Discretion drift in primary care commissioning in England: Towards a conceptualization of hybrid accountability obligations

In the context of welfare delivery, hybrid organizations mix public and ‘new’ market, social, and professional types of mechanisms and rationales. This article contributes to our understanding of accountability within hybrid organizations by highlighting how accountability obligations can become hybrid, simultaneously formal and informal. Instead of seeing accountability as hybrid only in the sense of the coexistence of types of organizational mechanisms and structures (i.e., the prevalence of both state and market types), we examine accountability arrangements governing a hybrid model—primary care commissioning in England—and interrogate the relationships between accountability actors and their accountability forums. We conceptualize ‘hybrid accountability obligations’ as a state whereby the nature of obligation underpinning accountability relationships is both formal-informal and vertical-horizontal concurrently. The article concludes by highlighting the consequences of this kind of hybridity, namely how it extended discretion from welfare delivery to the domain of welfare governance.     

DOES PUBLIC ACCOUNTABILITY WORK? AN ASSESSMENT TOOL

In recent years, there has been a drive to strengthen existing public accountability arrangements and to design new ones. This prompts the question whether accountability arrangements actually work. In the existing literature, both accountability ‘deficits’ and ‘overloads’ are alleged to exist. However, owing to the lack of a cogent yardstick, the debate tends to be impressionistic and event‐driven. In this article we develop an instrument for systematically assessing public accountability arrangements, drawing on three different normative perspectives. In the democratic perspective, accountability arrangements should effectively link government actions to the ‘democratic chain of delegation’. In the constitutional perspective, it is essential that accountability arrangements prevent or uncover abuses of public authority. In the learning perspective, accountability is a tool to make governments effective in delivering on their promises. We demonstrate the use of our multicriteria assessment tool in an analysis of a new accountability arrangement: the boards of oversight of agencies.     

SYMPOSIUM OVERVIEW: CONCEPTUALIZING NEW GOVERNANCE ARRANGEMENTS

This symposium, ‘Conceptualizing New Governance Arrangements', takes up the challenge of refining governance theory to better integrate work in several disciplines, most notably politics, public administration and law. To this end, we argue for a theoretical framework that profiles three key dimensions of governance: institutional, political and regulatory. This framework, in our view, offers new insights into the nature and operation of various governance arrangements, and offers the potential to assess and measure change within such arrangements over time. After describing our methodology for selecting and analysing the case studies profiled in the symposium, we introduce each of the articles that apply our three‐dimensional governance framework. These articles employ the framework to consider a variety of contemporary governance scenarios that vary widely by sector (environmental, climate change, forestry and education policy) and level of analysis (sub‐national, national, and bi‐national).     

Central banks under stress: Reputation,accountability and regulatory coherence

This symposium homes in on an area of public administration that has been through a period of significant change in the last ten years. Since the global financial crisis, central banks have expanded their operations in financial markets, buying up vast quantities of assets as part of expansive monetary policy strategies. They have also played a leading role in the reform of financial regulation and have been entrusted with enhanced authority to supervise financial institutions. This activity has taken place amid heightened political contestation, with central banks increasingly viewed as the quintessence of a technocratic mode of governance that eschews traditional democratic control. The purpose of this symposium is to consider how central banks’ reputation, accountability and regulatory roles have changed since the financial crisis, and what those changes tell us about the balance of power between independent regulatory agencies and elected policy‐makers.     

THE NEW GOVERNANCE ARRANGEMENTS FOR NHS FOUNDATION TRUST HOSPITALS: REFRAMING GOVERNORS AS META‐REGULATORS

New governance arrangements for NHS Foundation Trusts (FTs) aimed to replace centralized state ownership of acute English hospitals with a new form of social ownership. Under this, trusts would exist as independent public interest organizations on the model of mutuals and co‐operative societies. Assessing the impact of the new arrangements on the management structure of four acute hospitals, we demonstrate that FTs have failed to deliver social ownership and local accountability on this model. We suggest that policy‐makers should re‐frame the governance apparatus associated with mutualism and social ownership in terms of the concept of meta‐regulation. By re‐framing governors as meta‐regulators, regulatory institutions would acquire new powers to steer FTs towards sustainable forms of compliance via non‐coercive, non‐intrusive means.     

Towards developing new partnerships in public services: users as consumers, citizens and/or co-producers in health and social care in England and Sweden

The causes and effects of marketization of public services have been analysed extensively in the literature, but there is relatively little research on how those policies impact on the development of new forms of governance, and the role of users in these new arrangements. This study reviews examples of competition, freedom of choice and personalized care in health and social services in England and Sweden, in order to examine the type of relationships emerging between the user/consumer vis-à-vis market driven providers and various agencies of the state under the marketized welfare. The article focuses on the possible roles users might assume in new hybrid arrangements between markets, collaborations and steering. A user typology: namely, that of a consumer, citizen, co-producer and responsibilized agent in various governance arrangements, is then suggested. The article concludes by arguing that pro-market policies instead of meeting the alleged needs of post-modern users for individualized public services are likely to promote a new type of highly volatile and fragile partnerships, and create a new subordinated user who has no choice but to ‘choose’ services they have little control over.     

The New Mode of Public Governance and Public Accountability in Developing Countries: An Analysis with Particular Reference to Bangladesh

Public accountability is a fundamental element of good governance. All countries all over the world strive to ensure the accountability of public officials by adopting different kinds of mechanisms. Following the liberal democratic tradition, most countries in the world have relied on the legislative instruments, executive means, judicial and quasi-judicial processes, official rules, codes of conducts, official hierarchies, public hearings, interest groups, media scrutiny and so forth for ensuring public accountability. However, in recent years, the new mode of public governance has brought new dimensions to the discourse on public accountability. This new mode focuses largely on the market- and society-centered mechanisms. This article is an attempt to assess the effectiveness of these market- and society-centered mechanisms in ensuring public accountability in Bangladesh. The article has the following objectives:

(a) to explore contemporary debates on the market- and society-centered mechanisms of public accountability;

(b) to sketch the state of public accountability in Bangladesh; and

(c) to analyze the effectiveness of the market- and society-centered mechanisms in view of the contemporary socio-economic and political dynamics of Bangladesh.     

Focusing on quality care rather than ‘checking boxes’: How to exit the labyrinth of multiple accountabilities in hybrid healthcare arrangements

Accountability relations in modern-day welfare states have multiplied due to the complex interaction of institutional and sectoral logics. Against this backdrop, this article seeks to unravel complexities which surround accountability relations in hybrid healthcare arrangements. For this purpose, a framework of multi-faceted identity is suggested in order to theoretically grasp multiple accountabilities of healthcare professionals. Accordingly, healthcare professionals have a cross-cutting identity (being a professional) that is fortified with nested identities such as the one of partner, citizen and manager. Each identity facet is attached to a specific accountability form such as professional and civic society accountability. By focusing on three settings of healthcare provision—hospital, outpatient and integrated care—the usefulness of a multi-faceted identity framework will be illustrated. It is concluded that developing a more nuanced understanding of healthcare professionals’ multiple identities and attached accountabilities might be a good starting point for planning healthcare redesign.     

A GENDER ANALYSIS OF WOMEN IN PUBLIC–PRIVATE–VOLUNTARY SECTOR ‘PARTNERSHIPS’

The nature of work and traditional notions of the public sector have been changing with increasing collaborative governance and delivery of public services among public, private and voluntary sector organizations. In the UK, governments at national and devolved levels of government have adopted collaborative governance for service delivery through various networks and partnerships. This article explores collaborative governance from a gender perspective, specifically the perceptions of women in public–private–voluntary sector partnerships. While previous research in this area has explored aspects of collaborative governance such as power, trust, accountability, decision‐making, performance, exchange of information and participation, there is very little research on women within these networks. The article therefore provides a gendered analysis, disaggregating survey data to better understand the dynamics, for women, of collaborative governance and partnerships among public, private and voluntary sector organizations.     

Open Source Governance—A More Ambitious Cousin of Collaborative Governance

Open source represents a model generally known for its success in software production. The objective of this article is to establish a new strategic approach of using open source development principles for managing collaborative arrangements between citizens and public administration. The identity of open source governance is developed by highlighting how it is different from its main “competitor”—collaborative governance, and from other two popular concepts—open government and e-democracy. The other sections are designed to answer to public managers regarding why and what to adopt from this governance model for public sector services.     

What about Financial Sustainability of Local Government!—A Critical Review of Accountability,Transparency, and Public Assurance Arrangements in England during Austerity

Austerity strained the financial sustainability of governments and ability of policy-makers to address policy challenges, and so having appropriate accountability and transparency arrangements to assure the public they were getting value for money took on renewed urgency. Comparing and contrasting findings from a critical review of policy developments in English Local Government during the Conservative led coalition central government 2010–2015 with those from related studies on accountability and transparency more generally, the article offers key themes for practitioners and policy-makers seeking to build stronger democratic systems of governance that go well beyond the UK jurisdiction.     

Multilevel governance and problem‐solving: Towards a dynamic theory of multilevel policy‐making?

In this article, we suggest that the governance of problems shapes the institutional dynamics of multilevel governance (MLG) polities. MLG arrangements—processes and institutions that enable policy‐making across different jurisdictional levels wherein both public authorities and non‐state actors are involved—can or cannot succeed in solving policy problems and at the same time they could create new problems. We argue that the problem‐solving capacity and problem‐generating potential of multilevel arrangements can result in further, downwards, upwards or sideways delegation of political authority, which in turn reconfigure the multilevel architecture of the political system following either centripetal or centrifugal tendencies. We illustrate our point with a stylized account of the dynamics of MLG in the European Union (EU) since the early 1990s. We conclude with some remarks about developing a more general theory of multilevel policy‐making.     

COMPETING TRADITIONS OF GOVERNANCE AND DILEMMAS OF ADMINISTRATIVE ACCOUNTABILITY: THE CASE OF DENMARK

This article offers a study of the changing role of the state in Denmark under the condition of the overall transformation from government to governance with particular emphasis on the corresponding transition from process accountability to performance accountability. It is argued that although new modes of governance have been introduced, and new interpretations of accountability have been proliferated, neither conventional modes of governance nor older interpretations of accountability disappear. Thus, what we see is a co-existence of competing traditions of governance and different and sometimes contradictory interpretations of administrative accountability, which create potential dilemmas and contradictions for the individual civil servant. Employing an interpretative approach to governance and public administration, the article analyses the constitution of competing traditions of governance and interpretations of accountability, and the way in which these competing traditions and interpretations lead to accountability dilemmas for the individual civil servant.     

Who is Governing What? Governing Local Technical Systems–an Issue of Accountability

The article discusses accountability in governance of local energy and IT systems. The aim is to focus on accountability of local policy making regarding technical systems by comparing consequences when new forms of governance are developed. Governance steering demands and ensures a clear division of responsibility regarding what a network is responsible for, but not regarding who is accountable for the decision making and implementation. On the other hand, in a steering context characterized by government, it is clear who is responsible and accountable for decisions, but the specific issues for which different actors can be accountable are unclear. We argue that demands for clarifications of accountability emerges from the complex modern governance.     

Conceptualizing throughput legitimacy: Procedural mechanisms of accountability,transparency, inclusiveness and openness in EU governance

This symposium demonstrates the potential for throughput legitimacy as a concept for shedding empirical light on the strengths and weaknesses of multi‐level governance, as well as challenging the concept theoretically. This article introduces the symposium by conceptualizing throughput legitimacy as an ‘umbrella concept’, encompassing a constellation of normative criteria not necessarily empirically interrelated. It argues that in order to interrogate multi‐level governance processes in all their complexity, it makes sense for us to develop normative standards that are not naïve about the empirical realities of how power is exercised within multi‐level governance, or how it may interact with legitimacy. We argue that while throughput legitimacy has its normative limits, it can be substantively useful for these purposes. While being no replacement for input and output legitimacy, throughput legitimacy offers distinctive normative criteria—accountability, transparency, inclusiveness and openness—and points towards substantive institutional reforms.     

WHAT’S MEASURED IS WHAT MATTERS: TARGETS AND GAMING IN THE ENGLISH PUBLIC HEALTH CARE SYSTEM

In the 2000s, governments in the UK, particularly in England, developed a system of governance of public services that combined targets with an element of terror. This has obvious parallels with the Soviet regime, which was initially successful but then collapsed. Assumptions underlying governance by targets represent synecdoche (taking a part to stand for a whole); and that problems of measurement and gaming do not matter. We examine the robustness of the regime of targets and terror to these assumptions using evidence from the English public health service on reported successes, problems of measurement, and gaming. Given this account, we consider the adequacy of current audit arrangements and ways of developing governance by targets in order to counter the problems we have identified.     

The Flypaper Effect Revisited: Intergovernmental Grants and Local Governance

Abstract

Local governance arrangements shape the incentives of local actors, which may in turn influence fiscal choices. By emphasizing the role of local government institutions in local fiscal choices, we seek to bridge between median voter and Leviathan models prevalent in the literature. We then offer some preliminary evidence to support this explanation by empirically testing several propositions regarding the flypaper effect in intergovernmental grants. One limitation of the median voter model is that the model does not consider political institutions and their influences on government expenditures. In this study, we attempt to capture the influence of political dynamics in determining public expenditures by considering institutional variables. Test results show that the political institutional variables could be one of the explanation variables for the flypaper effect.     

Public Sector Reform in Central Asia and the Caucasus

Many developing countries are constantly seeking to reform their public services as part of a wider agenda which supports moves to a market economy and better governance arrangements. Some have embraced public management reforms as the template for their activities with limited success. This paper considers existing research on the impact of public sector reform in developing countries and offers an alternative approach, through case studies of Azerbaijan, Georgia and Kazakhstan, based on two keys elements: an agenda which attempts to shift developing countries to an outcomes based accountability approach operationalized through a “quality of life” framework; and, peer‐to‐peer learning.     

Localism and Accountability in a Post-Collaborative Era: Where Does It Leave the Community Right to Challenge?

Since the establishment of subsidiarity in the early 1990s, the European-wide move to devolve governance has been interpreted by previous and present UK governments adopting differing ideological positions within a ‘localism agenda’. Interpretations have changed the dynamics of the community right to challenge, as well as the structure and mechanisms for community accountability. This article adopts the typology of forms of local governance developed by Lowndes and Sullivan (2008, How low can you go? Rationales and challenges for neighbourhood governance. Public Administration, 86 (1), 1–22) to explore the hypothesis that the localism agenda realigns the synergy between neighbourhood rationales; citizen engagement in service delivery and the opportunity for public scrutiny and accountability. It concludes that opportunities for communities to challenge service delivery and ensure increased accountability to the local level will be tempered by increased complexity and demands on local authorities to develop new relationships with both service users and providers.     

Silos as barriers to public sector climate adaptation and preparedness: insights from road closures in Norway

Organisational perspectives propose that structural arrangements affect policy outcomes. Drawing on these perspectives, it is worthwhile to find out whether and how disagreements among public authorities create barriers to public sector adaptation and preparedness. As the literature on weather vulnerabilities and climate adaptation recommends increased public sector coordination, exploring the possibilities of governance can contribute to the improvement of lifeline conditions. Insights from a Norwegian case study suggest that the different mandates of responsible public authorities sometimes clash. Such clashes limit the abilities to sustain welfare and business conditions when avalanches and blizzards cause highway outages. The findings also show that governance might only partly improve public sector peril response measures, as there is rarely sufficient flexibility to consider specific interests or preferences, for example, to keep a highway open until a school bus or a freight delivery has passed.