Warfare and the launch of medical reform in Britain, 1793–1811

Until the beginning of the nineteenth century, registering and regulating the training of any medical practitioners in Britain had rarely been attempted, unlike in many other European countries. During the Revolutionary War with France, fevers swept through British armies, leading to numerous fatalities and crushing military defeats, especially in the disastrous expedition to St Domingo. The problem, as forcibly advocated by Robert Jackson, the leading expert on military fevers, seemed to be poor medical care due to both lack of compulsory medical training and the unsuitability of whatever training was available for army medical practitioners. With the simultaneous rapid advance of French military and civilian medical training and the threat of a French invasion, regulating British medical training and excluding the unqualified became a military necessity, and suddenly medical reform was receiving widespread attention. Emphasising the benefits to the Britain’s fighting ability, the reform effort, led by Edward Harrison, a very provincial Lincolnshire physician, under the patronage of Sir Joseph Banks, the President of the Royal Society, gained the support of leading politicians, including three Prime Ministers. For a short time, comprehensive medical reform seemed inevitable: but the opposition of the medical corporations, especially the London College of Physicians, could not be circumvented, and although Harrison persisted in his efforts for 6 years, no legislation was achieved. Nevertheless, within months, the Association of Apothecaries continued the process by pressing for a more limited reform, culminating in the 1815 Apothecaries Act. The long march towards the full regulation of doctors in Britain was started by the perceived military needs of the country during the war with France.

An educational history of the future

The importance of active, “experiential” learning, and the belief that schools and colleges need to engage the world outside their walls in new ways in order to equip students for the rapidly changing future, is increasingly held to be fundamental to any educational program or reform effort, and in particular to the current rethinking about what (and how) students need to learn. In fact, however, this truth was recognized as early as in ancient Athens. In recent years the world has been transformed, and we are now well into a new era of individual and social experience. With the unprecedented processing power of mobile devices, the seemingly endless expansion of storage capacity, and unlimited access to information, we confront a vastly different landscape for education. This essay examines what this all means for education futures.

Reflections on continuity and change in public service reform in Ireland

This article reviews the elements of continuity in the approach to public service reform in Ireland and of change in expectations of public service performance in Ireland over recent decades. It concludes that supporting democratic governance is the primary goal of public service and that trust in its capacity to meet society’s needs is the most appropriate criterion to assess reform programmes. It also suggests some priorities for future reform effort.

The Security Council and International Crimes in Syria

Chapter 3 revisits some of the conflict history through the lens of (in)action at the U.N. Security Council, whose discursive practices, pronouncements, operational initiatives, and vetoed resolutions offer a distinctive window into the trajectory of the conflict and the international community’s meager and ineffectual reaction to the atrocities underway. This chapter traces these malfunctions on a number of fronts alongside the few areas of progress. The areas of concern include condemnations of human rights violations and abuses; attempts to impose ceasefires and expand humanitarian access; the use of force and the Responsibility to Protect; inspiring the parties to pursue a political transition; the international community’s preoccupation with counterterrorism and countering violent extremism measures; neutralizing Syria’s chemical weapons; futile efforts to impose U.N. sanctions; and—most relevant to this volume—attempts to promote accountability, including a French-led effort to refer the situation in Syria to the International Criminal Court. Along the way, the chapter assembles the vetoes deployed by the P-5 during the Syrian conflict and captures the deteriorating dynamics within the Council chamber. The paralysis in the Council sets the scene for the chapters that follow, which recount efforts to promote accountability elsewhere. The chapter concludes with a short discussion of the way in which the Syrian conflict has further stimulated the Security Council reform effort.

The Multiple forms of Transparency in International Investment Arbitration

This chapter explores transparency in international investment arbitration. In the field of international investment arbitration, there has been a particularly concerted campaign for the publication of awards and other arbitral documents, for the opening of arbitral hearings to the public, and for the participation of a more diverse group of stakeholders in arbitral proceedings. In isolation, each of these strands of the campaign for greater transparency in international investment arbitration might be characterized as a reform effort focused on a series of technical changes to aspects of the international arbitral process. However, they could alternatively be viewed from a broader angle, insofar as collectively they articulate and are driven by more fundamental concerns about international investment arbitration. Seen from this broader perspective, the campaign for greater transparency in international investment arbitration is underpinned by differing perspectives on the structure of transparency, on its role in the international arbitral process, and on the subjects and stakeholders which it might benefit. Reforms to transparency in international investment arbitration are thus ‘both technically narrow and strategically broad’.

Assessing the Efficiency of the District Courts of Pakistan—Why is Better Evaluation Needed?

In this article, the case is made for the need for appraisal of performance of the district courts of Pakistan from an efficiency perspective and a framework of practical tools are suggested to secure that end. It is argued that an effective appraisal system using empirical research is desirable in view of an absence of judicial accountability by democratic institutions and gaps in the internal official appraisal practice and in methods for locating the impact of the justice reform initiatives. The assessment can be done by analysing the relevant statistical data, qualitative feedback of the litigants and by comparing Pakistan’s judicial performance with countries with similar conditions. Empirical evidence available so far suggests that the court service in Pakistan is plagued with delay, vexatious litigation and abuse of court process causing suffering for the end-users. Hence, for any future reform effort to eradicate these maladies, institutionalized empirically based scrutiny of judicial performance is indispensable.

Body Count Politics: Quantification, Secrecy, and Capital Punishment in China

As quantification has become socially ubiquitous, the disclosure of numerical data emerges as a key feature of legal reform and global governance. Scholars document how seemingly value-neutral statistical indicators shape, and are shaped by, institutional interests. Although less attention has been paid to cases where states resist numerical disclosure, prohibitions on the disclosure of such indicators also produce social effects. This article extends scholarship on the governance effects of quantification to include secrecy by exploring the case of capital punishment data in China, which is reportedly the world’s leading executioner state. Amid a major death penalty reform effort, China steadfastly refuses international calls to publicly disclose relevant statistics. I analyze capital cases and draw on seventy-three interviews with legal insiders in China’s death penalty system to identify the impact of state efforts to conceal capital punishment indicators while undertaking reforms in three areas: transparency; legal representation; and criminal procedure. I show how tension between the disclosure and nondisclosure of death penalty numbers does not simply suppress data; it also shapes and becomes data, influencing both policy and action in the legal sphere in ways that are seemingly far removed from quantification.

Corruption and economic competitiveness: What Greece can tell us

Under the assumption that economic competitiveness has a significant impact on the overall level of corruption in a given country, the present study evaluates the influence that a wide array of national reforms related to the pillars of structural competitiveness has on corruption in the case of Greece. In order to inform national and regional policies against corruption, three indices were calculated that express: (1) the impact of each specific reform on corruption; (2) the required reform effort and (3) the efficiency of the reform index, taking into consideration the competitiveness gap between Greece and Switzerland – the country with the best performance worldwide in terms of competitiveness. These indicators may indicate which reforms have the highest payoff in terms of corruption abatement, which are less costly to undertake and which deliver the greatest reduction in corruption per required effort, respectively. The empirical results of this study suggest that in a number of areas the associated reforms may translate into lower levels of corruption. Under this conceptual framework, institutions seem to be of high importance as they have a substantial impact as far as the reduction of corruption is concerned, with relatively low reform effort. Therefore, a comprehensive policy reform referring to the pillars of structural competitiveness is expected to deliver lower levels of corruption in Greece, allowing the substantial increase of its competitiveness and hence its faster convergence with the more advanced economies in the European Union.

Barbados’ 2018–19 Sovereign Debt Restructuring–A Sea Change?

This paper examines the causes, processes, and outcomes of Barbados’ 2018–19 sovereign debt restructuring—its first ever. The restructuring was comprehensive, featuring several rarely used approaches, including the restructuring of treasury bills, and the use of a retrofitted collective action mechanism. The debt restructuring has helped to set Barbados’ public debt on a clear downward trajectory. A sustained reform effort, maintaining high primary surpluses and ambitious structural reforms, will be needed to gradually reduce public debt from about 160 percent of GDP before the restructuring to the country’s 60 percent debt-to-GDP target.

Sovereign Debt and Structural Reforms

We construct a dynamic theory of sovereign debt and structural reforms with limited enforcement and moral hazard. A sovereign country in recession wishes to smooth consumption. It can also undertake costly reforms to speed up recovery. The sovereign can renege on contracts by suffering a stochastic cost. The constrained optimal allocation (COA) prescribes imperfect insurance with non-monotonic dynamics for consumption and effort. The COA is decentralized by a competitive equilibrium with markets for renegotiable GDP-linked one-period debt. The equilibrium features debt overhang: reform effort decreases in a high debt range. We also consider environments with less complete markets. (JEL D82, E21, E23, E32, F34, H63)