Working Paper: CEPR ID: DP4118
Authors: Simon Burgess; Denise Gossage; Carol Propper
Abstract: This Paper examines the relationship between performance of English public sector hospitals (NHS trusts) and the quality of their nursing staff. Performance ratings of NHS trusts published in 2001 and 2002 indicate a clear regional divide. This divide is not explained by lower medical need. The gap between wages in the private and public sector (the private sector premium) has a regional divide similar to that of the performance ratings. Utilising cross sectional variation in the private sector premium, we find that performance against several of the individual targets that are aggregated into the NHS performance ratings is negatively associated with the private sector premium.
Keywords: performance ratings; private sector wage premia; public sector performance
JEL Codes: H40; I10; J30
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Higher private sector wage premium (J31) | Poorer performance ratings of NHS trusts (I14) |
| Higher private sector wage premium (J31) | Decline in quality and quantity of nursing staff in public sector (J45) |
| Decline in quality and quantity of nursing staff in public sector (J45) | Poorer hospital performance (I14) |
| Higher private sector wage premium (J31) | Poorer performance in key targets related to patient waiting times and hospital cleanliness (I14) |
| Financial resources per head (O15) | Complex relationship with performance (D29) |