Spending Review Research Articles

Defining spending reviews: a proposal for a taxonomy, with applications to Italy and the UK

After the 2008 global financial crisis, many governments introduced spending reviews (SRs). The paper provides a valuable definition of the concept of the SR by proposing a taxonomy of the main organizational and methodological aspects involved in the SR process. The paper identifies two different SR models, which feature alternative approaches to cutting back spending. The authors highlight some important considerations when looking to make sustainable and sensible cuts in spending.

Spending Review: una, nessuna, centomila

Internationally, spending reviews are increasingly considered to be the most appropriate tool to facilitate the reallocation and the reduction of public expenditure because they offer a path to improve the rationality of decisionmaking aimed at the achievement of the final goals of public intervention. However, the actual experiences are very diverse, difficult to encode, and change their features over time even in the same country, in response to the external environment. This paper presents the contribution expected in recent years from spending reviews in connection with the financial and economic crisis. It also describes the main features of a spending review, drawing considerations on the Italian case. In particular, it highlights the multiplicity of actions taken and the associated coordination problems, and it discusses the need to implement a tighter integration of the spending review in the budget process, signaling the difficulties encountered.

Ten lessons from the 2014 Italian spending review

This paper discusses ten lessons for future spending reviews based on the experience of the 2014 Italian spending review. Among other things, it underscores the importance of a clear top down component, of transparency, of outreach, of avoiding equal cuts to spending units that differ in terms of efficiency level, and, of course, of political support, as spending cut decisions are ultimately political decision, given their impact on resource allocation and income distribution.

La revisione della spesa pubblica "made in Italy"

The control of public spending in Italy started to be experienced in the Eighties and it has evolved into a process of spending review characterized by a variety of approaches and a number of key figures appointed to implement such policy interventions. The main consequence of the heterogeneous nature of these spending review exercises was a difficult achievement of the efficiency targets in public expenditure revision. The experience of the Italian spending review was also notable for substantial linear cuts to the public budget and for the attitude to frequently assign outside - often beyond the political boundary - the guidance of the spending review process. On the one hand, this approach has been justified by the will of exploiting high technical skills on that ground. On the other hand, it has often undermined the assumption of political responsibility by governments on specific areas of intervention and on the identification of the best tools to achieve the political objectives related to the re-allocation and rationalization of public spending in Italy.

Le specificità dei processi di revisione della spesa pubblica locale

The article analyses the specific features of procedures in medium-large Italian municipalities. The author recalls as the local public expenditures is oriented, more than in all other sectors of Public Administration, to directly enhance the welfare of citizens, and it has direct effects on potential growth of the local territory where the municipality is working. The work emphasizes the implications of spending review in terms of quantitative and qualitative levels of public service and in terms of investments on local infrastructures maintenance. It presents the case of Florence municipality that has applied spending review procedures in 2012 and 2013. Finally, it deals with the perspectives for these procedures by the public accountancy reform recently carried on in Italy.

L'orologiaio e il tagliaboschi

The paper deals with the theme of the spending review from a methodological point of view and its intertwining with the budget decision. The thesis of the authors is that there is a strong link between economic growth and balance of public finance. And this connection is clouded by legal and accounting categories that can never be combined with a clear assessment of the objectives and financial results that the different sectorial policies aim to achieve. To argue this thesis is presented a reconstruction of the experience of spending review in Italy. The analysis reveals two distinct approaches: the dominant one, still widely prevalent, based on linear cuts, sometimes partially targeted, according to the moment and the persons called to identify them(which can be framed the period of Commissioners); the other, structural and fully integrated with the budget cycle, inaugurated by Ciampi in 1997 and taken over by Padoa Schioppa in 2006-2008. The objective of the SR, according to the authors, is not cut but innovate in depth to achieve public policies furthering development and productivity. The crucial question is the recombination of inputs (human and technical resources) in the territory and among the structures that articulate public policies. This requires a major reorganization of the administrative machinery.

La prima esperienza di Spending Review in Italia

The aim of this paper is to describe the first experience of the Spending Review in Italy, which took place between April 2007 and May 2008 through the work of a specific Commission (Technical Commission on Public Finance), under the political guidance of the Minister of the Economy and Finance, Tommaso Padoa Schioppa. After recalling the meaning and the goals of the Spending Review, the paper illustrates the framework, the composition, the organization, the working methods and the main proposals of the Commission. The author concludes that, compared with following chapters of the story of the Spending Review in Italy, the first experience, rarely recalled in the political debate, is still offering valid indications as for the working methods and the policy proposals.

Who should review public spending?

Since the early ‘80s of the last century, Italy has experienced different waves of spending reviews. The ideal aim of these processes is (at least) twofold: efficiency, namely to reach public goals at a lower cost, and effectiveness, that is, to clearly state priorities of public activity. Has any of the different reviews in Italy ever been successful? Even taking into account the most recent experience, it would be hard to reply affirmatively. So what are the sources of this long series of failures? And why international experience, on the contrary, seems to reach its goals? To answer, we review international experience, scientific literature, and provide a detailed story of the different attempts of spending reviews in Italy. Our conclusions are that lack of political will and lack of economic competence among Italian bureaucracy are the most likely causes: and that the appointment of external technocrats is not the solution, particularly under illdefined mandates.

Proton Pump Inhibitor Prescription in Patients with Liver Cirrhosis: Indications in Theory and the Real World

In a climate of spending review and pharmaeconomics any prescription should be made according to recognized indications, also to limit exposure of fragile patients to possible secondary effects and complications. In this editorial we comment on the case of PPIs in patients with cirrhosis or with polypathology.

The Gender Agenda in an Age of Austerity

This article reports on a research project undertaken to assess the implications and consequences of the Comprehensive Spending Review and associated Force Change Programmes upon the female police workforce in England and Wales, alongside wider policing reforms across the UK. The research examines the views of female and male police officers and staff with a view to updating and reviewing evidence of progress in relation to the continued development and achievement of the gender agenda aims (BAWP, 2006, The Gender Agenda 2. London) and the Home Office 2010 report ‘Assessment of Women in the Police Service’. Focus groups, questionnaires and semi-structured interviews were undertaken between November 2012 and June 2013, across 14 force areas, in addition to national policing bodies, local and national representative staff support associations, and diversity and equality practitioners. The findings underpin the recommendations Gender Agenda 3 launched in October 2014 by the British Association for Women in Policing.

Managing a research hospital at the time of a global economics crisis: Cruising between Scylla and Charybdis

Managing a research hospital at the time of a global economics crisis: Cruising between Scylla and Charybdis

Budgeting and governing for deficit reduction in the UK public sector: act three ‘accountability and audit arrangements’

This paper explains how the UK central government has changed accountability and audit arrangements for local government in England, while retaining its approach to setting annual budgets within the context of multi-year spending reviews. It highlights how dismantling the institutions and processes that monitored outputs and outcomes for spending, such as public service agreements and comprehensive area assessment, meant that top-down accountability became focused overwhelmingly on financial conformance rather than organizational performance for local government. Supplementary reforms to increase the transparency or ‘visibility’ of public administration, and thereby enable greater bottom-up accountability, have resulted in a performance assessment system that is neither rigorous nor standardized. The overall result is a weakening of local accountability arrangements.

Policy Analysis in Times of Austerity: A Cross-National Comparison of Spending Reviews

ABSTRACTThe sovereign debt crisis that hit the world fueled a discussion about fiscal consolidation. Across-the-board cuts and one-off measures are no longer adequate to reduce the budget deficit and public debt. A more evidence-based policy is needed for the reduction of government deficits and debt accumulation. One promising route to fiscal consolidation is the establishment of so-called spending reviews, which are aimed at the generation of smart cuts – i.e. cuts supported by evidence in order to balance the budget. The empirical data are primarily taken from two OECD countries – Canada and the Netherlands – with a long-standing tradition of spending reviews.

Conceptual Design of a Decision Support System for the Economic Sustainability of Nonprofit Organizations

In Italy, a continuous growth of nonprofit organizations has occurred in the last years. These organizations have been favoured by the concomitant reduction of direct public intervention (due to spending review) and the effect of the economic crisis on the business system. Despite their growth, nonprofit organizations present usually a critical lack in financial and economic management. In other words, their management does not consider all the factors related to economic balance, social success, reputation and promotion of their projects. The managerial role appears often to be overlooked compared to the actual needs and this results in a real limit for the growth and sustainability of these organizations. The present paper introduces a complete management review for the nonprofit using an Axiomatic Design based on the case study of one “Misericordia” (onlus) located in Florence. The proposed application leads to the definition of the minimum set of assessment tools that have to be considered and used as a Decision Support System (DSS) to support the management in a nonprofit organization. The DSS is developed as an integrated system of tools which allows a systemic approach tailored to meet the specificity of this kind of organization.

Republic of Slovenia: Technical Assistance Report-Establishing a Spending Review Process

Republic of Slovenia: Technical Assistance Report-Establishing a Spending Review Process

Penile prosthesis surgery in out-patient setting: Effectiveness and costs in the "spending review" era.

Penile implant patients are required to remain in the hospital after the operation for monitoring, antibiotic and analgesia administration. Cost containment, however, has resulted in the increased use of ambulatory surgery settings for many surgical procedures. Few studies have studied the feasibility of performing penile prosthesis insertion in an outpatient setting. The results are controversial and nowadays, in the most of centers that deal with prosthetic surgery, patients are still hospitalized. The aim of our investigation was to compare the feasibility of the performance as well as the complication profiles of penile implant surgery performed in an in-patient and an outpatient setting at a single center by a single surgeon. From January 2009 to June 2014, 50 patients of the same uro-andrological unit underwent penile prosthesis implantation performed by a single surgeon (N.M.). Twenty implantations were performed in an ambulatory day surgery setting. Effectiveness and costs of outpatient setting versus the in-patient setting of the penile prosthesis surgery. There were some differences between the two groups in the intra-operative parameters, such as, operating time. Time lost from work was similar in both groups approximating 14 days. The mean number of analgesic pills ingested by the patients post-operatively was similar in both groups, averaging just under 25 pills per patient. There weren't post-operative complications in the outpatient group. Cost were 17% less in outpatient clinic. The outpatient setting for this surgery is safe and effective even in patients with comorbidities or in case of secondary procedures. Costs are reduced by 17%.

The politics of police ‘privatization’: A multiple streams approach

In October 2010, the UK Coalition government announced a 20 per cent reduction in the police budget over four years as part of its post-financial crisis Comprehensive Spending Review. In response to this new ‘politics of austerity’ many police forces began to consider outsourcing key services areas to the private sector on an unprecedented scale so as to make the required savings. However, this policy initiative was soon cut short. By March 2012 a prominent media debate on police ‘privatization’ was starting to heat up; in July 2012 the failure of G4S to meet the conditions of its Olympics security contract generated extensive negative publicity and triggered a parliamentary enquiry; and in the run-up to the November 2012 Police and Crime Commissioner elections many candidates could be found campaigning on an ‘anti-privatization’ platform – all of which had the effect of removing police outsourcing from the policy agenda. It had become too politically controversial. This article uses the multiple streams approach to explore the opening and closing of the police outsourcing window. In so doing, it contends that the dynamics of this policy area have ultimately been shaped by the liberal state-building process which emerged out of early enlightenment political thought and continues today.

University regulation and university–industry interaction: a performance analysis of Italian academic departments

In a context characterized by public spending reviews and research funding shortages, governments in several countries are putting pressure on universities to increase their applied research activity, intensify their interaction with industry, and attract funding from the nonacademic domain. The economic literature provides rich evidence on the convergence between institutional factors and individual-level characteristics that are influencing university involvement in knowledge transfer activities. The aim of this article is to investigate the impact of universities’ regulation of knowledge transfer activities on the institutional capability to raise funding from research contracts and consultancies. Based on extensive department-level data on university funding, we address the characteristics of institutional knowledge transfer practices and investigate how these activities influence the intensity of funding to Italian universities

Spending reviews

This article focuses on the optimal design of spending review processes. It contents that sending review should be an integral part of the government budget preparation process, in order to support aggregate fiscal discipline and to increase the fiscal space available for essential new spending initiatives. The article discusses the appropriate focus and coverage of spending review, the assignment of roles and responsibilities during the process, and the information base of spending review. JEL classification: H500, H610. Keywords: Baseline expenditure, fiscal space, savings options, efficiency reviews, strategic reviews, bottom-up review, joint review, top-down review, comprehensive review, selective review.

Costs of pain in rheumatology.

Chronic pain has been identified as an important issue related to various rheumatic diseases. At the time of a major government spending review, it is appropriate to discuss the pain characterising rheumatic diseases and its related costs. It is clearly essential for healthcare authorities to rationalise their policies on the basis of the increasing expectations of the users of healthcare services while simultaneously balancing their books. There are few published studies concerning the costs of pain of any kind, and the same is true of the costs of the chronic pain associated with diseases such as rheumatoid arthritis, osteoarthritis, and fibromyalgia.