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How to fix or remove this? A: While starting/refreshing the browser you might get this problem if you have already installed a previous version of flash player. In this case, you need to uninstall the previous flash player before installing 7.5.3 version. Or, you can get the solution for the same here REFORMING of the health system in Ireland is being driven by four new forces: the political economy, patient empowerment, enhanced governance and clinical leadership. There is some debate about whether the new forces are replacing the old ones. The concern, however, is that the new forces are not being clearly defined in policy terms, nor in their strategic directions. We need clear, strategic directions and clear, strategic policy. The published reform programmes for 2009 to 2013 are a good start but they do not go far enough. There is also an assumption that the reform will occur without significant disruption and that it will be a seamless process. This is an assumption that has no evidence base to support it. THE political economy It is generally accepted that public policy has a major influence on the way that public services are provided. Public expenditure is constrained by political finance arrangements, budgetary politics and the need to balance the books. Budgetary politics, in turn, depend on the fiscal policy arrangements which determine the composition of the public finances. This circular process means that it is often difficult to reform the provision of public services while managing a spending and taxing environment which constrains public expenditure. In the absence of reforms to the fiscal and political environment, government policy will tend towards traditional market-based public services. This is particularly true of those services that the public pay for directly through taxation. These tend to be the public services that are most exposed to the natural constraints of budgetary politics. This is not to say that the public services that the state pays for through taxation are not also exposed to political constraints. These are the services that are most exposed to the political economy. In many cases, it is not the market which provides the best services, but the political economy. The greatest constraint on policy in this area is the highly inefficient spending and tax regime for the State sector. The State spends a great deal of money on public services that it



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