“Success” in policy piloting: Process,programs, and politics

Research has demonstrated that pilots contain multiple shifting purposes, not all of which relate to simple policy testing or refinement. Judging the success of policy pilots is therefore complex, requiring more than a simple judgment against declared goals. Marsh and McConnell provide a framework against which policy success can be judged, distinguishing program success from process and political success. We adapt Boven's modification of this framework and apply it to policy pilots, arguing that pilot process, outcomes and longer-term effects can all be judged in both program and political terms. We test this new framework in a pilot program in the English National Health Service, the Vanguard program, showing how consideration of these different aspects of success sheds light on the program and its aftermath. We consider the implications of the framework for the comprehensive and multifaceted evaluation of policy pilots.     

Joining it up? Health and Wellbeing Boards in English Local Governance: Evidence from Clinical Commissioning Groups and Shadow Health and Wellbeing Boards

Statutory responsibility for health care and social care has long been separated between National Health Service (NHS) bodies and local government authorities. Repeated policy attempts to promote service integration through collaboration between such authorities have achieved little. The latest of such policy interventions are the Health and Wellbeing Boards (HWBs) established by the 2012 Health and Social Care Act (HSCA) alongside a range of other organisational innovations, including Clinical Commissioning Groups (CCGs). These organisations await full legal and operational status but have begun to develop structures and processes. HWBs are intended to lead the integrated assessment of local needs to inform both NHS health and local authority social care commissioners. We undertook detailed qualitative case studies in eight CCGs during 2011–2012 and here report observational and interview data related to CCGs’ perspectives and observations of early HWB developments. We found that developing HWBs vary greatly in their structure and approach, but we also identified a number of significant issues that are familiar from earlier research into health and social care integration. These include heavy dependence on voluntary agreements to align the strategic plans of the many different new statutory bodies; a significant role for mundane organisational processes in determining the extent of effective co-operation; and problems arising from factors such as size and the arrangements of local boundaries.     

Établissements d’enseignement et de santé confessionnels,espace public et agency à Ouagadougou (1987–2010)

Abstract

In response to the significant urbanisation and the demographic expansion of Ouagadougou, the Catholic Church and Islamic associations are diversifying their operations, which were already significant in terms of health and education at the end of the 1980s. This social engagement is at the heart of humanitarian, proselytising, socio-economic and political challenges and influences the position of these actors in the public space. This article intends to contribute to consideration of the relations between these religious actors and the State in Burkina Faso with the aim of analysing the sectors of secondary teaching and health in Ouagadougou. It will be demonstrated that the operations of these actors (Muslim and Catholic) made their legitimacy evolve differently in the public space from 1987 to 2010. The Catholic actors have had a greater influence than the Muslims on the decisions of the State. Subsequent to the challenges and the political context, the capacity of agency (capacity to act) of the actors of the two denominations has modified.     

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.     

Sisters in a Fashion: Martha Ansara and Elaine Welteroth

ABSTRACT

This article discusses Martha Ansara and Elaine Welteroth, two US born feminists who came to Australia during two key moments in feminist history, as a way of thinking about the relationship between feminists and fashion. Ansara arrived in Sydney in 1969 carrying women’s liberation literature in her suitcase; she became an important generative figure in the Australia’s women’s liberation movement, particularly as an independent filmmaker and proponent of consciousness raising. Welteroth arrived in 2017 to speak at the Sydney Writers’ Festival during a period of international resurgence of feminist activism. She brought with her images of women of colour she had featured in Teen Vogue and she invoked second wave consciousness raising, albeit in a remodelled, corporate-led form when she talked about the title’s plans to bring young girls around kitchen tables to ‘solve’ political problems. The article uses comments both women have made in relation to fashion and beauty, close readings of their works, and a discussion of their respective feminist milieus to suggest a trajectory of feminism’s relationship to the fashion industry that appears to have changed from a position of opposition to one of open embrace. It also complicates this reading by pointing to the resonances between these women of different feminist eras.