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The Challenge to Change -- Contents -- Acknowledgments -- List of Abbreviations -- Introduction -- 1. Health Care Systems in the United States and the United Kingdom: A Lifetime of Change -- 2. Turbulence in the Two Systems -- 3. Measuring and Rewarding Performance: Imposing Change from above in the United Kingdom -- 4. Regulating the Front Line from Above: The Joint Commission and Hospital Regulation in the United States -- 5. Pushing Back from the Front Line: Staff Responses to Privatization in the National Health Service

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This study aims to determine the Renewable Energy Development Implementation in South Solok Regency. New and Renewable Energy is clean energy that is rich in diversity and quantity such as solar energy, wind, natural gas, ocean waves, garbage, wood, biomass, nuclear and water (microhydro). New and Renewable Energy was developed by the West Sumatra Provincial ESDM Office in the South Solok area since 2013, however, in implementing this development there were still some obstacles which was faced by the West Sumatra Provincial ESDM Office as the community which has not felt the impact of developing the benefits of PLTMH. It was because there were some PLTMH which were not functioning or have damaged caused by natural disasters such as floods and landslides, there was still a lack of technicians to repair the damage to the PLTMH, there was still a lack of costs obtained from PLTMH customers who aimed to repair damage to PLTMH generators and turbines. This study was a qualitative research which used descriptive method. The research respondents were selected by using a purposive sampling technique. For the data collection, this study used interview guidelines, observation, and documentation of the research as the instrumentation. The validation technique used the triangulation method. Furthermore, the data analysis technique was reducing data, displaying data, and drawing the conclusions of the study which has been conducted. The findings showed that the Renewable Energy Development implementation for Micro Hydro Power Plants (PLTMH) by the ESDM Office of West Sumatra Province in South Solok was still not running as it should be, because there were still some obstacles which were faced in developing of New Renewable Energy of PLTMH that the results was not being implemented properly. Supporting factors for the implementation of this PLTMH development were the data and information, communication, bureaucratic attitudes, and organizational structure. While communication, organizational characteristics, economic environment and human resources were the inhibiting factors. The Effort to overcome these obstacles was the government has signed several commitments related to the development of Renewable Energy. Beside that, to fill the conditions of the national electricity, the government has also involved the private sector

It is a curious feature of the debate about the UK Labour government's modernization agenda that the consequences for trade unions have been almost wholly neglected. Focusing on a case study of UNISON, the public service trade union that is dominant in local government and health, this paper argues that UNISON has emulated key aspects of the modernization agenda, adopting a dual strategy to union renewal. It has attempted to rebuild workplace organization, but has placed strong emphasis on managerial‐led renewal, adopting many components of the target culture. These measures have created tensions within the organization that mirror some of the broader contradictions of the modernization agenda. The paper concludes by considering the implications of these findings for public service union renewal.

AbstractWhen the British National Health Service was founded in 1948, professional employees and support staff, with the exception of family doctors, worked directly for the state. Since the 1980s, private employment in the National Health Service (NHS) has steadily grown. Beginning with the outsourcing of support services, the number of privately-employed workers in the National Health Service has gradually increased. This paper argues that marketization in the health sector has increased dramatically under the New Labour government. As policymakers have moved from ideological to pragmatic justifications for marketization, union opposition has similarly become more pragmatic and less ideological. With unions unable to stop these reforms, they have turned to the practical concerns of their members in partially-privatized workplaces under complex employment arrangements. This article shows that while ideologically opposing marketization, unions and employees have been forced into a more pragmatic position. Research at two privately-funded public hospitals shows that unions in the workplace have used their resources to protect their members, as thwarting the involvement of the private sector is nearly impossible.