European History 1914-to present Essay Example for Free

European History 1914-to present Essay The period that immediately followed the First World War was marked by the autocratic regimes in Austria, Germany and Russia being replaced by republics as they were overthrown. There seemed to be a promise of an era of democracy as the seven states that had all been newly created adopted the republican form of government giving the impression that democracy had finally been found after the First World War. However, this did not last as after only two decades, a form of dictatorship took over most of the democratic European countries. While some countries became communists, others took to fascism which resulted to totalitarian form of government (Gardner, Kleiner Mamiya, 2005). In totalitarianism individuals had absolutely no freedom in their life as all political, intellectual, social, cultural, economic and even religious and spiritual activities were subordinated to the authority of the rulers and the government. This form of rule was characterized by the rulers of the government as a central power controlling all the aspects of the citizens lives through force and repression such that those who held views that were different from the ideologies of the rulers and had different practices in the mentioned aspects of their lives were considered to be against the state hence enemies. Totalitarianism was manifested through mass-media that was state controlled, one party state in which the party controlled everything that went on in the state, mass surveillance accompanied with state terrorism and restricted free discussion or criticism especially of the governmental ideologies. In European countries such as such as Russia under Stalin and Germany under Hitler, totalitarianism and the practices of the government received overwhelming support from the citizens (Gardner, Kleiner Mamiya, 2005). The support was however not spontaneous, it required the rulers to be charismatic so that he would be able to draw support. The rapid development in infrastructure especially communication and transportation played a great role in the rise and spread of the totalitarianism and growth of its popularity amongst the citizens in the countries in which it was practised. This paper seeks to discuss totalitarianism and the reasons for its rise in Europe in the early 20th century. Totalitarianism is characterized by the state pursuing some goal that is special such as conquest of a certain region, exclusion of all others who hold different ideologies from those ones of the state or industrialization. All resources of the state usually are directed and focussed on achievement of these goals regardless of their cost. Anything that furthers the attainment of the goal is fully supported while the things that threaten to foil this achievement are rejected. It is a form of obsession that triggers an ideology that explains and describes things in terms of the intended goal, justifying all obstacles that could arise and all the forces that may struggle against the state in achieving the desired goal (Gardner, Kleiner Mamiya, 2005). This results to the state getting popular support from the citizens which gives it the power to practice any form of governmental actions. Anyone opposing the goals or ideologies of the state is considered evil and political differences within the state not allowed. Achievement of the goal is never acknowledged even in the event the state actually gets to achieve it. This is because totalitarianism is entirely founded on the ideology of achieving the goal such that in the event the goal is achieved then it should cease to exist. The pursuit of specific goals by different leaders for the states they ruled is considered to be the main reason for the rise of totalitarianism in Europe. As mentioned earlier, fascism was one of the main reasons for totalitarianism. This ideology was common in Germany and Italy. It originated with Mussolini Benito in his rule over the country. This ideology in which the proponents advocated for the creation of a single party state was a reaction against equality, liberty and fraternity that were being proposed by democratic nations such as France and Britain after they won the war. Fascists argued that nations and races usually are in a conflict in which only the strongest and the healthiest survive. Apart from being healthy the strongest also survive by asserting themselves against the weak through repression and in combat (Griffiths 2005). These governments prohibited and suppressed opposition and any form of criticism to the government. In Germany, races that were not German such as the Jews, Slavs and individuals who were either sick or disabled were targeted for execution as Hitler’s government sought to have a nation of pure healthy Germans. Fascism claimed that a nation was the race and hence sought to execute everyone who was not of the race of the rulers (Griffiths 2005). Fascism is also characterized by respect and love for collective organization in which individuals work together to achieve a certain goals and ideology. This formed totalitarianism in Italy and Germany. In which the citizens were organized against other individuals of other races that were considered a threat to achieving a nation that was formed of one superior race. Nazism was movement mostly in Germany which was is also referred to as National Socialism. This movement sought to spread the ideologies of Adolf Hitler’s government in Germany and the world as a whole. Nazism is argued to be a form of fascism as its characteristics are the same as those ones of fascism as it featured racism, expansion and obedience/loyalty to one leader. Hitler expected everyone to be loyal to him and executed anyone who defiled his orders. Nazism also had theories about other races which portrayed them as inferior to German Aryans and a threat to its existence hence the necessity to get rid of them. This led to the massive execution of the Jews and the disabled Germans as they were considered unfit for survival according to fascism. This ideology is therefore one of the reasons for the rise of totalitarianism in Germany and most of its neighbouring nations (Klaus Vondung 2005). Bolshevism-Stalinism was the reason for the rise of totalitarianism in Russia. Bolshevism was a movement formed by professionals who believed in military control over the country and democratic centralism such the party (Marxist Russian Social Democratic Labour Party) took form of internal hierarchy in which individuals from other groups were not allowed to lead the party. Only these members made decisions and any party that was formed to challenge Marxist Russian Social Democratic Labour Party it was purged (Worley, Morgan Laporte 2002). This movement greatly supported single party state and is believed to have caused the rise of Stalinism. Stalinism refers to the form of government used by Joseph Stalin and those who were allied to his ideologies (Worley, Morgan Laporte 2002). This ideology is sometimes referred to as red fascism as it is a form of fascism. Stalinism refers to a form of governance that is characterized by oppression of the citizens and extensive spying by the government so that individuals can not criticize or form movements to overthrow it. This system was also characterized by purging in which those who were opposed to the government ideologies were sent to prison camps or sometimes killed. The state used propaganda and established some form of cult around a leader who was a dictator so that he would have absolute control over the communist party and maintain control over all the citizens of Russia. Apart from the mentioned countries, Austria also participated in the rise of totalitarianism by supporting Nazism and Fascism. Its Prime Minister Kurt Waldheim is said to have assisted Germany in transporting Jews to dearth camps. Several other Eastern and Central European countries also got obsessed with the fascist movement (Klaus Vondung 2005). This included Serbia, Romania, Bulgaria, Ukraine, Slovakia, Lithuania and Croatia. The fascist movements in these countries were all characterized racism specifically against the Jews whom they associated with communism which they greatly despised. Spain is the only country which though fascist never got obsessed with race and believing in the ant-Jewish conspiracies that characteristic of German’s Nazism. The rise of totalitarianism in Europe during the early 20th century was mainly due to fascism. Both Nazism and Bolshevism-Stalinism which were the main movements in Europe at this time and are all forms of fascism which emphasizes on the power of the state over the citizens. A significant characteristic of these movements is racism in which each state believed in being occupied by only those who were of its race hence eliminating those who belonged to different races or had different practices than were contrary to the ideologies of the ruling government. The most affected race in Europe was the Jewish. The rise of totalitarianism in Europe can therefore be solely attributed to fascism. References Gardner, H. , Kleiner, S. Mamiya, C. , (2005). Gardners Art Through The Ages: The Western Perspective. Sidney: Cengage Learning. Griffiths, R. (2005). Fascism second ed. New York, NY: Continuum International Publishing Group. Klaus Vondung, K. (2005). The Apocalypse in Germany, Columbia and London: Univ. of Missouri Press. Redles, D. (2005). Hitler’s Millennial Reich: Apocalyptic Belief and the Search for Salvation. New York, NY: New York Univ. Press. Worley, M. , Morgan, K. Laporte, N. , (2002). Bolshevism, Stalinism And The Comintern: Perspectives On Stalinization. New York, NY: Palgrave Macmillan.

Finance & Strategic Management Essay Example for Free

Finance Strategic Management Essay Over the past decades the concept of Corporate Social Responsibility (CSR) has continued to grow in importance and significance due to external pressure of diverse stakeholders, and has thereby become more prominent on companies’ agendas (Carroll Shabana, 2010; Beurden Gossling, 2008). The concept of CSR has been subject to considerable debate, commentary, theory building and continues research (Carroll Shabana, 2010). The question, of whether CSR investments result in financial and social benefits that outweigh its costs, is intensively scrutinized in existing literature (Schreck, 2001; Carroll Shabana, 2010). Adherents of CSR argue that it is in the long-term self-interest of corporations to be socially involved (Carroll Shabana, 2010; Barnet 2007). The overall logic is that CSR increases the trustworthiness of firms and strengthens the relationships with stakeholders. CSR may further result in decreased transaction costs and thereby improved corporate financial performance (CFP), by decreasing employee turnover, reducing operating costs, as well as functioning as a buffer in disruptive events (Carroll Shabana, 2010; Barnet, 2007). Barnett (2007) and Schreck (2011) argue that, if the financial benefits of CSR meet or exceed the costs, CSR can be justified as a rational investment. According to Kurucz, Colbert and Wheeler (2008), firms may attain four distinct benefits from engaging in CSR; cost and risk reduction; gaining competitive advantage; developing reputation and legitimacy; and seeking win–win outcomes through synergistic value creation. Critics of CSR typically use classical economic arguments, articulated most forcefully by Friedman (Carroll Shabana, 2010). Traditionally, the expenditures of CSR are considered an illegitimate waste of resources, which conflict with a firm’s responsibility to its shareholders (Schreck, 2011, Barnet, 2007). According to Friedman (1970) â€Å"There is one and only one social responsibility of business – to use it resources and engage in activities designed to increase its profits so long as it stays within the rules of the game†¦Ã¢â‚¬ . Friedman further argued that, social issues are not the concern of business people, and â€Å"the business of business is business† (Carroll Shabana, 2010). Even though CSR have been subject to critique, an increasing number of corporations are accepting responsibilities that extend well beyond the immediate interest of the owners, by considering â€Å"non-shareholder stakeholders’ concerns† (Grant, 2010; Clegg, Carter, Kornberger Schweitzer, 2011). Although the existence, direction and strength of possible links between CSR and CFP have been the subject of several empirical analyses (Schreck, 2011), and even though CSR is almost universally practiced, the results from empirical studies are inconclusive (De Bakker, Groenewegen Hond, 2005). After more than thirty years of research, it cannot clearly be concluded, whether a one-dollar investment in social initiatives returns more or less, than one dollar in benefits to shareholders (Barnet, 2007; Surroca Tribo Waddock, 2008). The inconclusiveness of empirical studies may be due to unclear and inconsistent definitions of key terms (De Bakker, Groenewegen Hond, 2005; Barnet, 2007), methodological differences (Carrol Shabana, 2010), and diverse approaches of measuring CSR and CFP (Beurden Gossling, 2008). In existing literature, CSR activities are often entioned to reduce risk, by avoiding the various consequences of moral disapproval by numerous stakeholders (Zadek, 2000). However, CSR derived risk reductions are considered as an ex-post beneficial outcome and not as a proactive risk management instrument to control or reduce idiosyncratic risk (firm specific). Under the assumption that, shareholders are risk adverse and prefer a high expected return (Bodie, Kane Marcus, 2011; Brealey, Myers Allen, 2011), a reduction of firm specific risk must be perceived as favorably. Provided that CSR investments can be applied as a risk management tool, CSR could be seen as investments by firms on behalf of its shareholders. Taking a shareholder perspective, this paper looks beyond the socially good deed of CSR, and focuses on the value of CSR as a method to reduce idiosyncratic risk without detriment of CFP. CSR and Risk Management Since this paper hypothesizes that, CSR can be applied as a risk management instrument to preserve CFP, risk need to be defined. Risk can be defined as the uncertainty about outcomes or events, especially with respect to the future (Orlitzky Benjamin, 2001). Widely risk management is defined as a managerial tool to avoid risk, transfer risk to another party, reduce risk, or in some cases accepting consequences of a certain risk (Froot, Scharfstein Stein, 1994). A shareholder’s perspective on risk management however, conflicts with the capital asset pricing model (CAPM) (Markowitz, 1952) and the Modigliani Miller’s theorem on capital structure (1958). CAPM theory states that, the cost of reducing idiosyncratic risks simultaneously reduces the expected return, and hence firm value (Markowitz, 1952). Risk reduction by holding a well-diversified portfolio of securities will be unattainable by risk management (Godfrey, Merrill Hansen, 2009), why a profit-maximizing investor would not prefer risk management. Total firm risk is in general the combination of systematic and unsystematic risk (Hoje Haejung, 2012). Systematic risk, often referred to as market risk or non-diversifiable risk, is usually defined as the firm’s sensitivity to changes in the market average returns, which cannot be reduced by diversification of shareholders (Weber, 2008; Luo Bhattacharya, 2009; Orlitzky Benjamin, 2001). Unsystematic risk is defined as idiosyncratic risk (Hoje Haejung, 2012; Luo Bhattacharya, 2009). Idiosyncratic risk is traditionally viewed as indifferent to the portfolio investors, since it is associated with specific companies and thereby can be reduced by diversified portfolios (Husted, 2005; Weber, 2008). Opposing idiosyncratic risk is of great relevance to the firm manager, whose very survival may depend upon taking adequate measures to reduce the idiosyncratic risk (Husted, 2005). Firms’ financial risk is often defined in terms of variability of returns (Orlitsky Benjamin 2001), or stock price volatility (Luo Bhattacharya, 2009), which is important risk measures, given that higher volatility implies greater investment risk and uncertain future cash flows (Luo Bhattacharya, 2009; Oikonomou, Brooks Pavelin, 2012). A reduction in idiosyncratic risk reflects reduced variance in the future expected cash flows, which translates into greater shareholder wealth (Luo Bhattacharya, 2009; Mishra Modi, 2012). In a strict Modigliani and Miller perspective, risk-management instruments are of no value, since these are purely financial transactions that do not affect the value of a company’s operating assets (Froot, Scharfstein Stein, 1994). The views of CAMP and Modigliani and Miller have been superseded by a postmodern view of risk management as an important strategic tool. Firms do invest in insurances even though the costs of these investments may be in excess of expected losses, which is in clear violation with the perfect market assumption (Smith Stulz, 1985; Stultz, 2002). If risk management can reduce firms’ exposure to idiosyncratic risks, it protects shareholders against the deadweight costs of severe financial distress in a way, that investors can not accomplish in the market by diversifying (Godfrey, Merrill Hansen, 2009). Review of the linkage between CSR and risk For several decades, researchers have aimed at discovering a conclusive linkage between CSR and CFP, the literature however, remains highly fragmented (Aguinis Glavas 2012). According to Orlitsky Benjamin (2001) true economic performance manifests itself in both high financial returns and low financial risk. Among financial and non-monetary benefits, risk reduction is often mentioned as a positive outcome of engaging in CSR activities. Porter and Kramer (2006) argue that, today’s pressure, of external stakeholders to hold companies accountable for social issues, learly demonstrate the potential large financial risks for any corporation. Several scholars emphasize, that the costs of CSR can be justified by reductions in risk and costs derived from engagement in social issues (Caroll Shabana, 2010). The primary argument is that the diverse demands of stakeholders represent potential threats and risks to the viability of the firm, why it is the economic interest of firms to mitigate these threats and gain legitimacy through social involvement (Caroll Shabana, 2010; Schreck, 2011; Kurucz, Colbert Wheeler 2008). Existing literature on the CSR-risk relationship is virtually unanimously agreeing upon a negative correlation between CRS and idiosyncratic risk, where empirical results show that CSR lowers idiosyncratic risk (Spicer, 1978; Orlitsky Benjamin, 2001; Godfrey, 2005; Hoje Haejung, 2012; Caroll Shabana, 2010; Godfrey, Merrill Hansen, 2009; Heal, 2005; Luo Bhattacharya, 2012; Oikonomou, Brooks Pavelin, 2012; Berman, Wicks, Kotha Jones, 1999; Hart, 1995; Shrivastava, 1995; Peloza, 2006). Several studies have also shown a significant negative relationship between CSR and systematic risk (non-diversifiable) (Hoje Haejung 2012; Orlitzky Benjamin, 2001; Mcguire, Sungren Scneewies, 1988; Luo Bhattacharya, 2009). CSR reduces idiosyncratic risk by reducing the probabilities of expected financial, social, or environmental crisis that could adversely influence firms’ cash flows (Hoje Haejung, 2012). Firms perceived as socially responsible may be able to increase interpersonal trust among stakeholders, build social capital, lower transaction costs, and therefore ultimately reduce uncertainty about future financial performance (Orlitzky Benjamin, 2001). Luo and Bhattacharya (2009) present the view of CSR, as helping the firm build a bulwark of defense against future losses of economic value by reducing firm specific risk and vulnerability of future cash flows. Firms with high social responsibility may have lower financial risk, since these are less sensitive to certain negative external events, like regulatory governmental intervention, undesirable publicity, probability of civil- and criminal legal proceedings or consumer boycotts, why risk reduction can be seen as a monetary benefit of CSR (Mcguire, Sungren Scneewies, 1988; Oikonomou, Brooks Pavelin, 2012; Weber, 2008; Orlitzky Benjamin, 2001; Mcguire, Sungren Scneewies, 1988). Participation in specific types of CSR, those aimed at a firm’s secondary stakeholders or society as a whole, is argued to create a form of goodwill or positive â€Å"philanthropic moral reputational capital†, which functions as an insurance-like protection, when negative events occur (Godfrey, 2005; Peloza, 2006). When business activity creates negative impact on society, stakeholders respond by sanctioning the firm (Godfrey, Merrill Hansen, 2009). It is argued that the goodwill, derived from engagement in CSR, reduces the overall severity of the sanctions, by encouraging stakeholders to give the firm ‘the benefit of the doubt‘(Godfrey, 2005; Uzzi, 1997; Peloza, 2006; Godfrey, Merrill Hansen, 2009). The resultant moral capital gained from social engagement has little to do with generating financial value, but the insurance-like protection contributes with preserving shareholder value and thereby financial performance (Godfrey, Merrill Hansen, 2009). Mishra and Modi (2012) fund a significant effect on idiosyncratic risk, when CSR is applied, the authors however enhanced this result by finding that, positive CSR reduces idiosyncratic risk, while negative CSR increases idiosyncratic risk. Literature has, according to Mishra and Modi (2012), often a singular focus on positive CSR, and overlooks that firms also occasionally engage in activities that qualifies as negative CSR. Luo and Bhattacharya (2009) and Porter and Kramer (2006) argue that CSR is not beneficial in all situations, but is rather advantageous in some contexts and disadvantageous in others and can even lead to additional risk. This is in line with Barnet (2007), who argues that stakeholders’ perception of firms’ CSR engagement are path-dependent (Barnet, 2007; Luo Bhattacharya, 2009; Hoje Haejung, 2012). For firms with social negative impact or prior bad reputation, CSR may be perceived as â€Å"blood money† to mitigate past sins, omissions or shortcomings (Luo Bhattacharya, 2009; Barnet 2007). CSR can thereby lead to reduced idiosyncratic risk, but can also expose a firm to additional risk (Weber, 2008; Barnet, 2007). Discussion Even though the CSR-risk relationship have received much attention in the existing literature, managing risk as the predominantly basic for engaging in CSR has not received specific attention. Focus within the field is on ex-post measures of risk-related benefits, where CSR is not valued as a proactive tool to reduce idiosyncratic risk. Existing research does not seem to provide any practical guidance to managerial proactive evaluations of the risk reductions derived from CSR involvement. It further lacks a practical framework to ex-ante quantify the risk related benefits of CSR (Weber, 2008). The above review demonstrates the focus on risk, solely as valuable side-effect of engaging in CSR activities. The authors of the paper posit a research gap exists within the existing literature of CSR and risk: CSR is not considered as a proactive ex-ante risk management instrument to control and reduce firm risk. Given the risk reducing benefits of CSR, the authors suggest that investments in CSR can be used as a proactive risk management instrument to reduce idiosyncratic risk. Such an approach could strengthen the overall CSR involvement and support rational ex-ante decision-making in this area (Weber, 2008). The aim is to draw a much-need attention to the risk-reduction potential of CSR by viewing CSR investments as a proactive risk management tool, where managing risk is the main purpose for engaging in CSR. Empirical resolving the research gap and verifying the hypothesis is beyond the scope of this paper. The authors however, suggest that a potential solution is to apply real option theory as a basis for proactive CSR risk management decision-making. CSR as a real option Attributable to the aforementioned arguments, the function of CSR as a risk management tool can be considered as a real option. Regular options are based on securities (financial instruments), whereas real options are based on hedging against uncertainties in real investment projects (Mun, 2002). An analysis of the costs and benefits of CSR projects, using traditional NPV models, often leads to a rejection, as these fail to contribute to maximizing shareholder value (Friedman, 1962). This is, nevertheless, not always the right decision, as the NPV approach fails to incorporate the main advantage of real options (Husted, 2005). Compared to the traditional NPV approach, real options offer management flexibility through multiple decision-making in situations with high uncertainty. Managers have the option, but not the obligation, to engage in, modifying or end strategies, as new information becomes available (Mun, 2002). A CSR option offers the choice of deferring, abandoning, expanding, or staging an investment project (Amram Howe, 2003). Due to the theoretical and mathematical complexity of option theory, which is beyond the scope of this scientific paper, option theory will be described on an incomprehensive level. In brief option pricing is a function of five variables: the value of the underlying asset, the exercise price, time to exercise, the risk-free interest rate, and the volatility of the underlying asset (Black Scholes, 1973). The value of the underlying asset is the resources resulted from the CSR option, such as qualified employees, PR and cost avoiding’s etc. Husted, 2005). The exercise price refers to the required additional investments needed for receiving the value created by the CSR option. The timing of the exercise is an essential variable, as it has great effect on the value of CSR options. The risk-free interest rate does not play an important role in most real options (Mun, 2002). The volatility or the uncertainty of the underlying asset has a significant impact on the value of CSR options (Mun, 2002). The variance of the expected value can both be higher or lower than the expected return. Black and Scholes is the most widely used regular option pricing model, however, also one of the most complicated models (Mun, 2002). A Binomial lattice approach is applied in most real option pricing, as it provides a more transparent and intuitive appeal compared with Black and Scholes’ theoretical and mathematical approach (Mun, 2002). However, since the aim is solely to clarify the value of real options in a CSR context, the choice of approach is of less relevance. Real options provide an important framework for firms to manage risk by reducing the risk of future investments, and can thus be an essential tool in corporate risk management (Husted, 2005). Finally, a real CSR option explicitly includes a time dimension. This ex-ante perspective is clearly different from the focus on risk in most CSR-risk research, which is ex post in nature. CSR as a risk management instrument – The Toyota example A few decades ago, car manufacturers did not focus so intensively on a green profiling as they do today. The increased oil prices in 1973 and 1979 were influential for the entry of Japanese car manufacturers in USA, who were producing smaller and more gas efficient cars (Andrews, Simon, Tian Zhao, 2011). The gas efficient cars of Japanese manufactures were causative to the car industry as a whole subsequently invested massively in green technology projects. These investments have met consumers’ need and have generated positive branding values. Toyota’s Prius has reached â€Å"cult status†, as it is one of the most gas efficient and green cars on the market. However, more interestingly is the security, that the green profile of the Prius has offered Toyota, which includes protection against the bad publicity of car manufacturers’ contribution to pollution and factors such as Middle Eastern conflicts that influence oil prices and hence sales of cars. At first glance, it appears as Toyota has been skilled at forecasting future trends and meeting customer’s needs without using CSR as management instrument. As the following example however illustrates, Toyota’s management could have benefitted from considering investments in CSR as real options to control idiosyncratic risk and thereby preserve CFP. In 2009 repeated accidents occurred, which were accused to be caused by flaws in floor mats and accelerator pedals in Toyota’s vehicles. This resulted in a recall of more than 5 million vehicles, alone in the North American market (Andrews, Simon, Tian Zhao, 2011). Before a product is recalled, companies have to make severe considerations. A product-recall can have great financial impact in terms of losses in brand value, consumer goodwill, decreasing sales and a negative effect on stock prices (Kumara Schmitza, 2011), which in this case is the value of the underlying asset of the CSR option. The decision to recall the cars is the price of the option. The recall option could have generated strategic flexibility, which however, meanwhile was eliminated, as Toyota’s management failed to exercise the option, before it was too late. The leisurely recall decision resulted in losses in brand value, consumer goodwill, decreased stock price, lower sales, a fine of $16 million and more than 130 potential class-action lawsuits (Andrews, Simon, Tian Zhao, 2011). The negative outcome of the late recall is considered as high volatility of the underlying asset. A faster recalling could have had a avoiding, a limited or opposite effect on product brand, consumer goodwill and the massive media coverage (Husted, 2005). Provided that Toyota’s management had viewed the recall decision as a valuable option rather than severe costs, strategic flexibility could have been obtained, why the negative outcome may have been avoided. A faster exercise of the recall option might have resulted in goodwill or trust, which could have been exploited by Toyota to limit the negative publicity caused by the repeated accidents. Toyota however, failed to exercise the recall option in acute time, why the result was lost flexibility to respond to the unexpected event of the accidents. The value of the real option foregone by Toyota was a function of inter alia lost sales, brand value and reputation. Toyota’s management failed to exploit the advantages of CSR as a risk management tool.

Analysis and evaluation of the NHS

Analysis and evaluation of the NHS The National Health Service (NHS) provides healthcare for all UK citizens based on their need for healthcare rather than their ability to pay for it. NHS is funded by taxes. This report identifies the problem with NHS with problem solving tools and techniques. For finding this problem Casual Loop and BOT methodologies has been used. NATIONAL HEALTH SERVICE (NHS): On 5 July 1948, NHS was launched by Health Secretary Aneurin Bevan and for the first time health care became free to all UK citizen. In 1952, Patients started being charged for prescription. First mass vaccination programme for polio and diphtheria started in 1958. Before this, there were 8000 cases of polio and 70000 of diphtheria each year. In 1961, contraceptive pills were launched which gives women control over how many children they have. In 1962, Health Minister Enoch Powell put forward The Hospital Plan which set out a 10 year vision for hospital building. Every population of 125,000 was to get a hospital or district general hospital as they become known. In 1967 Abortion Act was passed by a free vote of MPs and introduced by Liberal MP David Steel which made abortion legal up to 28 weeks if a womans mental or physical health was at risk and further limit reduced to 24 weeks in 1990. In 1968, UKs first heart transplant surgery was carried out in the National Heart Hospital in London with 18 doctors and nurses operating a 45 year old man for seven hours. CT scanners were used for first time in 1972. CT scanners started to be used on patients through the development of the previous five years. CT scan machines take pictures of the body to develop 3D images, revolutionising investigations of the body. Worlds first test tube baby was born on 25 July 1978 before midnight in Oldham District General Hospital. To reduce breast cancer deaths in women over 50, breast screening was introduced in 1988 and along with improved drug treatment screening was estimated to have cut deaths by a fifth. In 1990 NHS and Community Care Act was introduced by the legislation which was known as the NHS internal market with health authorities given their own budgets to buy care for local populations from hospitals. In 1994 organ donor register created to co-ordinate supply and demand. It was the result of a five year campaign by John and Rosemary Cox whose son Peter died in 1989 and he had asked for his organs to be used to help others. In 2006, patients were given the choice of four or five hospitals, ending the long held tradition of going where GPs decides. The scheme has now been extended to include all hospitals in England but not adopted elsewhere in UK. PEST ANALYSIS: A review of the political, economic, social and technical (PEST) environment involves analysing the environment for any organisation. UK based healthcare provider for the public, NHS funded by contributions made from taxes distributed by the government to each of the trusts. NHS operates within a politically stable economy with funds pledged by both previous and current governments to the service for improvements in healthcare and salaries for staff. NHS facing the economic environment is a growing economy with a rising elderly population and less working people to support them. It has become increasingly difficult to recruit medical staff and shortages have often been counteracted by employing staff from other European Union countries which in turn increases the population within the UK. The social environment shapes beliefs, values and norms (Kotler). Belief is the core values of the health service and the services it offers was high on the publics list of concerns during the last general election as if NHS is an internal part of the UK and its culture. The technological environment is moving fast within the health care sector with continually development of drugs, advancement of techniques for operations and the use of technologies for both medical and administrative procedures. SWOT ANALYSIS: Strengths: There is no real competitor for the NHS although it doesnt have monopoly in the market. Accident and Emergency service is unique to the NHS though private hospitals are available throughout the UK. The NHS has continued to grow and expand upon its services since it was established in 1948. NHS maintains good relationship with health community partners. Weaknesses: Due to increasing population NHS is unable to cope with the demand. High waiting time for the patients. Bad behaviours and attitudes of some staff. Opportunities: Uses of marketing strategies to raise the profile of the NHS. Partnerships and joint ventures with private and voluntary sector. Threats: Work of contractors affects image of NHS. High turnover of staff. Shift of services to primary care. CAUSAL LOOP DIAGRAM: Causal Loop Diagrams contain several components: One or more feedback loops that are either reinforcing or balancing processes. Cause and effect relationships among the variables. Delays. Where feedback reduces the impact of change, it is a Balancing loop. Balancing loops try to bring things to a desired state and keep them there. Where feedback increases the impact of change, it is a Reinforcing loop. Reinforcing loops compound changes in one direction with even more changes in that direction. Causal Loop Diagram has two kinds of relationships between variables: When variable A changes, variable B changes in the same(S) direction. It is indicated by (S) in the diagram. When variable A changes, variable B changes in the opposite (O) direction. It is indicated by (O) in the diagram. The Causal Loop Diagram for NHS contains variables which are as follow: Number of Doctors, Nurses and other medical staff: The number of doctors, Nurses and other medical staff working in the NHS is inversely related to the waiting time for patients. This implies that when the number of staff increases, the waiting time for patients decreases because of added capacity. The number of staff working with NHS depends on softer variables such as their morale and work environment. Number of Patients on the Waiting List: This refers to the number of patients on NHS waiting list. The waiting list becomes short when a large number of patients shift from NHS to private health care and becomes particularly long due to seasonal peaks. Waiting time: This is time a patient has to wait before he/she can be treated by NHS. Number of hospitals, beds, medical equipment: The number of hospitals, beds and medical equipment are dependent on the annual NHS budget and funding. If there is a lack of these resources than it would increase tension in the system and it would take longer to treat patients. Perceived quality of Health Services (Waiting time, Treatment and After Care): -This varies from patient to patient, if the waiting time is too long, the perceived quality of the service is low and this in turn causes more people to complain against the NHS. Number of Complaints: Dissatisfaction of the patients due to increase in waiting times leads to an increase in complaints against the NHS. This increases pressure on the government and the Department of Health by acts of the National Audit Office. Number of Patients shifting to private Health care: The patients dissatisfied by the long waiting times of NHS, started complaining and shifting to private health care. Government action: Longer waiting lists increased media pressure causing the Government to increase its annual NHS budget which relaxes the system temporarily as new funds increases the NHS capacity. Investment in facilities, Medical equipment and information technology: An increase in the NHS budget allows the NHS to hire more medical staff and improve the capacities in hospitals. More patients can be treated within short time and the waiting lists can become shorter as the budget increases. Partnership with Private Health Care: NHS cannot cope with the excessive demand when the waiting lists become too long. So it tends to outsource its service to private health care e.g. BUPA, NHS express surgery units in partnership with state run German and French health care firms. This is quick and short way to fix the problem and tends to bring down the waiting time in the short run. Morale of doctors and other medical staff: This is a soft variable that depends on factors like the quality of the work environment in the NHS hospitals, the work pressure and employee satisfaction. The morale of doctors and other medical staff has a positive effect on the quality of service provided to patients. It also determines the number of doctors and medical staff that stay with NHS or join NHS. Number of patients coming back to the NHS: The waiting list tends to decrease when a large number of patients shift to private health care or/and when the NHS budget is increased to support improved health care. The waiting time for the treatment becomes short and due to this some of the patients who had previously shifted to private health care return to NHS. This once again increases the waiting list of the patients. All the actions and movements of these variables are shown in the Causal Loop Diagram of NHS (figure 1) Figure : Causal Loop Diagram for NHS Key: = Loop 1(Balancing Loop) = Loop 5(Reinforcing Loop) S = Augmenting Relationship O = Inhibiting Relationship The causal loop diagram suggests that a deeper set of forces is at work and the problem situation to be modelled is complex and dynamic. It is necessary to consider both hard variable (number of beds and hospitals) and soft variables (morale of staff). There are 6 loops in the system. There are 2 positive loops or reinforcing loops and 4 loops are negative or balancing loops. In loop 1, increasing number of patients on waiting list increases the waiting time which leads to dissatisfaction and complaints against the NHS. This also switches some patients to private health care. Increasing pressure from public and media forces the government to increase the NHS budget. This tends to have positive effect on the system by increasing NHS capacity and reducing the waiting list. Loop 1 is affected by loop 5 which is positive and reinforcing loop. Some patients decide to return to NHS from private health care as waiting list is decline. This increases the waiting list once again. Hence, there are no proper solutions to the problem or solution is difficult to achieve. Many obvious solutions to the problem like increasing the NHS budget failed in the past. The causal loop diagram contains more negative loops than positive loops. Hence the system appears to be a negative system that tends to counter uncontrolled deviation and stabilise if the waiting list increases significantly. CONCLUSION: NHS is the UK health care service run by the government funded through the taxes. This report shows environmental condition of NHS through PEST analysis and Strengths, weaknesses, opportunities and threats of NHS through the SWOT analysis. The causal loop diagram for NHS point out the main problem of NHS which is increasing waiting time for patients and a temporary increase in resources (NHS budget) gave short run solution for the problem. RECOMMENDATION: Collaboration with private health service to decline waiting time. NHS should maintain good relationship with private health service. NHS should overcome its weakness through its strength and reduce its threats through appropriate use of its opportunities. Increase its work force and equipment. NHS should stop the contract based employee and there should be better coordination between doctors, nurses and other employees.

Exemplification Essay: Euthanasia Should Be Legalized -- Exemplificatio

Jack has just been in a serious car accident. He is suffering from brain damage and paralysis. His family does not want him to live the rest of his life this way, but do they have a choice in ending the pain and suffering of their loved one? According to most state governments and countries, the answer is no; however, there is method allowed in some states to stop the pain and suffering for both the patient and his family. This method is called euthanasia. Euthanasia is the deliberate, painless killing of persons who suffer from a physically or emotionally painful or incurable disease or condition. Euthanasia is illegal in most countries and few doctors practice it, but it is a decision that seriously ill or injured people and their families should be allowed to make. Jack is unable to do anything. He cannot walk, talk, or even kiss his wife and kids goodnight. Imagine the pain that Jack and his family are going through. His family would much rather see him be put to rest than to watch him suffer the rest of his life. Would you be able to live your life this way? Many people would not be able to, and that is why euthanasia is an important choice to have. It would prevent the family from a lifetime of suffering because the family would not have to see the ill person suffer and they would know that they did the right thing by ending the misery. The major advantage of euthanasia is that it prevents a person from having to endure the rest of their life in pain. There is no appropriate reason that a person who is suffering from an incurable disease or condition should have to spend the rest of his or her life that way. If their family agrees with them, then the patient’s suffering should be put to an end. Many peop... ...d on a patient who wants the help. Would you want to live the rest of your life the way Jack has to, and would your family want you to? The only way in which this can be prevented is euthanasia. If you would not want to spend the rest of your life suffering, how can we expect anyone else to? Works Cited â€Å"Let Death Be My Dominion.† The Economist. Oct 16, 1999. 353 (1999): 89-92. Proquest. Online. 19 Nov. 1999. Daniel, Caroline. â€Å"Killing with kindness.† New Statesman. 126 (1997): 16(3). Infotrac. Online. 19 Nov. 1999 Emanuel, Ezekiel J. â€Å"Death’s Door.† The New Republic. 220 (1999): 15-16. Proquest. Online. 19 Nov. 1999. Gillon, Raanan. â€Å"When Doctors Might Kill Their Patients.† British Medical Journal. 318 (1999): 1431-1432. Proquest. Online. 19 Nov. 1999. â€Å"Suicide.† Clinical Reference Systems. Jul (1999): 1421. Infotrac. Online. 2 Dec. 1999. Exemplification Essay: Euthanasia Should Be Legalized -- Exemplificatio Jack has just been in a serious car accident. He is suffering from brain damage and paralysis. His family does not want him to live the rest of his life this way, but do they have a choice in ending the pain and suffering of their loved one? According to most state governments and countries, the answer is no; however, there is method allowed in some states to stop the pain and suffering for both the patient and his family. This method is called euthanasia. Euthanasia is the deliberate, painless killing of persons who suffer from a physically or emotionally painful or incurable disease or condition. Euthanasia is illegal in most countries and few doctors practice it, but it is a decision that seriously ill or injured people and their families should be allowed to make. Jack is unable to do anything. He cannot walk, talk, or even kiss his wife and kids goodnight. Imagine the pain that Jack and his family are going through. His family would much rather see him be put to rest than to watch him suffer the rest of his life. Would you be able to live your life this way? Many people would not be able to, and that is why euthanasia is an important choice to have. It would prevent the family from a lifetime of suffering because the family would not have to see the ill person suffer and they would know that they did the right thing by ending the misery. The major advantage of euthanasia is that it prevents a person from having to endure the rest of their life in pain. There is no appropriate reason that a person who is suffering from an incurable disease or condition should have to spend the rest of his or her life that way. If their family agrees with them, then the patient’s suffering should be put to an end. Many peop... ...d on a patient who wants the help. Would you want to live the rest of your life the way Jack has to, and would your family want you to? The only way in which this can be prevented is euthanasia. If you would not want to spend the rest of your life suffering, how can we expect anyone else to? Works Cited â€Å"Let Death Be My Dominion.† The Economist. Oct 16, 1999. 353 (1999): 89-92. Proquest. Online. 19 Nov. 1999. Daniel, Caroline. â€Å"Killing with kindness.† New Statesman. 126 (1997): 16(3). Infotrac. Online. 19 Nov. 1999 Emanuel, Ezekiel J. â€Å"Death’s Door.† The New Republic. 220 (1999): 15-16. Proquest. Online. 19 Nov. 1999. Gillon, Raanan. â€Å"When Doctors Might Kill Their Patients.† British Medical Journal. 318 (1999): 1431-1432. Proquest. Online. 19 Nov. 1999. â€Å"Suicide.† Clinical Reference Systems. Jul (1999): 1421. Infotrac. Online. 2 Dec. 1999.

St. Augustine and the Problem of Evil from a Christian Basis Essay

St. Augustine and the Problem of Evil from a Christian Basis In his Confessions, St. Augustine writes about a large number of topics that continue to have relevance today. The text documents the development of Augustine’s faith and his Christian philosophy, and one thing of particular interest is his argument for the nature of evil. Christianity predicates several important ideas that Augustine builds upon in his philosophy, and within its context, he presents a thorough, compelling argument against the problem of evil that identifies evil as a misperception. Augustine first characterizes God based on how he experiences God’s presence and qualities. Augustine searches for Him unsuccessfully in the physical world, and the physical universe for that matter, and then decides that he must look within himself to find God. His description of God illustrates the ideas in Christianity that God is omnipotent and entirely good, or all-loving. â€Å"I entered and with my soul’s eye, such as it was, saw above that same eye of my soul the immutable light higher than my mind†¦ It transcended my mind†¦ It was superior because it made me, and I was inferior because I was made by it.† (Augustine, 123) Augustine clearly conveys the magnitude of God and his greatness, which exceed the comprehension of man’s mind. This is perhaps the most important quality of God’s being, which properly coincides with His descriptions in Christianity, because it establishes a scale for measuring the qualities of God that He instilled in his creations. Augustine next discusses three aspects that define God for him. Of particular importance is the idea that the Christian God is eternal, so there has never been a time w... ... possible that, as with Augustine, the perception of evil leads people to think about its nature and, ultimately, they begin to learn the truth. From that point, they grow until they are able to feed from God’s goodness, and then they achieve the supreme goodness and become one with God. There is, then, no problem in ‘evil’ because it in fact is good. Ultimately, it is impossible to know exactly the reasons for God’s actions. His qualities are such that He transcends being, and a person’s best effort to understand God can at best give him or her approximate understanding. Only through reason and discovery of the truth can a person grow until, finally, he or she is transformed by God into His Being. At that point, comprehension of it is no longer necessary. Works Cited Augustine. Confessions. Trans. Henry Chadwick. Oxford: Oxford UP, 1998.

Iago and Angelo as the Hypocrites of Shakespeares Othello Essay examp

Few plot elements inspire such an emotional reaction in readers as does hypocrisy. Not only do readers feel genuine anger at the actions of the hypocritical character, but they also feel deep sympathy for the Hester Prynnes of the stories they read. This tandem of anger and sympathy is a powerful tool for an author to use to draw readers into his or her tale, because creating an emotional response in one’s audience is the best way to make them identify with the story. The response of the readers to these situations is a fascinating one. Perhaps the reader remembers a time when s/he was the victim of a two-faced action. Perhaps stories about hypocrisy evoke a sense of moral outrage or awaken a sense of justice in the reader. Perhaps the reader is simply fascinated with having a secret that s/he is unable to tell. For whatever reason, authors have carefully woven threads of hypocrisy into the fabric of their stories since the very dawn of literature. Some of the best examples o f this skill (as indeed of many others) come from the writings of William Shakespeare. Shakespeare’s astute observations of human nature coupled with his amazing word craftsmanship have created some of the most memorable hypocrite characters in all of literature. From the twisted, jealous, hatred of Iago in Othello to the lusty self-righteousness of Angelo in Measure for Measure, we can glean a sense of Shakespeare’s masterful manipulation of hypocrisy to create a tempting tale. Iago and Angelo are true hypocrites. In Othello, we are first introduced to Iago, a military officer under the command of the Othello, a well-respected Moorish captain. Iago’s hatred for Othello is revealed in the very first lines of the play, when it is revealed that he has been... ...haracters who exhibit hypocrisy. Whether it is anger at the hypocrite or empathy for the victim, a good author or playwright can capitalize on this tendency but constructing a plot with a few hypocritical timbers. Shakespeare was a master at such structures, introducing two of them in Othello and Measure for Measure. Iago and Angelo are both men of relatively high rank whose own hypocrisies lead to their downfalls. Iago’s hypocrisy permeates every facet of his character, including loyalty, friendships, and marital relations. Angelo, meanwhile, falls victim to his desires and commits one major hypocritical action, exhibiting both lust and lawlessness. The fact that these two plays are driven by these hypocritical actions is a testament to the ability of hypocrisy to promote a response in an audience, and a testament to the Bard’s incomparable playwriting skills. Â   Iago and Angelo as the Hypocrites of Shakespeare's Othello Essay examp Few plot elements inspire such an emotional reaction in readers as does hypocrisy. Not only do readers feel genuine anger at the actions of the hypocritical character, but they also feel deep sympathy for the Hester Prynnes of the stories they read. This tandem of anger and sympathy is a powerful tool for an author to use to draw readers into his or her tale, because creating an emotional response in one’s audience is the best way to make them identify with the story. The response of the readers to these situations is a fascinating one. Perhaps the reader remembers a time when s/he was the victim of a two-faced action. Perhaps stories about hypocrisy evoke a sense of moral outrage or awaken a sense of justice in the reader. Perhaps the reader is simply fascinated with having a secret that s/he is unable to tell. For whatever reason, authors have carefully woven threads of hypocrisy into the fabric of their stories since the very dawn of literature. Some of the best examples o f this skill (as indeed of many others) come from the writings of William Shakespeare. Shakespeare’s astute observations of human nature coupled with his amazing word craftsmanship have created some of the most memorable hypocrite characters in all of literature. From the twisted, jealous, hatred of Iago in Othello to the lusty self-righteousness of Angelo in Measure for Measure, we can glean a sense of Shakespeare’s masterful manipulation of hypocrisy to create a tempting tale. Iago and Angelo are true hypocrites. In Othello, we are first introduced to Iago, a military officer under the command of the Othello, a well-respected Moorish captain. Iago’s hatred for Othello is revealed in the very first lines of the play, when it is revealed that he has been... ...haracters who exhibit hypocrisy. Whether it is anger at the hypocrite or empathy for the victim, a good author or playwright can capitalize on this tendency but constructing a plot with a few hypocritical timbers. Shakespeare was a master at such structures, introducing two of them in Othello and Measure for Measure. Iago and Angelo are both men of relatively high rank whose own hypocrisies lead to their downfalls. Iago’s hypocrisy permeates every facet of his character, including loyalty, friendships, and marital relations. Angelo, meanwhile, falls victim to his desires and commits one major hypocritical action, exhibiting both lust and lawlessness. The fact that these two plays are driven by these hypocritical actions is a testament to the ability of hypocrisy to promote a response in an audience, and a testament to the Bard’s incomparable playwriting skills. Â  

Considerations for Funny Thing Happened

1. A Funny Thing Happened on the Way to the Forum is a musical written by Stephen Sondheim, Burt Shevelove, and Larry Gelbart. The three collaborated on the work, which had a Broadway debut on May 8, 1962. It ran for a total of 964 performances and closed on August 29, 1964. 2. A Funny Thing Happened on the Way to the Forum is the title of this work. This leads us to believe the play will be a comedy and that many â€Å"funny things† will occur. As one will soon notice, the play parodies many aspects of Plautus’ work Pseudolus. 3. The cast list is enclosed with the play. . The play takes two hundred years before the Christian era, on a day in spring. The action occurs on a street in Rome, in front of the houses of Erronius, Senex, and Lycus and is continuous, with only one intermission. The theatregoer knows that the work will be a comedy; also, provided one has knowledge with Plautus’ play, he may have a general idea as of the plot of this parody. 5. The major c onflict is Pseudolus vs. Miles Gloriosus. Pseudolus, trying to gain his freedom from Hero, tries to thwart Miles’ purchase of Hero’s love interest, Philia.The inciting incident is when Hero informs Pseudolus that he can be free if he arranges them together. Without this happening, the rest of the events of the play would never have happened. Some complications arise when our protagonists learn of Philia’s impending sale to Miles. Also, Senex sees the opportunity for an affair with Philia because she thinks he is Miles; he thinks she is a maid. The climactic scene occurs when the watcher discovers that Philia and Miles are the long lost children of Erronius. Thus, Miles voids his purchase arrangement for Philia; Philia can marry Hero and Pseudolus gains his freedom. 6.The overall situation in this work is the fact that Hero wants to marry a beautiful virginal woman. If he did not have this desire, Pseudolous would not have managed to concoct such a great tale, an d win his freedom. The point-of-attack is rather early in the play as the conflict begins right away. 7. a. Pseudolus: He is a Roman slave, owned by Hero who wants to win his freedom by gaining the heart of Philia. Pseudolus is very witty and clever, although this wit just gets him into a deeper and deeper hole each time. b. Hero: He is in love with Philia and does not play an overly major role in the story; he is also Senex’s son. c.Philia: She is a virgin in the house of Marcus Lycus and is the object of Hero’s affection. She is very beautiful, but perhaps dimwitted, as she believes Senex is her owner. Her name means love in Greek. d. Miles Gloriosus- A captain in the Roman army, Miles has purchased Philia from Marcus and returns to Rome to pick her up. He soon is lead on a literal wild goose chase before he realizes she is actually his sister. e. Hysterium: The very name implies someone who is extremely anxious and over emotional. He is the chief slave to Senex and Domina, Hero’s parents. He pretends to be Philia when Pseudolus says she died from the plague. . The major theme is that everything is not always what it seems and that sometimes interventions happen for a reason. No one knew that Miles and Philia were related or that Erronius actually played an integral part to the story. At least when I read it, I cast Erronius aside as the crazy character who really had no role. If it would have not been for Pseudolus’ shenanigans their connection would never have been realized. 9. The mood of this play is definitely comic. The audience should come away from watching this play laughing and in improved spirits. The play ends happily and well, as all conflict has been resolved.