Jane Lethbridge BA, MA, MSc, MA in HE, PhD, PGCHE, FHEA
BA, MA, MSc, MA in HE, PhD, PGCHE, FHEA
Director, Public Services International Research Unit (PSIRU)
Department of International Business and Economics
Jane Lethbridge's main research interests are the impact of liberalisation and privatisation on the health and social care sector, digitalisation and the public sector, social dialogue in the health and social care sector and democratic professionalism in the public sector, in the UK and internationally.
She has worked on public health issues in the UK and internationally for over 20 years, with experience of management and project implementation in both the public and NGO sectors. From 2001-07, Jane was Senior Research Fellow, Public Services International Research Unit (PSIRU) at the University of Greenwich before becoming principal lecturer in 2007. In 2013, she was appointed Director of PSIRU.
Since 2012, she has been part of the project PESSIS; 'Promoting Employers' Social Services in Social Dialogue' (funded by the European Commission) which has developed a series of national case studies of social dialogue in the social services sector in 22 European countries.
She is currently a researcher for the Council of European Municipalities and Regions (CEMR) / European Federation of Public Service Unions (EPSU) Joint Project 2015-2017 "New forms of service delivery for municipalities, the contribution of social dialogue and good practice for well-being at work."
Jane Lethbridge led a Masters in public administration (MPA) programme from 2007-10. She was international coordinator for international partnerships in the Department of International Business & Economics from 2010-2013. She was appointed Director of the Public Services International Research Unit (PSIRU) in 2013.
Advisory board of Teaching Public Administration
Jane Lethbridge's main research interests include:
- Global commercialisation of health and social care
- Social dialogue in the health and social care sectors in Europe
- Impact of public sector reforms on public sector workers
- Trade union responses to liberalisation and privatisation
- Professionals improving public services
The value of Jane Lethbridge's work since she started as a senior research fellow with the Public Services International Research Unit (PSIRU), in 2001, has been to highlight the growing involvement of for-profit companies in public sector healthcare systems across the world. This research has identified the similarities in the health sector reforms that allow for-profit companies to access public sector health systems. She has provided an analysis of company strategies in the healthcare sector, which is unusual in the field of healthcare policy where the focus is more often on government healthcare policy. She has also contributed to a greater understanding of the processes of social dialogue at a European level in both health care and social care, through some participant observer research into the creation of a European level social dialogue committee in the hospital sector. She has recently taken part, as a European research coordinator, in the first stage of the development of a European level social dialogue committee in the social services sector, which is expected to be extended with EU funding.
'A Parallel Approach to Analysis of Costs/Benefits and Efficiency Changes Resulting From Privatisation of Health Services'
Public Services International (PSI) commissioned this study as a way of drawing together evidence of the impact of health care privatisation on service users and health workers. Although informed by studies in water and municipal services, which have not found evidence of lower cost with private production, designing a study for the health care sector is more complicated because of some of the difficulties in measuring the costs and benefits of health services as well as the efficiency and effectiveness of health service delivery.
Aims of research
To review evidence showing the impact of marketisation and privatisation on health care workers, on service delivery and service users and identify implications for the future.
There are recognisable steps in the process of moving from a state/ government run health care system to a marketised and privatised system but this can take place over many years. It is a more complex process than the privatisation of public utilities.
One of the most significant changes is the introduction of decentralisation policies which transfer responsibility for management and funding from national/ central government to local level. Decentralisation is presented as benefiting local people because it gives greater control over decision making but when linked to reduced resource allocation from government with no balancing powers of local taxation, the result is often a reduction in resources, leading to cuts in services.
Corporatisation or self-management of hospitals accompanied by reduced central funding change the ways in which a public health care institution operates, which results in hospitals being more concerned with reducing the costs of service delivery than with delivering improved quality of care. The status and integrity of health workers is directly affected by decentralisation and other health reforms. Cutting costs of labour intensive activities, such as health and social care results, results in cuts in the labour force or reductions in salaries. This affects the quality of care. For health workers, reductions in salaries and irregularly paid salaries, forces them to secure alternative sources of income.
Areas for future research
Marketisation and privatisation of health care promoted the need for effectiveness, efficiency and equity but implementation and the resulting research has focused on effectiveness and efficiency. Research into health care efficiency has used methodologies and instruments that were created for measuring industrial efficiency, developed for the private sector. Health care is not an industrial production process but depends on the quality of care. There is a lack of quality measures of health and social care. Future research needs to address ways of measuring in quantitative and qualitative ways, what is quality health and social care.
'Project PESSIS: Promoting Employers' Social Services in Social Dialogue'
Health and social care is one of the European Union's fastest growing economic sectors, generating about 5% of total economic output (European Commission, 2010). However, the social services sector faces problems of recruitment and retention because of low pay, the low status of caring as an occupation and poor working conditions. Social services workers are employed by public, private and not-for-profit employers, with a trend for greater provision by private and not-for-profit providers. Union representation of social services workers is also lowest in these two sectors. The implication of this diverse coverage for trade union action is that social dialogue is necessary if workers and employers were to work together to deliver quality services with improved working conditions. Social dialogue is the essential link between quality social services and pay and working conditions but is little understood across Europe.
Aims of research
To map the size of the social services sectors in 11 European countries in terms of workforce and aggregate value of the sector, the level of representation of employers and workers covered by collective agreements, the types of social dialogue that exist, the level of involvement of employers in social dialogue and labour issues that would best be covered at European level.
Poor working conditions, problems with the shortage and retention of staff, lack of training opportunities, special needs of women workers, mobility and working time are all issues that face the social services sector in many European countries. Social dialogue in the social services sector is not organised at European Union (EU) level or sectoral level. The not-for-profit sector is expanding fast and becoming a significant employer in all countries. The European social services sector is heterogeneous and underrepresented. Further data is needed to better understand how social dialogue is sustained in the social services sector in the eleven PESSIS study countries and in other European countries, especially in central and Eastern Europe.
Areas for future research
To identify how social dialogue can be sustained in countries where there are already social dialogue structures. To identify approaches to promoting social dialogue in countries where social dialogue does not exist.
Lethbridge, Jane (2016) Public enterprises in the UK - A declining force. Franco Angeli Journals & Series. ISSN 0390-6140
Lethbridge, Jane (2014) Public enterprises in the healthcare sector – a case study of Queen Elizabeth Hospital, Greenwich, England. Routledge. ISSN 1748-7870
Lethbridge, Jane (2011) Understanding multinational companies in public health systems, using a competitive advantage framework. BioMed Central. ISSN 1744-8603
Lethbridge, Jane (2011) Social dialogue in the hospital sector at EU level. SAGE Publications / European Trade Union Institute. ISSN 1024-2589
Lethbridge, Jane (2011) Understanding multinational companies in public health systems, using a competitive advantage framework. BioMed Central Ltd.. ISSN 1744-8603
Lethbridge, Jane (2009) Trade unions, civil society organisations and health reforms. SAGE Publications. ISSN 0309-8168
Lethbridge, Jane (2011) Public sector 'ethos'. In: Working for the State - Employment Relations in the Public Services. Palgrave Macmillan, Hampshire, England. ISBN 9780230278639
Lethbridge, Jane (2010) Labor movement strategies to address corporate globalization / Labour movement strategies to address corporate globalisation . In: The Bottom Line or Public Health: Tactics Corporations Use to Influence Health and Health Policy, and What We Can Do to Counter Them . Oxford University Press, New York. ISBN 978-0-19-537563-3
Lethbridge, Jane (2010) Ireland. N15 Bundoran/Ballyshannon by-pass. In: The inter-relationship between the structural funds and the provision of services of general (economic) interest and the potential for cross-border service delivery. Annex. European Parliament. Directorate-General for Internal Policies. Policy Department B: Structural and Cohesion Policies, Brussels, Belgium. ISBN 9789282334102
Lethbridge, Jane (2010) United Kingdom. Infrastructure investment-Northern Ireland natural gas project. In: The inter-relationship between the structural funds and the provision of services of general (economic) interest and the potential for cross-border service delivery. Annex. European Parliament. Directorate-General for Internal Policies. Policy Department B: Structural and Cohesion Policies, Brussels, Belgium. ISBN 9789282334102
Lethbridge, Jane (2009) La sanidad en la Unión Europea y el mercado europeo de servicios sanitarios. In: Globalización y Salud 2009. Fundación Sindical de Estudios Ediciones GPS, Madrid, Spain. ISBN 978-84-9721-380-6
Lethbridge, Jane (2015) Strengthening the workforce for people with disabilities: Initial mapping across Europe . European Association of Service Providers for People with Disabilities (EASPD), Brussels, Belgium.
Lethbridge, Jane (2014) Financing health care: False profits and the public good. Public Services International, London, UK.
Lethbridge, Elizabeth (2014) PESSIS 2: Promoting employers' social services in social dialogue (Final European report 2). Public Services International Research Unit, University of Greenwich (UK), Brussels, Belgium.
Lethbridge, Jane, Greer, Ian, Kretsos, Lefteris, Umney, Charles and White, Geoff (2014) Industrial relations in central public administration: Recent trends and features. European Foundation for the Improvement of Living and Working Conditions, Dublin, Ireland.
Lethbridge, Jane (2012) Care home versus home care? Which direction for care services in Europe? Eligibility for European Works Councils . European Federation of Public Services Unions (EPSU), Brussels, Belgium.
Lethbridge, Jane (2012) Empty promises: the impact of outsourcing on NHS services. UNISON, London, UK.
Lethbridge, Jane (2012) PESSIS - Promoting employers' social services in social dialogue: Final European report. European Federation of Public Service Unions, Brussels, Belgium.
Lethbridge, Jane (2011) A parallel approach to analysis of costs/benefits and efficiency changes resulting from privatisation of health services. PSIRU, Greenwich, London, UK.
Lethbridge, Jane (2011) Care services for older people in Europe - Challenges for Labour. European Federation of Public Service Unions, Brussels, Belgium.
Lethbridge, Jane (2010) Care services, multinational companies and expanding European markets. PSIRU, Greenwich, London, UK.
Lethbridge, Jane (2010) Care services, multinational companies and expanding European markets: major trends and eligibility for European Works Councils. European Federation of Public Service Unions (EPSU), London, UK.
Lethbridge, Jane (2010) European healthcare services, multinational companies and a European healthcare market. European Federation of Public Service Unions (EPSU), London, UK.
Lethbridge, Jane (2009) Privatisation of ambulance, emergency and firefighting services in Europe – a growing threat? . PSIRU, London, UK.
Lethbridge, Jane (2009) Briefing paper 'On the European workforce for health' . PSIRU, London, UK.
Lethbridge, Jane (2016) Radical practice as democratic professionalism - learning from the past.
Lethbridge, Jane (2012) Welfare state reforms as seen through changing skills and knowledge .
Lethbridge, Jane (2011) Professional development for the Welfare State – a shared model or diverse paths?.
Lethbridge, Jane (2010) Five years on - global health companies in the public sector.
Lethbridge, Jane (2010) From welfare state to public service reform – teachers as an evolving profession?.
Lethbridge, Jane (2009) Promoting public sector 'ethos'.
Lethbridge, Jane (2009) Understanding the impact of scale on labour strategies using a five stage typology.