In Sidaway v Board of Governors of the Bethlehem

In Sidaway v Board of Governors of the Bethlehem In Sidaway v Board of Governors of the Bethlehem Royal Hospital [1984] 1 ALL ER 1018 Dunn LJ stated in the Court of Appeal that 'the concept of informed consent plays no part in English law' (per Dunn LJ at 1030). Is this still an accurate reflection of the law? In Sidaway, the plaintiff brought an action against the hospital and surgeon who performed an operation on her back. The operation she had undergone carried an inherent risk to her spinal column and nerve roots. Even if it was performed perfectly, there was still about a two per cent chance that she would suffer injury to her spinal column. As it turned out, the operation was performed correctly, but nevertheless, the plaintiff suffered injury to her spinal column. She brought an action for negligence based solely on the ground that she had not been warned of the inherent risks of the procedure and that she would not have consented to the operation had she been so informed. It was found in fact at the trial that the surgeon failed to inform the plaintiff that the operation was not necessary and was actually optional. It was also found that while she had been warned of the risk of damage to the nerve roots, she had not been warned of the less likely, but potentially more serious, ris k to the spinal column. It was also accepted that had the plaintiff been aware of these facts she would not have undergone the surgery. However, the trial judge also found that the course the surgeon had taken was backed by a ‘responsible body of medical opinion’ and therefore, applying the test formulated in Bolam v Friern Hospital Management Committee [1957] 1 WLR 582, the standard of care that the surgeon owed the patient had been discharged. This ruling was upheld by the Court of Appeal and made its way to the House of Lords, where Dunn LJ’s quotation in the title is taken from. The House of Lords, by applying the Bolam test, also upheld the judgment on the ground that if a responsible body of medical opinion supported a course of action, this was sufficient to discharge the duty of care owed to a patient by a doctor. However, the reasoning in the case on the issue of informed consent is very enlightening. The first point to note is that Lord Scarman was the sole dissenting opinion in the case. Lord Scarman was of the opinion that, ‘the doctor’s duty arises from his patient’s rights. If one considers the scope of the doctor’s duty by beginning with the right of the patient to make his own decision whether he will or will not undergo the treatment proposed, the right to be informed of significant risk and the doctor’s corresponding duty are easy to understand: for the proper implementation of the right requires that the doctor be under a duty to inform his patient of the material risks inherent in the treatment.’(p. 888) Lord Scarman’s conclusion therefore was that the law ‘recognizes a right of a patient of sound understanding to be warned of material risks save in [exceptional circumstances]. This was not however the view of the other judges. Lord Bridge of Harwich for example, gave three reasons why the imposition of such a duty on patients would not be practical under English law. The first is that it would fail to take into account the reality of the doctor patient relationship in many situations. The doctor bases his decision to follow a certain course of treatment on a variety of factors and it would be impractical to expect him to educate the patient of the full implications of all of these factors. In fact, doing so may increase the trauma and stress of some patients. Secondly, the question of whether disclosure of information should have been made in any case would be best answered by reference to expert medical opinion on a case by case basis and not as a general rule applicable to all cases. Thirdly, Lord Bridge thought it would be impossible in practice for a court to apply a subjective test to the question of what was a ‘material risk’ that a pati ent should have been informed of, and what was an immaterial risk that would not require disclosure. This subjective test being one put forward in the American case of Canterbury v Spence (1972) 464 F. 2d 772. The statement of Dunn LJ quoted above was firmly upheld in the House of Lords. Sidaway however, was a case decided in 1984 and 1985. Massive advancements have been made both in the standard of medical care provided by doctors, and the requirements of the law in this field, in the intervening years. Therefore, it falls to be discussed, does the principal in Sidaway still apply? Perhaps the best starting place for such a discussion would be to follow Lord Scarman’s approach, quoted above, of looking at the right of the patient. The first right that all of us have, dating back to the early sources of the common law, is the right to bodily integrity. This right is so ingrained in our law that it can rarely be violated, even with the victim’s consent. As Swift J stated in the case of R v Donovan [1934] 2 KB 498 at 507, when it comes to violation of the principle of bodily integrity, ‘consent is immaterial.’ Furthermore, for the most part, the motive of the violator is often irrelevant and even the good intentions of a doctor will not excuse a violation of the principle. In the American case of Schloendorff v Society of New York Hospital 105 NE 92 (NY, 1914) Cardozo J put it clearly when he said that ‘a surgeon who performs an operation without the patient’s consent commits an assault,’ This position has been affirm ed in England in A-G’s Reference (No 6 of 1980) [1981] QB 715 where it was clearly asserted that it is the patient’s consent alone, and not the good motives of the doctor or any other public interest that make a doctor’s interference with the patient lawful. However, absolute as the twin principles of bodily integrity and patient consent appear, there are a number of exceptions in practice. The law distinguishes involuntary treatment, that is treatment that the patient does not consent to, from non-voluntary treatment, that is treatment that the patient is unable to consent to because he is for example unconscious or otherwise unable to provide valid consent. One justification for non-voluntary treatment is that the patient is presumed to consent, as it is highly likely that he would have done so had he been conscious. This approach however, does not have universal academic support (Mitchell, 1995). The more favoured justification comes from the law of necessity, which recognizes the need to act in an emergency, despite the fact that the necessary consent has not been obtained (Skegg, 1974). The requirements for this exception to apply are that the patient is unable to consent, that there is no one capable of consenting on his behalf, th at there is genuine urgency and that there are no known objections to treatment from the patient (In re Boyd, 403 A2d 744 (DC 1979)). The basic approach has been summed up succinctly by Lord Devlin (1962: p. 90) where he said ‘The Good Samaritan is a character unesteemed in English law.’ The principle has been developed further by the Canadian Supreme Court which has developed a distinction between procedures which are necessary and procedures which are convenient. While a doctor may be justified in performing a necessary procedure without consent, to perform a merely convenient one would be beyond what he is authorized to do. Two colourful Canadian cases illustrate the distinction well. The first, Marhsall v Curry [1933] 3 DLR 260, concerns a case where a doctor removed a testicle during the course of a hernia operation. While the patient was naturally dismayed to wake up to the discovery, the court held that the doctor had been justified in acting as he had because of the nature of the patient’s condition and the fact that the operation could not have been regarded as successful but for the doctor’s decision. This case is contrasted with that of Murray v McMurchy [1949] 2 DLR 442 in which the doctor tied a defective fallopian tube during the course of a caesarian section. This was held to have been convenient as the woman would have been at risk, had she undergone another pregnancy, and a separate operation to tie the tube could be avoided by performing the procedure now. However, the court found that the operation was not necessary in the legal sense and therefore a breach of the patientà ¢â‚¬â„¢s right. The relevance of these cases to English law was affirmed by the Court of Appeal in Devi v West Midland Regional Health Authority [1981] CA 491 which followed the Canadian courts reasoning. It should also be clearly noted that the consent of the patient, and the principle of patient autonomy takes precedence over any arguments of medical paternalism. This fact was stated in the two highly publicized and controversial cases of Re T (adult: refusal of medical treatment) [1992] 4 All ER 649 and Airedale NHS Trust v Bland [1993] 1 All ER 821. Also, where a doctor acts without any consent at all, law sees this situation as appropriate for a charge of battery. This will be the case where a doctor proceeds to act on a patient, despite the fact that the patient has expressly refused the treatment (Molloy v Hop Sang [1935] 1 WWR 714). It is also the case where the doctor proceeds to provide a patient with treatment that is materially different from the treatment that the patient consented to. This was the case in Schweizer v Central Hospital (1974) 53 DLR (3D) 494 where a patient consented to a toe operation, and the surgeon subsequently operated on the patient’s back. This is therefore. The starting position that led Lord Scarman to dissent from his colleagues in the Sidaway judgment. It is clear that the principle of bodily integrity is given the highest level of respect and protection under English law. Lord Scarman was saying that in order for a patient to exercise and enforce this right, he had to be informed of the details, risks and nature of a medical procedure. Further to this, Lord Scarman also was of the opinion that if a patient gave his consent without being properly informed of the risks and nature of the procedure he was consenting to, then this consent was in an important sense defective. This is the nature of the principle of informed consent, and requires that in order for a patient’s consent to be effective, and in order for a doctor to be able to properly act on it, the patient must have understood what he was consenting to. Sidaway was clearly a decision that rejected the concept of informed consent. This was recognized in Canada where the courts expressly refused to follow the decision and instead opted for upholding the informed consent requirement. One example of many is that of Haughian v Paine [1987] 4 WWR 97 in which the Saskatchewan Court of Appeal decided not to follow Sidaway and instead ruled that a doctor had been negligent in performing an operation for which the patient had not been told the consequences of undergoing no treatment at all. This case followed quickly on the heals of Sidaway. However, as late as 1997, academics in England were still confidently asserting that â€Å"English law does not recognize the doctrine of informed consent† (Grundy, 1997: p. 211). However, by this time, the attention had shifted to another principle in English law that was providing patient’s with a choice. This principle can also be traced to the Sidaway decision, the very case that rejected the application of informed consent in England. In his dissenting judgment, Lord Scarman said (at p. 884), ‘Unless statute has intervened to restrict the range of judge-made law, the common law enables the judges, when faced with a situation where a right recognized by the law is not adequately protected, either to extend existing principles to cover the situation or to apply an existing remedy to redress the injustice.’ It is this principle of the law that has been leading to significant inroads being created into the Bolam test in the context of the information given to a patient to enable him or her to make a decision. The view of Lord Bridge that it would be impractical to expect the doctor to explain absolutely everything to the patient, has in fact been flipped on its head, and the prevailing sentiment now seems to be that it would be unreasonable for the patient to explain the entire circumstances of his life, medical, social, economic and otherwise, that would be necessary to make a truly informed decision and that therefore, it is the patient who is in a far better position to make the best decision based on the information available. Even in Sidaway a pure Bolam approach was being compromised. Both Lord Bridge and Lord Keith were of the opinion that, ‘When questioned specifically by a patient of apparently sound mind about risks involved in a particular treatment proposed, the doctor’s duty must, in my opinion, be to answer both truthfully and as fully as the question requires’ (per Lord Bridge at 898). If one was to think about this statement in practice, it is in fact a lot more significant a compromise than it may seem. In reality, it is extremely likely that the vast majority of patients would ask their doctor a large number of questions concerning the risks and relative benefits of different courses. It would be a rare patient these days who would see a doctor, hear of a course of recommended treatment, and then accept it unquestioningly. The easy availability of medical information, and access to education and awareness of relevant issues has been promoted in the last couple of decades to the standard where patients are likely to be highly informed on their conditions and the options available to them, and they will certainly expect to engage in a frank discussion with their doctor on the courses of treatment available. It could almost be assumed, that in cases where a patient did not ask about the risks of a procedure of his doctor, either he had sufficient knowledge and cons ented to the doctor’s approach, or abrogated his right to further information in favour of accepting the doctor’s assessment. The second inroad contained in Sidaway itself was asserted by Lords Bridge, Templeman and Keith to the effect that (per Lord Bridge at 900), ‘Even in a case where, as here, no expert witness in the relevant medical field contends the non-disclosure as being in conflict with accepted and responsible medical practice, I am of the opinion that the Judge might in certain circumstances come to the conclusion that disclosure of a particular risk was so obviously necessary to an informed choice on the part of the patient that no reasonably prudent medical man would fail to make it.’ Combined with the previously mentioned inroad, the two conditions together provide significant safeguards to the patient’s right to meaningfully consent. Even if the patient fails to touch on serious issues and risks in his own research, or conversation with the doctor, the doctor is also under an obligation to raise of his own initiative, particular risk that are obviously necessary for ‘an informed choice on the part of the patient.’ Without actually using the phrase, the standard that the court was setting out in Sidaway was in fact starting to sound quite close to the concept of informed consent, at least for the vast majority of cases, in practice. As identified by Gurndy (1997: p. 213) the approach adopted in Sidaway is in fact a limited form of informed consent, ‘for it acknowledges that: a patient’s right of decision should be recognized and respected; where the patient undergoes an operation involving a substantial risk of grave adverse consequences a doctor failing to disclose such risk would be negligent save for circumstances where there was some cogent clinical reason why the patient should not be informed.’ Since Sidaway therefore, there have been a number of cases highlighting the importance of the patient’s right to know, and putting the Bolam test into a subsidiary role as merely one of a number of factors that should be taken into account. In Blyth v Bloomsbury Health Authority [1993] 4 Med LR 151 (per Kerr LJ at 157) it was said, ‘The question of what a plaintiff should be told in answer to a general enquiry cannot be divorced from the Bolam test any more than when no such enquiry is made. In both cases the answer must depend upon the circumstances, the nature of the enquiry, the nature of the information which is available, its reliability, relevance, the condition of the patient and so forth.’ Without creating an express right to all information that is available, the court was saying that Bolam is just one of the factors that are relevant in questions of this type. In Smith v Turnbirdge Wells Health Authority [1994] 5 Med LR 334 (per Mr. Justice Morland at 399) the court went against Bolam when it said, ‘By 1988 although some surgeons may still not have been warning patients similar in situation to the plaintiff of the risk of impotence, that omission was neither reasonable nor responsible.’ Therefore, despite passing the Bolam test, the defendants failed on the grounds of a reasonable and responsible test. In Moyes v Lothian Health Board [1990] 1 Med LR 463 the court found that the overarching test was ‘whether the doctor has shown reasonable care for the safety of his patient.’ In Abbas v Kenney [1996] 7 Med LR 47 the court stated that ‘A doctor has a duty to explain what he intends to do and the implications of what he is going to do. It must be explained in such a way that the patient can understand.’ Therefore, to conclude, it is possible to say that while the courts purport to be applying the Bolam test, as set out in Sidaway, the fact of the matter is that they are actually operating on principles much closer to a practical understanding of a modified form of informed consent. There are numerous cases that show that the mere fact that a body of professional opinion would not have disclosed certain information will not be enough for a doctor to avoid a finding of negligence. At the same time, there are numerous judicial statements to the effect that doctors must inform their patients of the basic information necessary in order for them to exercise their right to consent. Therefore, while in theory there is no doctrine of informed consent in English law, the practical approach, stemming from Sidaway and subsequent practice, is that a modified doctrine of informed consent does prevail in English law, and any doctors who ignored this fact would be standing on very shaky legal groun d. Reference List Texts and Articles Beauchamp Childress, Principles of Biomedical Ethics, 3rd ed. 1990, Cambridge Buchanan Brock, Deciding for Others, 1989, London Campbell, Moral Dilemmas in Medicine, 3rd ed. 1984, Oxford University Press Castiglioni, A history of Medicine, trans and ed E B Krunghaar, 2nd ed. 1947 Fulford, Moral Theory and Medical Practice, 1989, Oxford Grundy, P., Bolam, Sidaway and the Unrecognised Doctrine of Informed Consent: A Fresh Approach, (1997) JPIL, Dec. 211 Lord Devlin, Samples in Law Making, (1962) Oxford University Press, Oxford Mason McCall Smith, Law and Medical Ethics, 4th ed. 1994, Butterowrths, London Mitchell, J., A Fundamental Problem of Consent (1995) 310 BMJ 43 Skegg, A., A Justification for Medical Procedures Performed without Consent, (19740 90 LQR 512 Cases Abbas v Kenney [1996] 7 Med LR 47 A-G’s Reference (No 6 of 1980) [1981] QB 715 Airedale NHS Trust v Bland [1993] 1 All ER 821 Blyth v Bloomsbury Health Authority [1993] 4 Med LR 151 Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 Canterbury v Spence (1972) 464 F. 2d 772 Devi v West Midland Regional Health Authority [1981] CA 491 Haughian v Paine [1987] 4 WWR 97 In re Boyd, 403 A2d 744 (DC 1979) Marhsall v Curry [1933] 3 DLR 260 Molloy v Hop Sang [1935] 1 WWR 714 Moyes v Lothian Health Board [1990] 1 Med LR 463 Murray v McMurchy [1949] 2 DLR 442 R v Donovan [1934] 2 KB 498 Re T (adult: refusal of medical treatment) [1992] 4 All ER 649 Schloendorff v Society of New York Hospital 105 NE 92 (NY, 1914) Schweizer v Central Hospital (1974) 53 DLR (3D) 494 Sidaway v Board of Governors of the Bethlehem Royal Hospital [1984] 1 ALL ER 1018 Smith v Turnbirdge Wells Health Authority [1994] 5 Med LR 334

3pl Providers and Users

A STUDY OF THIRD PARTY LOGISTICS PROVIDERS AND USERS Dr. S. Samar Ali, Associate Professor : Operations & Logistics Management * JK Business School, Damdama Lake Road,Bhondsi, Gurgaon 122102, India Telephone: +91-9971876017, Email address: [email  protected] com ABSTRACT Third party logistics (3PL) has been gaining importance in most places in the world. The implementation of 3PL practices is just beginning and emerging effectively. This paper examines the Indian 3 PL Supply Chain Management and practices with respect to the key success factors and growth strategies .After identifying the critical success factors SERVQUAL is applied to reveal the gap between their achievement and expectation. Respondents to the survey are categorized based on their rating of the key growth strategies on the basis of AHP. Key Words: 3PL; Third Party Logistics Providers; India; Factor Analysis; SERVQUAL; AHP 1. Introduction As conditions for doing business in a global setting have changed significant ly during the last two decades the importance of logistics and supply chain management (LSCM) has been recognized universally.As companies realized the need to adapt to the ever changing conditions in an environment of globalization, technological innovation, and more sophisticated consumer demand to survive and flourish they began to incorporate into their systems of operations and focus on a strong LSCM component (Rushton & Walker, 2007). Superior logistics and supply chain performance is now a well-recognized strategic dimension for companies to gain competitive advantage.The growth of logistics outsourcing in the USA is attributable to better transportation solutions; greater focus on core businesses; impact on cost reduction; improvements in services; development of necessary technological expertise; availability of computerized systems; and the need for more professional and better prepared logistics services (Sheffi, 1990). The growth of business dynamics has caused outsourci ng of the logistics activities to gain increasingly greater importance.Companies have been considering various options to manage their logistics activities including, creating in house dedicated logistics function, setting up logistics subsidiaries or acquiring a logistics firm. (Sahay & Mohan, 2006). A 3PL provider is a company which supplies and/or co-ordinates logistics functions across multiple links in the supply chain. The company acts as a 1 â€Å"third party† facilitator between seller/manufacturer (the â€Å"first party†) and buyer/user (the ‘second party’), Figure 1. Figure 1. Main components of 3PL.Source: Research on India – Third Party Logistics – India, November – 2009. www. researchonindia. com Various authors have provided their version of 3PL definition, which are listed in Table 1. Table 1 – Definitions of 3PL in the logistics literature. Authors Lieb (1992) Definition The use of external companies to perform l ogistics functions that have traditionally been performed within an organization. The function performed by the third party can encompass the entire logistics process or selected activities within that process. Andersson (1997) Murphy and Poist (1998)The procurement of an integrated set of logistics services in a longterm relationship between a shipper and a service provider. A relationship between a shipper and third party which, compared with basic services, has more customized offerings, encompasses a broader number of service functions and is characterized by a longer term, more mutually beneficial relationship. 2 Vab Laarhoven et al. (1999) Berglund (2000) Bask (2001) Activities carried out by a logistics service provider on behalf of a shipper and consisting of at least management and execution of transportation and warehousing.In addition, other activities can be included, for example inventory management, information related activities, such as tracking and tracing, value ad ded activities, such as secondary assembly and installation of products, or even supply chain management. Also, the contract is required to contain some management, analytical or design activities, and the length of the co-operation between shipper and provider to be at least one year, to distinguish 3PL form traditional â€Å"arm’s length† sourcing of transportation and/or warehousing.Organizations use of external providers, in intended continuous relationships bound by formal or informal agreements considered mutually beneficial, which render all or a considerable number of the activities required for the focal logistical need without taking title. Relationships between interfaces in the supply chains and third party logistics providers, where logistics services are offered, from basic to customized ones, in a shorter or longer-term relationship, with the aim of effectiveness and efficiency.Source: Marasco, A. , A Survey of Third Party Logistics Literature: Prelimina ry Findings. RIRL 2006 – Sixth International Congress of Logistics Research. Since the 1980s, along with the trend to outsource non-core activates (Sink and Langley, 1997), companies have increasingly turned to third-party logistics providers (3PL) both in the USA (Lieb and Randall, 1996; Rabinovich et al. , 1999; Knemayer and Murphy, 2004) and in Europe (Van Laarhoven et al. , 2000). PL services help to achieve the strategic objectives by concentrating more on core competency of the main business. The study by Sahay and Mohan, 2006, has cited substantial growth in various financial indicators using services of 3PL, for instance, various improvements in sales revenue by 13. 5%, working capital by 12. 3%, returns on assets by 10%, capital assets reduction by 10%, production cost reduction by 10. 5%, labor cost reduction by 10. 0%, and logistics cost reduction by 15%. PL users depend on 3PL service providers to secure capacity and gain agility (Hannon, 2005) who not only provid e core services like supplying right quality product, Figure 2. Outsourcing Development of Logistics Services and Network Source: Hapanen and Vepsalainen, 1999. 3 in the right amount, at the right price and place, and at the right time but also provide value added services such as tracking and tracing, sending information prior to the arrival of products, flexibility in delivery, which are valued by customers.The role 3PL service providers play in enhancing services and thereby satisfying customers has been universally recognized. The growth in 3PL service providers is seen across the world. As the logistics service demand increases, the challenges and opportunities will continue to increase. With the wide availability of modern decision making tools and information technology a paradigm shift in logistics is witnessed. Figure 2 depicts the evaluation and the state of the art witnessed in ogistics outsourcing. Companies across industries and around the world regard logistics and sup ply chain management as key components of their overall business success. Many users feel that their relationships with 3PLs have helped them achieve critical goals related to service, cost, and customer satisfaction. Third Party Logistics in India: Ever since the liberalization of its economy India has been on a path to become one of the top economic powers in the world.New avenues for progress and development have opened up; manufacturing and retail sectors gained popularity because of the changes in China’s export policy of not exporting manufactured items, from which Indian manufacturing firms have benefitted. Hence this sector will contribute to GDP significantly in the long run. The growth and competitiveness in these two sectors largely depend on the efficiency of the logistics operations that facilitate the companies’ ability to reach out to their customers quickly and at the desired location.Realizing this many manufacturers and retailers are now restructuring their supply chain processes in a manner to incorporate partnerships with expert supply chain service providers and outsourcing such activities as domestic transportation, international transportation, customs brokerage, warehousing, forwarding, cross-docking, product labeling, packing, assembly, kitting, reverse logistics, freight bill auditing and payment, IT services, fleet management, supply chain consultancy services provided by 3PLs, order entry, processing and fulfillment and limited liability partnership (LLP)/4PL Service.Currently 3PL services are in their nascent stage in India. Third party logistics will gain considerable share of the logistics sector because of the following compelling facts. †¢ 1 Globally, the logistics industry is valued at US$3. 5 trillion and the Indian logistics industry is currently estimated at US$90 billion (CII)1. Colliers International – Logic of Logistics – http://www. colliers. com/Content/Attachments/India/2009_Logic_Of_L ogistics. pdf 4 †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢The industry has generated employment for 45 million people in the country in comparison with the IT and ITES sector, which employs approximately 4. 3 million people1. As per the World Bank Survey, India ranks 39th in terms of the logistics performance index and indicators, with Singapore on top, the UK, USA and China in 9th, 14th and 30th positions, respectively. India spends US$1,148 in handling costs to import one cargo container and US$820 to export it. In comparison, Singapore spends US$367 per imported container and China US$390, according to a World Bank study1.India spends 13% of its GDP on logistics compared to an average of 10% in developed countries, while the U. S. spends just 8%. Better supply chain management has reduced logistics costs by nearly 1% in 10 years1. The Indian government plans to spend US$24 billion over the next eight years on supply chain infrastructure1. 3PL solutions are on course to grow at a compound annual growth rate (CAGR) of over 16% from 2007-2010. Consequently, 3PL service providers are expected to corner an increased share of the Indian logistics pie, from 6% in FY2006 to 13% in FY2011, at a CAGR of 25% (CII)1.According to the ASSOCHAM2, outsourcing of 3PL businesses in India should reach the value range above US$ 90 million by 2012 as the concept first introduced in US and Europe is being adopted at a pace that will lead to increases in the efficiency of domestic operations through better managed logistics functions. Companies in textile, automotive, pharmaceutical, manufacturing, retail and FMCG sectors are increasingly opting to outsource their logistics requirements to specialized service providers. According to a recent survey of 3PL service providers engineering, automotive and retail sectors were top revenue earners. PL Market Structure in India The 3PL market in India is comprised of two segments: the first one is asset based in which assets like trucks, distribution centers and warehouses are utilized in supply chain management, and the second one is non-asset based. There is a significant difference between the nature of Indian 3PL and its counterpart elsewhere, especially in the U. S. , Table 2. Table 2: Comparative Analysis of 3PL in India and the U. S. Parameter Usage of 3PL Common activities outsourced 2 USA 71% Warehousing (73. 7%) Outbound Transportation (68. 4%) India 55% Outbound Transportation (55%) Inbound Transportation (52%) http://www. ommodityonline. com/printnews. php? news_id=23489 5 Reasons for not outsourcing Necessity of ecommerce Collaborative relationship Gain sharing is important for relationship Freight bill payment (61. 4%) Inbound warehousing (56. 1%) Control would diminish (63%) Costs would not be reduced (63%) Service commitment would not be met (48%) Logistics is a core competency (44%) 72% Custom clearing and forwarding (51%) 82% 14% 80% 6. 6% Source: 3PL Practices in India, Sahay. B. S. , Poor infrastructure of provider (81%) Inability to respond to changing needs (81%) Unreliable promised from providers (80%) Concerns about capability of providers (77%) 7% www. cscmpindia. com/Events/20112003/3. PDF Considerable amount of research on the topic of the implementation of 3PL in different countries has been published in academic and trade journals. Viewpoints of both users and service providers have been considered to identify the major issues, industry dynamics, current status and future prospects of the 3PL industry. However most of the research is descriptive in nature and does not go into in-depth statistical analysis of survey data. In the present study Indian 3PL providers’ service dimensions are analyzed in terms of the key success factors and growth strategies using various tatistical tools. 2. Literature Review In this section a review of the literature is presented, which examines the perspectives of the 3PL users and service providers to under stand the variation in the services offered and services expected. Table 3 provides a list of recent contributions that address the reasons for outsourcing logistics activities. Table 3. Reasons for outsourcing logistics activities. Author, (Year) Objective Conclusion Sheffi, (1990) Understand the motives for the growth of logistics outsourcing in USA The main motives are to focus on †¢ Core businesses †¢ Better transportation solutions †¢ Cost savings and improved ervices †¢ Development of necessary technological expertise and computerized systems; and need for more professional and better- 6 Maltz, (1994) Establish relative impact of cost and services on the decision to outsource warehousing The study determined that organizations are reluctant to use third party warehousing due to customer service considerations. Author, (Year) Objective Conclusion Rao & Young, (1994) Identify the factors influencing outsourcing of logistics functions Daugherty et al. , (1996) Study the perception of the third party logistics service users van Damme et al. , (1996) Examine outsourcing ogistics management activities Sink & Langley, (1997) Develop a managerial framework for the acquisition of third party logistics services The study identified factors such as †¢ Centrality of the logistics function †¢ Risk and control †¢ Cost/service trade-offs †¢ Information technologies and relationships with logistics service providers †¢ Product-related (e. g. special handling needs), process-related (e. g. cycle times) and networkrelated (e. g. countries served) drivers are believed to have an indirect influence in the outsourcing decision The service users believe that they are getting benefits like reduction in nventory levels, order cycle times, lead times and improvement in customer service. The â€Å"do or buy† decision is also affected by evaluation of cost/service trade-offs. One important determinant of the decision is cost comp arison between alternative options. Costs associated with performing logistics activities inhouse and investment in capital assets are traded-off against service provider fees. The lowest cost solution should Concentration towards the core competencies was the most important factor for the acquisition of third party logistics services. Bhatnagar et al. , (1999) Find out factors for decision-making process or choosing contract logistics service providers. Ascertain benefits of alliance between manufacturing and global logistics service providers. Study benefits of outsourcing the logistics activities. The major reasons to outsourcing of logistics activities were cost saving (86. 8%), customer satisfaction (76. 3%) and flexibility (75%). Study growth strategies for logistics service providers Forming relationships with 3PL providers is an efficient and effective means of achieving the required services without investing heavily in assets and new capabilities. Bhatnagar and Viswanathan , (2000) Bask, (2001)Persson and Virum, (2001) The manufacturing firms got the advantage of reduction in inventory levels, order cycle times, lead times and improvement in customer service. The customer satisfaction increases significantly and provides access to international distribution networks. 7 Sohail & Sohal, (2003) Examine the reasons for outsourcing logistics activities in Malaysia The major reasons reported are †¢ Cost savings †¢ Improved services †¢ Better transportation solutions †¢ Better professionalism Author, (Year) Objective Conclusion Wilding & Juriado, (2004) Determine customer perceptions on logistics outsourcing in theEuropean consumer goods industry The main reasons for outsourcing the logistics activities are †¢ Competencies of 3PLs †¢ Operating flexibility †¢ Cost reduction †¢ Focus on core businesses Aktas & Ulengin, (2005) Review the reasons for outsourcing logistics activities in Turkey Turkish firms basically outsou rce the transportation activities to reduce the operating costs. Simchi-Levi et al. , (2008) Determine the effect of outsourcing of logistics on the management of the supply chain. The most important reason for outsourcing is that it allows a company to focus on its core competencies and hence on customer requirements.Studies based on user firms appear to indicate that outsourcing logistics activities is appropriate if it has an impact on one or more factors depicted in Table 4. Table 4. Impact of outsourcing logistics activities. Factor Impact on customer satisfaction Indentified by Gooley (1992); and Lieb et al. (1993) Impact on logistics system performance Lieb et al. (1993) and Dapiran et al. (1996) and Bhatnagar et al. (1999) Reduction in capital investment in facilities Reduction in capital investment in equipment Foster and Muller (1990) and Richardson (1992, 1995) Fantasia (1993), Foster and Muller (1990) and Richardson (1992)Reduction in investment in information technology Impact on employee morale Goldberg (1990), Sheffi (1990), Trunick (1990) and Fantasia (1993) Bowersox (1990) and Dapiran et al. (1996) Reduction in manpower cost Foster and Muller (1990) and Richardson (1992, 1995) Minaham (1997) and McMullan (1996) Improvement on specific logistics function parameters Improvement in inventory turnover rates Improvement in on-time delivery Increasing productivity Richardson (1990, 1995) Richardson (1995) Bradley (1995) 8 A list of references that address the issue of selection criteria for 3PL providers is given in Table 5. Table 5.Selection criteria for 3PL providers. Reference Objective Conclusion Bagchi and Virum, (1996) Develop a management model for selecting the logistic service provider Selection criteria typically include: †¢ Cost †¢ Service quality and reliability †¢ Flexibility †¢ Responsiveness to requests †¢ Financial stability Sink & Langley, (1997) Develop a managerial framework for the acquisition of 3PL serv ices Menon et al. , (1998) To study the selection criteria for 3PL providers. Meade and Sarkis, (2002) To develop conceptual model for selecting and evaluating third-party reverse logistics providers. Managers of a firm assign greater mportance to qualitative factors such as supplier reputation, references from clients, and response to information requests, which are used for the initial screening of candidate service The firm’s competitiveness strategy and its external environment affect the selection criteria. The important criteria for the selection of a 3PL provider are: †¢ On time shipment and deliveries †¢ Superior error rates †¢ Financial stability †¢ Creative management †¢ Ability to deliver as promised †¢ Availability of top management †¢ Responsiveness to unforeseen occurrences †¢ Meet performance and quality The most important factors for 3PL election are: †¢ Time †¢ Quality †¢ Cost †¢ Flexibility Aghazade h, (2003) To select the effective 3PL provider. The criteria for selecting 3PL provider are: †¢ Similar value †¢ Information technology systems †¢ Key management 9 Colson and Dorigo, (2004) H. S. Hwang et al. , (2005) Efendigil et al. , (2008) To develop public warehouse selection support system. The software tool select the public warehouse on the basis of factors like †¢ Storage surface and volume †¢ Dangerous items †¢ Geographical distance to highway connection †¢ Certification †¢ Assistance with customs †¢ Use of technology such as RFID/bar-coding, modemTo develop the supplier The major supplier selection selection and planning indicators are: model. †¢ Serviceability – Meet the lead time †¢ Inventory rotation rate †¢ Lead time †¢ Customer satisfaction †¢ Market share †¢ Production flexibility †¢ Multi-item production capability †¢ New item development/production capability †¢ Qualit y – Quality assurance Selection of a thirdThe third party reverse logistics party reverse logistics providers selection can be done by provider in the using performance indicators like: presence of vagueness. †¢ On time delivery ratio †¢ Confirmed fill rate †¢ Service quality level Unit operation cost †¢ Capacity usage ratio †¢ Total order cycle time †¢ System flexibility index †¢ Integration level index †¢ Increment in market share †¢ Research and development ratio †¢ Environmental expenditures †¢ Customer satisfaction index Table 6 gives Jharkharia and Shankar’s (2006) list of the selection criteria for 3PL providers as identified by some authors. Table 6. Selection criteria. N o Selection Criteria Relevance in 3PL Selection Reference 10 1 Compatibility with the Users The ability of the user, provider and their support systems to work together in co-ordination. Anderson and Norman 2002), Lynch (2000), Mohanty and Deshmukh (1993). 2 Cost of Service Total cost of logistics outsourcing. Lynch (2000), Stock et al. (1998), Tam and Tummala (2001). 3 Quality of Service It includes many aspects like transportation time, on-time delivery, frequency and cost of damages etc. Razzaque and Sheng (1999), Thompson (1996), Langley et al. (2002). 4 Reputation of Vendor 5 Performance Measurement Opinion of concerned people about 3PL firm. Provision for periodic evaluation of the performance. Lynch (2000), Thompson (1996). Bhatanagar et al. (1999), Lynch (2000), Langely et al. (2002). 6 Willingness to UseLogistics Manpower Razzaque and Sheng (1998), Ackerman (1996). 7 Flexibility in Billing Willingness of 3PL provider to retain users’ logistics employee, who would otherwise become unemployed after outsourcing contract. Flexibility in billing and payment conditions which increases goodwill between user and supplier. 8 Long-Term Relationship Includes shared risk and rewards. Lynch (2000), Boyson et al. ( 1999). 9 Quality of Management Anderson and Norman (2002), Lynch (2000), Boyson et al. (1999). 10 Information Sharing and Mutual Trust Able management not only provides good services but also fosters a long-term elationship. For continuance of agreement and continuous improvement of services. 11 Operational Performance 12 Information Technology Capacity 13 Fixed Asset Langely et al. (2002), Tam and Tummala (2001). Anderson and Norman (2002), Lynch (2000), Langely et al. (2002), Babbar and Prasad (1998). Hum (2000), Boyson et al. (1999). 14 Experience in Similar Product 15 Delivery Performance Can be measured by delivery performance, performance monitoring capacity etc. The advanced IT capacity helps in reducing uncertainties and inventory level. Tracking of goods becomes an easy process. Size and Quality of fixed sset helps in good operational performance. Prior experience in product line of shipper is added advantage. Speed and reliability. Bradley (1994). Lynch (2000). Razzaque an d Sheng (1998), Ackerman (1996). Stock et al. (1998), Gattorna and Walters (1996). 11 16 Employee Satisfaction Level Improves operational performance. 17 Financial Performance Ensures continuity in services, regular updation of equipments. 18 Market Share It reflects its financial performance, customer satisfaction and reputation. Thompson (1996). 19 Geographical Spread and Range of Services Provided Flexibility in Operation and DeliveryCreate enhanced access to the user. Maltz(1995), Boyson et al. (1999), Bradlley (1994). Stank and Daugherty (1997). 20 It may enable the user to give customized service to the shipper, particularly in special or non-routine request. Lynch (2000), Boyson et al. (1999), Langely et al. (2002). Anderson and Norman (2002), Boyson et al. (1999). Table 7. Growth Strategies Reference Objective Conclusion Sum and Teo, (1999) To find out Strategic posture of logistics service providers in Singapore 3PL performance and profits can be improved by: †¢ Cost r eduction, †¢ Market segmentation †¢ Service differentiationEnvironmental changes and the introduction of new technologies have an impact on LSP strategic planning Both vertical (shipper-LSP) and horizontal (among LSPs) alliances are set up mainly with the aim of getting access to complementary resources and capabilities. In particular, horizontal alliances among LSPs are deemed necessary for the development of cross-border logistics solutions Hum, (2000) van Hoek, (2000) To find out the factors that affect the LSP strategic planning To find out the reasons for doing alliances. 12 Stone, (2001 & 2002) To find out the growth strategies used by UK’s 3PL providers.Carbone and Stone, (2005) To identify the growth strategies used by European logistics service provider and its out come C. John Langley, Jr. , Ph. D. , and Capgemini U. S. LLC. 2009, 2008, 2007, 2006, 2005 To identify the growth strategies used by the logistics provider in the world. LSPs employ a variety of growth strategies. Important means of expansion include: †¢ Mergers and acquisitions (M&As) †¢ Joint ventures †¢ Strategic alliances †¢ Piggybacking (i. e. following the client's expansion and establishing new operations in foreign markets) †¢ Organic growth European logistics service providers use M for gaining dvantage in factors like: †¢ Economies of scope †¢ Expanded geographical coverage †¢ Acquisition of specialized capabilities †¢ Requirements for investment in IT and equipment Third party logistics providers use following strategies for growth of the company. †¢ M †¢ Service Portfolio †¢ 3PL User/Provider Relationships. †¢ RFID and IT †¢ Future Growth of the 4PL Provider Concept †¢ 3PL Creation of Supply Chain Value †¢ Integration & Collaboration †¢ Green Supply Chain 3. Research Methodology The research objectives of this paper are as threefold: 1. To identify the success factors of Indian 3PL firms and their relative importance. . To analyze the gap between achievement and expectation as defined by the success factors identified. 3. To prioritize the growth strategies and their relative importance. 13 3. 1 Type of Research Employed In this paper we used an exploratory research to help formulate relevant questions and hypotheses that can be the basis of subsequent inquiries into the issues faced by 3PL providers and users. This type of research is particularly useful when the researcher is uncertain of the theories that are relevant, and would like to seek insights and ask questions to assess the phenomena he has observed in a new light.The tools one may employ to conduct exploratory research include review of the literature, and surveys of the opinions of experts and focus groups. 3. 2 Sampling Procedure We employed a non-probability sampling technique, Quota Sampling. Quota sampling is used to ensure that a set of specific characteristics that are of interest to the investigator is present in the sample. 3. 3 Sample Size To collect data we sent out a structured questionnaire to 220 third party logistics providers’ employees. 124 of the replies could be used for the analysis. Industry Review factor analysis, the research . 5 Tools of Analysis Literature Review Research Issue In our study we used SERVQUAL and AHP. The stages of process are shown in Figure 3. Research Questions First Version Development of Questionnaire Final Version Revised Version Data Collection Data Analysis 14 Conclusion Figure 3 Research Process 5 . Data Analysis 5. 1 To identify the success factors of Indian 3PL firms and its relative importance. The data collected through questionnaire was analyzed through SPSS 15. 0 to find out the success factors and their relative importance. The KMO and Bartlett’s test results shown in Table. indicate the suitability of the data for factor analysis. Kaiser-Meyer-Olkin Measure of Sampling Adequacy is 0. 769 which is great er than 0. 5. This indicates that a factor analysis will be useful with the data. The value of significance level is 0. 000, which is less than 0. 05. So there is a significant relationship among the variables. The initial extraction shows that the communalities are very high, which indicate that the extracted components represent the variables well. Table 9. Table 8. KMO and Bartlett's Test Kaiser-Meyer-Olkin Measure of Sampling Adequacy. 0. 769 Bartlett's Test ofSphericity 3167. 333 Approx. Chi-Square Df Sig. 325 .000 Table. 9 Communalities Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Initial 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 Extraction .477 .611 .638 .667 .595 .670 .653 .536 .766 15 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20 Q21 Q22 Q23 Q24 Q25 Q26 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 1. 000 .661 .588 .624 .604 .664 .753 .748 .774 .589 .690 .695 .734 .671 .653 .582 .607 .641 Extraction Method: Principal Component Analysis. 16 Table 10. Total Variance ExplainedInitial Eigen values % of Cumulative Variance % 23. 065 23. 065 12. 909 35. 974 Extraction Sums of Squared Loadings % of Cumulative Total Variance % 5. 997 23. 065 23. 065 3. 356 12. 909 35. 974 Rotation Sums of Squared Loadings % of Total Cumulative % Variance 3. 064 11. 786 11. 786 2. 964 11. 398 23. 184 42. 224 1. 625 6. 250 42. 224 2. 602 10. 007 33. 191 47. 529 1. 379 5. 305 47. 529 2. 118 8. 147 41. 339 4. 802 52. 331 1. 249 4. 802 52. 331 1. 829 7. 034 48. 372 4. 467 56. 798 1. 161 4. 467 56. 798 1. 599 6. 151 54. 523 1. 098 4. 225 61. 023 1. 098 4. 225 61. 023 1. 434 5. 515 60. 038 1. 023 . 935 64. 958 1. 023 3. 935 64. 958 1. 279 4. 920 64. 958 Component Total 1 2 5. 997 3. 356 3 1. 625 6. 250 4 1. 379 5. 305 5 1. 249 6 1. 161 7 8 9 .936 3. 598 68. 557 10 .869 3. 344 71. 901 11 .788 3. 031 74. 931 12 .704 2. 707 77. 638 13 .671 2. 580 80. 218 14 .608 2. 338 82. 556 15 .594 2. 284 84. 839 16 .552 2. 123 86. 9 63 17 .542 2. 083 89. 046 18 .503 1. 933 90. 979 19 .389 1. 497 92. 476 20 .380 1. 462 93. 938 21 .343 1. 318 95. 256 22 .317 1. 220 96. 476 23 .297 1. 144 97. 620 24 .242 .931 98. 550 25 .196 .753 99. 304 26 .181 .696 100. 000 Extraction Method: Principal Component Analysis. 7 Table 11. Rotated Component Matrix (a) Component 1 2 Q1 Q2 3 4 5 6 7 8 .504 .431 Q3 .760 Q4 .417 Q5 .639 Q6 .502 .488 Q7 -. 407 .646 Q8 .505 Q9 Q10 .813 .739 Q11 .555 Q12 .419 .699 Q13 .647 Q14 .639 Q15 .823 Q16 .815 Q17 .772 Q18 .457 Q19 .514 .491 Q20 .658 Q21 .731 Q22 .643 Q23 .742 Q24 .676 Q25 Q26 .688 .635 Extraction Method: Principal Component Analysis. Rotation Method: Varimax with Kaiser Normalization. a Rotation converged in 24 iterations. We note that about 65% (. 64958) of the total variation in the 26 variables is attributable to the first eight components, Table 10.We also observe that Component 1 explains a variance of 3. 064, which is 11. 786% of total variance of 26; Component 2 explains a vari ance of 2. 964, which is 11. 398% of total variance and so on. The rotated component matrix contains the same information as the component matrix, except that it is calculated after rotation, Table 11. From this table we construct the following factor matrix, Table 12, where the key elements of importance in relation to the eight factors are shown. 18 Table 12. Factor Matrix Eigen Value Factor No. Factor Name Total

Never Before Told Stories on Why I Deserve This Scholarship Essay Samples You Really Need to Read or Be Left Out

Never Before Told Stories on Why I Deserve This Scholarship Essay Samples You Really Need to Read or Be Left Out The Downside Risk of Why I Deserve This Scholarship Essay Samples In any event, it's well worth applying for, because it is going to help lessen the expense of your education. You ought to be ready to pay for a big part of your education. Looking for scholarship is extremely easy, as there are various organizations, foundations, and businesses that are ready to offer money for your school. To submit an application for a scholarship, students must develop a new debt relief program to help consumers that are behind on their charge card payments. Where to Find Why I Deserve This Scholarship Essay Samples Shared reading can be exceedingly useful in stimulating interest. Additionally, the writers offering freelance essay writing services ought to be capable of giving essays without any grammatical errors. 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Artificial Intelligence and Cognitive Reasoning - 1597 Words

In today’s fast paced technologically savvy society, everyone wants the most advanced technology, this thirst for the next big thing is what makes technology fields the fastest changing and growing sectors. In countless movies, television shows, and novels, there is a representation of a humanoid character that is in fact a machine functioning and learning new skills with artificial intelligence. The problem with these shows is that the representation of modern day artificial intelligence is largely skewed, these machines have personalities and emotions making them relatable to humans when they are still just a very elaborate computer program. Artificial intelligence is the cognitive ability to solve problems, recognize patterns, and have†¦show more content†¦The concept of artificial intelligence was first labeled by a man named Alan Turing in 1950, he believed that the future would hold the possibility for man to communicate with computers and sustain a conversation (Atkinson, Solar 1). Although, we have reached the point where it is possible to hold a simple preprogrammed conversation with a computer and give them the ability to learn, there is still a long way to go in making computers fully artificially intelligent. Atkinson and Solar continue to describe some real world applications of artificial intelligence such as, â€Å"Data mining technologies, fraud detection, and industrial-strength optimization† (8). In these examples, forms of artificial intelligence like cognitive reasoning abilities are already being used making the demand for them higher. 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