior member of staff. DPs are not a substitute for publication in peer-reviewed journals. It is to be hoped t...
Intercultural Europe, 2019
Consumption, Jobs and the Environment, 2002
In Chapter 6 we set out a framework of social concerns. Later in the chapter, we showed how such ... more In Chapter 6 we set out a framework of social concerns. Later in the chapter, we showed how such a framework would imply very different directions for many government policies, from those currently followed. In Chapter 7 we introduced some concrete estimates of the effects on work and the environment of the kinds of shifts that we think would be required to approach a resolution of some of the problems identified in Chapters 2 to 4, while achieving the same and possibly improved levels of welfare or quality of life for the population.
Consumption, Jobs and the Environment, 2002
The overall aim of this book is to focus on the problem of how to increase or at least maintain w... more The overall aim of this book is to focus on the problem of how to increase or at least maintain welfare (the benefits) while reducing ecological clam-age and risks and alienating labour (the costs). We believe that the case for reducing ecological impact of economic activity is proven (see Chapter 2) so that the issue is how to reduce economic activity and what would be the consequences of so doing. We have shown in Chapter 3 that much of current employment has little measurable impact on welfare other than on the person’s income which, with current employment and income policies, is nearly always higher when one has a job.1 In Chapter 4, we showed that for a number of reasons, the consumption which is derived from income is a very poor measure of welfare.
Consumption, Jobs and the Environment, 2002
The impact of economic activities on the natural environment has often been ignored: it is ‘hidde... more The impact of economic activities on the natural environment has often been ignored: it is ‘hidden’ from economic accounting since no one pays for it directly, and ‘external’ to economic transactions in the sense that those suffering the impact are generally not the ones gaining from the activity. This has long been known, but with industrialisation such impacts became greater, as did pressure to reduce them. National legislation against air pollution in the UK for example goes back to the 1820s. More recently, the emphasis has been on taxes designed, at least in principle, to reflect the full pollution impact of activities.
Consumption, Jobs and the Environment, 2002
The last three chapters have looked at the impact on welfare of ecological damage, employment and... more The last three chapters have looked at the impact on welfare of ecological damage, employment and consumption. We conclude that continued growth in economic (or not so economic) activity may reduce rather than improve welfare. This chapter focuses on the policies which have been implemented or proposed, from orthodox or green perspectives, to influence the extent of this activity or mitigate the consequences.
Social Science & Medicine, 1989
The Quality Adjusted Life Year (QALY) has been proposed as a useful index for those managing the ... more The Quality Adjusted Life Year (QALY) has been proposed as a useful index for those managing the provision of health care because it enables the decision-maker to compare the 'value' of different health care programmes and in a way which, potentially at least, reflects social preferences about the appropriate pattern of provision. The index depends on a combination of a measure of morbidity and the risk of mortality. Methodological debate has tended to concentrate on the technicalities of producing a scale of health; and philosophical argument has concentrated on the ethics of interpersonal comparison. There is little recognition of the fragility of the theoretical assumptions underpinning the proposed combination of morbidity and risk of mortality. The context in which the proposed indices are being developed is examined in Section 2. Whilst most working in the field of health measurement eschew over-simplification, it is clear that the application of micro-economics to management is greatly facilitated if a single index can be agreed. The various approaches to combining morbidity and mortality are described in Section 3. The crucial assumptions concern the measurement and valuation of morbidity; the procedures used for scaling morbidity with mortality; and the role of risk. The nature of the valuations involved are examined in Section 4. It seems unlikely that they could ever be widely acceptable; the combination with death and perfect health poses particular problems; and aggregation across individuals compounds the problem. There are also several technical difficulties of scaling and of allowing for risk which have been discussed elsewhere and so are only considered briefly in Section 5 of this paper.(ABSTRACT TRUNCATED AT 250 WORDS)
Journal of Research in Nursing, 1997
NT Research, 2003
This paper describes key findings and implications from analyses of activity and workload of nurs... more This paper describes key findings and implications from analyses of activity and workload of nurses of different grades and support workers based on data collected using Nursing Information Systems for Change Management (NISCM). 'Activity' refers to the amount of time on a shift spent on different tasks, and 'workload' refers to the number of patients in a variety of wards by demand/dependency group. The activity evidence is based on data from 5,208 staff recording their activity in 535 shift blocks in 19 hospitals and the workload evidence is based on data from 38,585 shifts across 90 wards in 17 hospitals. Four of the seven main findings have been selected for presentation here: variations, division of labour, skill-mix issues and flexibility. The findings show that there appears to be substantial systematic variation between hospitals in the grade mix of nursing staff and that there is little difference in the types of task undertaken by different grades of staff....
International Journal of Health Services, 1980
This article is concerned with the way that social statistics reflect particular views of the wor... more This article is concerned with the way that social statistics reflect particular views of the world, and focuses on the specific case of the Organization for Economic Cooperation and Development's program to develop a set of social indicators. Some illustrations of previous attempts to collect social indicators are given, but the bulk of the article discusses the series of contradictions which regulate the generation and use of statistics by governments, the principal one being between measures which play the ideological role of displaying economic and social “progress” and measures which are of direct use in social planning. This is discussed both for social indicators in general and for social concerns linked to the measurement of health. The article ends with an attempt to evaluate the future of the OECD program within the development of modern capitalism.
Working Papers, 1999
General Medical Services (GMS) are provided mainly through Family Practices, on a demand led basi... more General Medical Services (GMS) are provided mainly through Family Practices, on a demand led basis: that is, there is no cash limit expect for certain specified selected services such as Practice Nurses etc. Nevertheless, since 1948, the Medical Practices Committee ( ...
Canadian Journal of Development Studies / Revue canadienne d'études du développement, 2014
Journal of the Royal Statistical Society. Series A (Statistics in Society), 1992
... By TREVOR A. SHELDONt ... The subject of regression-based formulae has been discussed previou... more ... By TREVOR A. SHELDONt ... The subject of regression-based formulae has been discussed previously in this journal, particularly in relation to local authority expenditure (Derbyshire, 1983, 1987; Jackman and Sellers, 1977) and the funding of teaching hospitals (Straf, 1981). ...
Journal of Development Effectiveness, 2018
International Journal of Educational Development, 2015
The paper reports on the choices nomadic pastoralists in Somalia have made and might make for the... more The paper reports on the choices nomadic pastoralists in Somalia have made and might make for the education of their children, based on a large scale household survey. Households were asked about their own and their children's education and the educational possibilities open to them; and, at the end, they were asked how they would use an unexpected remittance from a friend or relative abroad.
a broad readership drawn from the academic community, professional health care staff and policy m... more a broad readership drawn from the academic community, professional health care staff and policy makers, both within the UK and internationally. Material published in DP form ranges from work in progress, to edited versions of completed project reports, from papers intended ultimately for journal publication, to those which seek to stimulate immediate debate. Hence the variation in length and complexity of DPs. In the past, DPs have been subject to a minimum of editorial revision, it being principally seen as the responsibility of individual authors to ensure that appropriate standards were met. Since June 1996, a more formal system of internal peer-review has been introduced to consolidate the high levels of quality that have been achieved in the past. That system involves the refereeing of DPs in draft form, with any recommended revisions being verified independently by a senior member of staff. DPs are not a substitute for publication in peer-reviewed journals. It is to be hoped t...
Intercultural Europe, 2019
Consumption, Jobs and the Environment, 2002
In Chapter 6 we set out a framework of social concerns. Later in the chapter, we showed how such ... more In Chapter 6 we set out a framework of social concerns. Later in the chapter, we showed how such a framework would imply very different directions for many government policies, from those currently followed. In Chapter 7 we introduced some concrete estimates of the effects on work and the environment of the kinds of shifts that we think would be required to approach a resolution of some of the problems identified in Chapters 2 to 4, while achieving the same and possibly improved levels of welfare or quality of life for the population.
Consumption, Jobs and the Environment, 2002
The overall aim of this book is to focus on the problem of how to increase or at least maintain w... more The overall aim of this book is to focus on the problem of how to increase or at least maintain welfare (the benefits) while reducing ecological clam-age and risks and alienating labour (the costs). We believe that the case for reducing ecological impact of economic activity is proven (see Chapter 2) so that the issue is how to reduce economic activity and what would be the consequences of so doing. We have shown in Chapter 3 that much of current employment has little measurable impact on welfare other than on the person’s income which, with current employment and income policies, is nearly always higher when one has a job.1 In Chapter 4, we showed that for a number of reasons, the consumption which is derived from income is a very poor measure of welfare.
Consumption, Jobs and the Environment, 2002
The impact of economic activities on the natural environment has often been ignored: it is ‘hidde... more The impact of economic activities on the natural environment has often been ignored: it is ‘hidden’ from economic accounting since no one pays for it directly, and ‘external’ to economic transactions in the sense that those suffering the impact are generally not the ones gaining from the activity. This has long been known, but with industrialisation such impacts became greater, as did pressure to reduce them. National legislation against air pollution in the UK for example goes back to the 1820s. More recently, the emphasis has been on taxes designed, at least in principle, to reflect the full pollution impact of activities.
Consumption, Jobs and the Environment, 2002
The last three chapters have looked at the impact on welfare of ecological damage, employment and... more The last three chapters have looked at the impact on welfare of ecological damage, employment and consumption. We conclude that continued growth in economic (or not so economic) activity may reduce rather than improve welfare. This chapter focuses on the policies which have been implemented or proposed, from orthodox or green perspectives, to influence the extent of this activity or mitigate the consequences.
Social Science & Medicine, 1989
The Quality Adjusted Life Year (QALY) has been proposed as a useful index for those managing the ... more The Quality Adjusted Life Year (QALY) has been proposed as a useful index for those managing the provision of health care because it enables the decision-maker to compare the 'value' of different health care programmes and in a way which, potentially at least, reflects social preferences about the appropriate pattern of provision. The index depends on a combination of a measure of morbidity and the risk of mortality. Methodological debate has tended to concentrate on the technicalities of producing a scale of health; and philosophical argument has concentrated on the ethics of interpersonal comparison. There is little recognition of the fragility of the theoretical assumptions underpinning the proposed combination of morbidity and risk of mortality. The context in which the proposed indices are being developed is examined in Section 2. Whilst most working in the field of health measurement eschew over-simplification, it is clear that the application of micro-economics to management is greatly facilitated if a single index can be agreed. The various approaches to combining morbidity and mortality are described in Section 3. The crucial assumptions concern the measurement and valuation of morbidity; the procedures used for scaling morbidity with mortality; and the role of risk. The nature of the valuations involved are examined in Section 4. It seems unlikely that they could ever be widely acceptable; the combination with death and perfect health poses particular problems; and aggregation across individuals compounds the problem. There are also several technical difficulties of scaling and of allowing for risk which have been discussed elsewhere and so are only considered briefly in Section 5 of this paper.(ABSTRACT TRUNCATED AT 250 WORDS)
Journal of Research in Nursing, 1997
NT Research, 2003
This paper describes key findings and implications from analyses of activity and workload of nurs... more This paper describes key findings and implications from analyses of activity and workload of nurses of different grades and support workers based on data collected using Nursing Information Systems for Change Management (NISCM). 'Activity' refers to the amount of time on a shift spent on different tasks, and 'workload' refers to the number of patients in a variety of wards by demand/dependency group. The activity evidence is based on data from 5,208 staff recording their activity in 535 shift blocks in 19 hospitals and the workload evidence is based on data from 38,585 shifts across 90 wards in 17 hospitals. Four of the seven main findings have been selected for presentation here: variations, division of labour, skill-mix issues and flexibility. The findings show that there appears to be substantial systematic variation between hospitals in the grade mix of nursing staff and that there is little difference in the types of task undertaken by different grades of staff....
International Journal of Health Services, 1980
This article is concerned with the way that social statistics reflect particular views of the wor... more This article is concerned with the way that social statistics reflect particular views of the world, and focuses on the specific case of the Organization for Economic Cooperation and Development's program to develop a set of social indicators. Some illustrations of previous attempts to collect social indicators are given, but the bulk of the article discusses the series of contradictions which regulate the generation and use of statistics by governments, the principal one being between measures which play the ideological role of displaying economic and social “progress” and measures which are of direct use in social planning. This is discussed both for social indicators in general and for social concerns linked to the measurement of health. The article ends with an attempt to evaluate the future of the OECD program within the development of modern capitalism.
Working Papers, 1999
General Medical Services (GMS) are provided mainly through Family Practices, on a demand led basi... more General Medical Services (GMS) are provided mainly through Family Practices, on a demand led basis: that is, there is no cash limit expect for certain specified selected services such as Practice Nurses etc. Nevertheless, since 1948, the Medical Practices Committee ( ...
Canadian Journal of Development Studies / Revue canadienne d'études du développement, 2014
Journal of the Royal Statistical Society. Series A (Statistics in Society), 1992
... By TREVOR A. SHELDONt ... The subject of regression-based formulae has been discussed previou... more ... By TREVOR A. SHELDONt ... The subject of regression-based formulae has been discussed previously in this journal, particularly in relation to local authority expenditure (Derbyshire, 1983, 1987; Jackman and Sellers, 1977) and the funding of teaching hospitals (Straf, 1981). ...
Journal of Development Effectiveness, 2018
International Journal of Educational Development, 2015
The paper reports on the choices nomadic pastoralists in Somalia have made and might make for the... more The paper reports on the choices nomadic pastoralists in Somalia have made and might make for the education of their children, based on a large scale household survey. Households were asked about their own and their children's education and the educational possibilities open to them; and, at the end, they were asked how they would use an unexpected remittance from a friend or relative abroad.