Public service responsiveness to users' demands and needs: theory, practice and primary healthcare in England

Analyses and policy statements about publicly funded services frequently distinguish 'demands' from 'needs'. The distinction has been challenged, calling into question the coherence of formulating welfare policy and evaluating public services in terms of needs. This paper explicates the conceptual distinction between demands and needs in terms of derived demand and information asymmetry. 'Needs' can be defined as 'rational demands', where 'rational' means 'consistent and evidence–based', and 'demands' as 'desires' rather than 'effective (i.e. economic) demand'. On that basis, practical demand management in needs–based public services would require:
1. Knowledge of users' demands for services;
2. Content analyses of users' demands to identify any misinformed demands;
3. Conversion of any misinformed demands into evidence–based specifications of needs;
4. Formulating coherent, evidence–based demands on behalf of users who cannot to do so themselves.
A study of English NHS Primary Care Groups explores the problems which authorities responsible for publicly funded services face in undertaking these activities. Demand management receives low priority in terms of the incentives and intellectual resources applied to it. Needs assessment has higher priority but is regarded as a branch of evidence–based professional practice, controlled by professionals rather than responsive to users. This separation tends to defeat the purposes of needs–based public services.     

Efficacy,effectiveness and efficiency in human resource use: A primer on the three e's

Disputes over resource use, particularly in the public sector, often stem from conflict over what is “efficient.” This paper systematizes and critiques the most frequently encountered efficiency notions, focusing on their their use and misuse in making human resource decisions. The conclusion is drawn that a triad comprising technical, cost, and allocative efficiency is the base upon which decisions ultimately must be founded if the aim is to obtain the most value from available resources. A corollary is that other conceptions mislead more often than clarify.

Technical efficiency requires getting the most from inputs; there must be no way to obtain greater output from those we are using. It underpins cost efficiency, which requires using the production technique that sacrifices least value from other outputs foregone. Allocative efficiency demands that resources cannot be redirected to produce outputs of higher value and in turn has both technical and cost efficiency as necessary preconditions.

Allocative efficiency is by far the most problematic. Few economists object to the Pareto principle, which states that resources are being misused if redeploying inputs or redistributing outputs can yield added benefits for some members of society without harming any others. However, it is rare to find real-world cases that simple and even when it can be applied, the approach risks biasing policy toward piecemeal methods when broader perspectives may be called for. The Kaldor-Hicks approach in part overcomes these limitations, but at a price. Since it sanctions what may be substantial income redistribution, willingness to accept its implications is much less certain.     

The Limits of Instrumentalism: Informal Work and Gendered Cycles of Food Insecurity in Mozambique

The instrumentalist literature suggests that women can help achieve household food security if they have access to productive resources but do not become overburdened as a result. This paper seeks to assess the relevance of this literature by exploring the gendered cycles of food insecurity in the context of women’s informal labour in northern Mozambique. It considers the relation between women and food security as embedded in the broader socio-economic setting, and finds that the interaction of different forms of deprivation, such as lack of secure employment and conflicting labour demands, generates food insecurity.     

Ethnic Group Identity and the Roma Social Movement: Transnational Organizing Structures of Representation

This paper examines the relationship between European integration and ethnonational demands with the example of selected regions in the European Union (EU). It follows the theoretical premises of new regionalism and explores the ways in which ethnonational groups use the opportunities and resources of European governance to express their identities, material interests, and political demands. Methodologically, it conducts a plausibility probe of the potential effects of European integration on ethnonationalism by testing for regional differences in identities, interests, and political attitudes. The case studies are drawn from the UK (Wales and Scotland), Belgium (Flanders), Austria (Carinthia and Burgenland), Romania (Northwest and Center regions), and Bulgaria (South-Central and South-Eastern regions) as a representative selection of regional interests in the EU. The paper finds that European integration affects ethnonational groups by reinforcing identity construction in the direction of inclusiveness and diversity. Although regional actors are more supportive of the EU than the European publics in general, they also seek access to representation in the authority structures of the state. Based on these findings, the paper concludes that European integration facilitates a growing public acceptance of its resources, in parallel with persisting allegiances to the nation-state, the community, and ethnoregional distinctiveness.     

Experiences of a learning organization in the public sector

This article explores the experience of a municipal government agency as it confronts the challenges and opportunities of meeting seemingly unlimited demands with limited resources. The City of Scottsdale, Arizona, enjoys a national reputation for innovative approaches to public policy issues. This article examines Scottsdale's efforts to create a learning organization, through a Venture Team which represents a core strategy for continuous improvement and lifelong learning.     

Managing life cycle demands through a leadership agenda

This article stresses that leaders can prepare their organizations to manage successfully life cycle demands by systematically developing administrative responses to life cycle demands. To this end, organizations are prepared to cope when leaders develop agendas that systematically manage chance. In this process change is anticipated, information is collected, and organizations are positioned to satisfy life cycle demands. It is our view that successfully managing life cycle demands enhances organizational survival. Further, most discussions of organization life cycle theory concentrate on the private sector. We develop a leadership agenda model with applicability to the public sector. The model is applied by examining the life cycle experiences of the Municipality of Metropolitan Seattle (Metro). Applying the leadership agenda model to Metro provides a longitudinal analysis of how life cycle demands emerge, re-emerge, and are satisfied. We argue that Metro's leaders were able to anticipate or respond to life cycle demands, collect information, and change their organization to cope with life cycle demands. Therefore, leadership agendas were used to minimize systematically the impact of chance on Metro's development.     

Partnerships and public procurement: building social capital through supply relations

As one means of dealing with an increasingly interdependent or shared power 'noone in charge' world (Bryson and Crosby 1992) and adapting the public sector to the demands of the global economy, successive administrations in the UK have aimed to develop a more strategic approach to public procurement by emphasizing inter–departmental co–ordination and establishing long–term partnership relations with suppliers. This has proved to be a difficult task, however, as the operating framework and culture of the public sector have hindered the development of interorganizational relationships and trust. By focusing on the co–operative processes and interaction within central government departments and between departments and the private sector, this paper aims to analyse and identify the obstacles to, and opportunities for, implementing long–term supply relations and facilitating departmental co–ordination. While the paper argues that partnership relations can build social capital, it also shows that these resources can have both positive and negative effects for public procurement. To conclude, lessons for developing collaborative arrangements in public procurement are identified.     

Democracy and bureaucracy

The issue in bureaucracy and democracy is one of control. This paper calls for greater control resources for elected officials whereby they can overcome the abundant power resources of bureaucrats. A process of exchange as against a process of authority is suggested as a strategic means of democratic control over bureaucracy.

Successfully meeting the challenge of reconciling deeply cherished norms of popular control with dependence on appointed administrators requires acknowledgement not only of the rights of the controllers but also of the powers of the controlled.⁽¹⁾ It requires thinking strategically about creating and marshaling alternative resources to counteract the abundant resources bureaucrats have, to circumvent control for both selfish and public spirited reasons. Such a focus on resources suggests the fruitfulness of conceptualizing democratic control more as a process of exchange than as an exercise of authority.     

Community resilience: a policy tool for local government?

In many countries, local government has been a prime target of austerity measures. In response, local authorities are exploring a new repertoire of policy approaches in a bid to provide more with less. In England, local authorities have been drawn to community resilience as a pragmatic response to the challenge of deploying shrinking resources to support communities exposed to social and economic disruption. This application of resilience thinking is not without its challenges. It demands a working definition of community resilience that recognises the potential for communities to prove resilient to shocks and disruptions, but avoids blaming them for their predicament. There is also the practical challenge of developing and targeting interventions to promote and protect resilience. This paper sets out to explore these issues and establish the potential utility of community resilience as a policy tool through case study analysis in the city of Sheffield.     

State,Citizenship and Religious Community: The Case of Indian Muslim Women

Thos article argues that granting citizenship rights to the minorities cannot help to instil a sense of confidence in them to participate as equal citizens in the public sphere. Rather the state has to create necessary conditions both through institutional mechanisms as well as through creating a democratic and egalitarian environment where those rights can be enjoyed. A liberal democracy can accommodate both individual as well as group rights and allow for legal pluralism by desisting from imposing any law that can result in the loss of identity for a minority group. But at the same time a liberal democracy is to ensure that individual rights are not jeopardised while safeguarding the minority rights. If particularistic demands do not conflict with basic individual liberty and dignity, they can and should be accommodated within the universalistic framework of citizenship.     

Terrorism and national security

The surge in mass casualty terror attacks during the first decade of the 21st century presented a special challenge for health organizations. Unique types of injury resulting from these Mass Casualty Events called for special capabilities to restore the balance between immediate demands and scarce resources. Post Traumatic Stress Disorder (PTSD), to both victims and healthcare providers and first responders required extra knowledge and early intervention. All these and the concerns of the possibilities of non-conventional weapons terror attacks, led to the defining of “Terror Medicine”, a new medical field. This field evolves the medical macro management of terror attacks, the focused clinical management of the specific injuries and coping with the aftermath consequences. The scope of Terror Medicine is: Prevention, Preparedness, Response and Recovery. The evolution and trends of Terror Medicine is discussed in this article.     

Issues of fairness in recruitment processes: A case study of local government practice

Since the 1980s local government recruitment practices have been characterised by the development of procedures designed to promote fairness in employee selection. This article examines recruitment practice in one local authority in terms of its effectiveness in providing fairness in selection and questions its ability to meet the changing demands being placed on recruitment processes. A central argument is that an emphasis on developing recruitment procedures to demonstrate equality of treatment can overlook important social psychological factors. It concludes that although a highly structured approach to employee selection has real advantages in meeting the requirements of equal opportunities it can, paradoxically, result in negative perceptions about its fairness and effectiveness.     

Managers’ Turnover in the Public Sector—The Role of Psychosocial Working Conditions

An important challenge for public organizations is to attract and retain skilled managers. The present study explores how profiles of psychosocial working conditions, assessed by the combination of managerial-specific job demands and job resources, longitudinally predict managers’ turnover intentions and actual turnover in Swedish municipalities. Considerable effects of managers’ psychosocial working conditions on turnover intentions but not on actual turnover were found. Thus, poor working conditions may result in psychologically detached managers in public organizations, which may have considerable and costly effects on both the organizations and the managers, in terms of decreased commitment, performance, and impaired health.     

Energy policy under austerity localism: what role for local authorities?

In the UK, local authorities (LAs) have been placed at the forefront of domestic energy-reduction strategies as the responsible actors for coordinating policy in this sector. Yet, there has been little research regarding the role of LAs in this policy agenda, and their abilities to bring together stakeholders in the successful design and implementation of strategies to reduce energy demands. The paper aims to fill this gap by highlighting the relevance and importance of the energy policy sphere to local government studies, building on the idea of resilient LAs within the context of tensions between the localism agenda and the actual implementation of energy efficiency polices. This is achieved through multiple rounds of semi-structured interviews with LA officers. Our findings reveal that LAs, operating under a localism agenda, lack the freedoms and resources from central government to meet the needs of multiple stakeholders, resorting to short-term policies.     

Participatory Budgeting in Germany – A Review of Empirical Findings

Participatory budgeting (PB) is one of the most popular democratic innovations worldwide. PB is connected with high stakes regarding mobilizing political inactive citizens, efficient and effective budgetary policy as well as positive effects on citizens (e.g., civic education, democratic attitudes). However, in many Western countries empirical evidence for such benefits is scarce. This also holds for Germany. Since the conduction of PB demands financial and personnel resources, a thorough evaluation is necessary. This article systematically summarizes the current state of research to make the literature on PB in Germany accessible to international scholars as well as political and administrative practitioners. It focusses on the context (which municipalities conduct PB and why), process (role of local administration and council, participation, deliberation), and outcome/impact dimension (outcomes and impact on policies and citizens). To conclude, further research venues are briefly outlined, followed by an outlook on PBs future and practical implications.     

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.     

Local Governance ‘in Swedish’? Globalisation,Local Welfare Government and Beyond

In this article local governance in the Swedish context is discussed. A case study of a Swedish city is framed in its historical, national and international context. By locating the redevelopment of an old harbour within a historical context, new insights are brought into the understanding of local governance. Cities are indeed nested. Deteriorating public finances, the deregulation of the economy (nationally and globally), the changed status of the welfare state, the restructuring of industry and the neo-liberal wave all taken together form a formidable challenge. A radical questioning of the values, principles and forms of the Swedish welfare state has tangible impacts on local governance. It is concluded that Swedish municipal actors face the dual challenge of acting efficiently (being sensitive to the needs and demands of local elites), while keeping democratic legitimacy (being sensitive to the needs and demands of all citizens).     

When do societal stakeholders matter for agency-CEOs? The role of stakeholder arrangements and social media attention

Public agencies have to deal with accountability demands from various societal stakeholders. Stakeholders may address their accountability demands via formal stakeholder arrangements but can also use social media for account-holding purposes. This contribution analyzes to what extent these different venues of social accountability affect the perceived relevance of societal stakeholders to agency-CEOs—their so-called “stakeholder orientation.” By combining quantitative and qualitative data, this study shows that agency-CEOs' stakeholder orientation is strongly associated with actual social media attention. In contrast, the relationship between formal stakeholder arrangements and stakeholder orientation is weak. Qualitative insights from focus group discussions suggest that the associations between social media attention and stakeholder orientation can be explained by mediatization processes within agencies and the reputational risks of social media storms. Overall, the findings support that social media attention is the most important catalyst for stakeholder orientation, rather than stakeholder arrangements.     

Hedonists and husbands: piracy narratives,gender demands,and local political economic realities in Somalia

The grand narrative of piracy has been instrumental in shaping how piracy off the coast of Somalia is understood and responded to. Self-proclaimed pirates, suspected pirates, and convicted piracy prisoners continue to tell the story of taking up arms against foreign illegal fishers to protect their personal livelihoods as well as Somalia’s natural resources. Although the grand narrative remains the most popular piracy narrative, this paper introduces and examines two newly emergent narratives of Somali piracy – the Somali women’s narrative and the piracy prisoner self-narrative. I explore how these narratives reveal a central paradox surrounding piracy and social reproduction in Somalia that, until now, has been absent from discussions about piracy narratives and the issue of Somali piracy. Whereas the grand narrative of piracy fails to address gender demands and local political economic realities in Somalia, the new narratives present piracy as a gendered experienced that is situated within the broader, evolving context of courtship and marriage in Somalia. I argue the new narratives can help push beyond over-simplistic understandings of piracy off the coast of Somalia as a ‘man’s crime’ that should be addressed by men.     

Education and training in public administration: transference of segmenting organizational behavior

Organizations can survive, let alone progress, only if they carry out meaningful transactions with society at large. This process requires they differentiate their “organizational being” to respond to clientele needs and/or user demands. The inherent problem is that these differentiated structures may become segmented into tightly closed systems, being in effect organizations within organization characterized by self-serving vested interests. Expediency becomes the operating rule. Segmentation is common to all societies, but it is especially prevalent in situations of decline.

Advanced in this discussion is that the segmentation process may be accelerated and consolidated by in-house training and education, and especially by those of a public management character. A plea is made for universities to become more actively engaged in (a) the preparation and placement of “quality” educated persons and (b) the search/development of new public organization.