INSTITUTIONAL LAYERING IN GOVERNING HEALTHCARE QUALITY

Since the 1980s, regulated markets and New Public Management have been introduced in the public sector across the world. How they have affected existing governance mechanisms such as self‐regulation and state regulation has remained largely unexplored, however. This article examines the origins and consequences of institutional layering in governing healthcare quality. Dutch health care, where a market‐based system has been introduced, is used as a case study. The results show that this market‐based system did not replace but modified existing institutional arrangements. As a result, hospitals have to deal with the fragmentation of quality demands. Using the concept of institutional layering, this study shows how different arrangements interact. As a consequence, the introduction of a certain policy reform will work out differently in different countries and policy sectors. Our ‘archaeological’ study in this layering can be seen as an example of how such incremental change can be studied in detail.     

ORGANIZATIONAL STRATEGY,EXTERNAL REGULATION AND PUBLIC SERVICE PERFORMANCE

We test the separate and joint effects of strategy and regulation on public service performance. Strategy is measured as the extent to which service providers are prospectors, defenders and reactors. Regulation is assessed on the basis of the number of inspection events and service managers’ perceptions of the supportiveness of regulators. We find that, controlling for prior performance and the level of service expenditure, prospecting is a more successful strategy than defending or reacting. In addition, inspection events generally disrupt the relationship between strategy and performance, but regulation that is supportive reinforces this relationship. The evidence suggests that the impact of organizational strategies in the public sector is contingent on the characteristics of regulatory regimes.     

JUDICIAL ROTATION AS CENTRIPETAL FORCE: SENTENCING IN THE COURT COMMUNITIES OF SOUTH CAROLINA*

Courts as communities theory emphasizes the sentencing differences that can arise between localities within a single state. The results of published studies have highlighted how local differences emerge based on informal sociological and political processes defined by the communities perspective. The findings from recent quantitative studies from South Carolina have revealed notably less county variation in sentencing than has been observed elsewhere. I use qualitative interviews with 13 South Carolina trial judges to investigate sentencing processes and to shed light on these findings. The interviews explore the state's legal structure and culture, including the practice of circuit rotation in which judges travel among counties holding court. The results suggest rotation serves as a centripetal force of sentencing culture, homogenizing what might otherwise be a more varied collection of county‐specific norms. Rotation leads to increased uniformity through judge shopping and the cross‐pollination of ideas and norms. Defendants can strategically judge shop and plead in front of a lenient judge—a process that gives rise to the term “plea judge,” which is a label for the most lenient judges who sentence a large number of defendants. Rotation also increases the interactions among judges and prosecutors, expanding networks and grapevines, and leading to cross‐pollination and the sharing of ideas.     

STRUCTURAL CHANGE AND PUBLIC SERVICE PERFORMANCE: THE IMPACT OF THE REORGANIZATION PROCESS IN ENGLISH LOCAL GOVERNMENT

Organization theory suggests that structural change has disruptive effects on managerial behaviour and organizational outcomes, and that these effects are likely to emerge in the period between the announcement and the commencement of the new structure. We evaluate the validity of this argument by analysing the performance of English county councils in the transition period before the voluntary restructuring of a sub‐set of these organizations. Disruptive effects are tested while controlling for a range of other variables, including the relative prosperity of the local population and the diversity of their service needs. The empirical results indicate that the performance of local authorities facing reorganization deteriorated prior to the onset of the new structures, and support the view that structural change has disruptive effects on organizational outcomes.     

CORPORATE CAPACITY AND PUBLIC SERVICE PERFORMANCE

Corporate capacity is arguably a key determinant of the success or failure of public sector organizations. However, while there is growing evidence on the extent of corporate capacity, few researchers have systematically examined whether it is linked to public service performance. Does a larger corporate centre lead to better or worse performance for the organization as a whole? To answer this question we apply seemingly unrelated regression to measures of effectiveness, cost‐effectiveness and equity in English local government. We find that the effect of corporate capacity on performance is nonlinear, following an inverted u‐shaped pattern, and that its positive effect turns negative around the mean for effectiveness and cost‐effectiveness, and above the mean for equity. The study therefore suggests that senior managers face important trade‐offs between organizational goals when deciding on the appropriate level of corporate capacity.     

VERTICAL STRATEGIC ALIGNMENT AND PUBLIC SERVICE PERFORMANCE

We report the results of a study examining the effects of vertical strategic alignment (that is, the degree to which strategic stances are consistent across different organizational levels) on public service performance. Longitudinal multivariate analysis is undertaken on a panel of public organizations over four years. We find that alignment on a prospecting strategy leads to better performance, but that no such effect is observed for a defending strategy. We also find that high levels of prospecting alignment produce stronger positive performance effects in centralized organizations and when environmental uncertainty is high. The implications of these findings for research and practice are considered in the conclusion.     

TASK COMPLEXITY,ORGANIZATION SIZE,AND ADMINISTRATIVE INTENSITY: THE CASE OF UK UNIVERSITIES

The task complexity and size of public service organizations are arguably key determinants of the proportion of resources devoted to administration. Moreover, the combined effect of these two variables is also likely to have important implications for the scale of the administrative function. To explore the separate and combined effects of task complexity and size on administrative intensity in public service organizations, we examine the determinants of the relative proportion of resources allocated to central administration rather than academic departments in UK universities between 2003 and 2008. The results suggest that there is a non‐linear U‐shaped impact of both task complexity and size on administrative intensity, and that in combination these characteristics lead to a bigger central administrative component in universities. Theoretical and practical implications are discussed.     

WHEN BUREAUCRACY MATTERS FOR ORGANIZATIONAL PERFORMANCE: EXPLORING THE BENEFITS OF ADMINISTRATIVE INTENSITY IN BIG AND COMPLEX ORGANIZATIONS

Administrative intensity is arguably a major determinant of public service performance. Although a large administrative function might constitute a bureaucratic burden, it could also enable organizations to better coordinate key activities. In particular, administrative intensity may strengthen or weaken the performance effects of other key organizational characteristics, such as size and task complexity. To explore these ideas, we analyse the separate and combined effects of administrative intensity, organization size and task complexity on the research and educational performance of UK universities between 2005 and 2011. The statistical results suggest that administrative intensity has a performance pay‐off for big and complex organizations.     

Trade Liberalisation in Latin America: the Bolivian Case1

Abstract— Bolivia adopted a drastic trade liberalisation in 1985 as part of its neo- liberal New Economic Policy. The paper discusses the theoretical arguments which underlie such a policy and the main neo-structuralist criticisms. It then looks at the effects of liberalisation on resource allocation, productivity growth and export performance. It concludes that the results have been disappointing which gives rise to some scepticism concerning the advantages of a wholesale policy of trade liberalisation in a low income country such as Bolivia.     

STRATEGY,STRUCTURE AND PROCESS IN THE PUBLIC SECTOR: A TEST OF THE MILES AND SNOW MODEL

We present a comprehensive empirical application of the Miles and Snow (1978) model of organizational strategy, structure and process to the public sector. We refine the model by distinguishing between strategy formulation and implementation, and applying it to 90 public service organizations. Although the empirical evidence shows that organizational strategies fit the Miles and Snow categories of prospector, defender and reactor, the relationship between these strategies and organizational structures (for example, centralization) and processes (for example, planning) is less consistent with their model. Conclusions are drawn for public management theory and practice.