NATIONAL HEALTH INSURANCE: A CASE STUDY IN THE USE OF PRIVATE NON-PROFIT MAKING ORGANIZATIONS IN THE PROVISION OF WELFARE BENEFITS

Some of the key features of co-operation between the State and other sectors (private, voluntary and informal) in providing welfare benefits are illustrated in the experience of the National Health Insurance scheme which operated in this country between 1911 and 1948. This is the only example in the UK of a major welfare scheme operating over a considerable period which utilized private, if non-profit making, organizations as responsible agents for administration. Under the scheme certain categories of working people were compelled to insure themselves against sickness. The scheme was administered and benefits paid through a multiplicity of independent 'approved societies', with insured people free to choose which society they belonged to. Contributions were paid by employers as well as employees, with a state subsidy on top. This study indicates that any future development of joint welfare provision with the private sector must overcome certain inherent divergencies in values between the public and private sectors.     

A CASE OF PARTIAL CONVERGENCE: THE EUROPEANIZATION OF CENTRAL GOVERNMENT IN CENTRAL AND EASTERN EUROPE

This article compares the Europeanization of central government in four Central and Eastern European countries (CEECs): Estonia, Latvia, Poland, and Slovakia. Using a large N survey of ministerial civil servants, it finds that the Europeanization of central government is characterized by partial convergence. The scope of Europeanization is large and similar among CEECs, reaching widely and deeply into government ministries. Moreover, patterns of Europeanization are similar among CEECs: the same ministries form the ‘inner core’ and ‘outer circle’ of Europeanized ministries; only a small proportion of civil servants work full‐time on EU issues and routinely engage in activities that ‘project’ national policies at EU level. Compared to old member states, patterns of Europeanization show signs of convergence, while the scope of Europeanization is larger in CEECs.     

HOW POLICY NETWORKS CAN DAMAGE DEMOCRATIC HEALTH: A CASE STUDY IN THE GOVERNMENT OF GOVERNANCE

This article examines a detailed case study of implementation networks in England using the example of the relocation of the Norfolk and Norwich hospital, which became a flagship PFI project for the Labour government after 1997. The case study illustrates the workings of the new order of multi‐layered governance with both local and national networks from different policy areas interacting. However, it also sheds light on the governance debate and illustrates how in the world of new public management, powerful actors, or policy entrepreneurs, with their own agenda, still have the facility, by exercising power and authority, to shape and determine the policy outputs through implementation networks. It is argued that, whereas policy networks are normally portrayed as enriching and promoting pluralist democratic processes, implementation networks in multi‐layered government can also undermine democratic accountability. Four aspects here are pertinent: (1) the degree of central government power; (2) local elite domination; (3) the fragmentation of responsibility; and (4) the dynamics of decision making which facilitates the work of policy entrepreneurs. All these factors illustrate the importance of ‘the government of governance’ in the British state.     

EUROPEANIZATION AND BUREAUCRATIC AUTONOMY IN THE NEW MEMBER STATES: A CASE STUDY OF THE AGRICULTURAL PAYING AGENCY IN SLOVAKIA

The paper explores the impact of Europeanization on bureaucratic autonomy in the new EU member states using as a case study the Agricultural Paying Agency in Slovakia. The paper shows that Europeanization had limited sustained impact on the personal autonomy of senior officials; however, it requires and sustains the personal autonomy of an extensive cadre of mid‐level and junior civil servants. At the same time, it necessitates and continues to sustain significant change in the way agricultural subsidies are distributed, with a high level of autonomy in implementation and a lower, but still significant, measure of autonomy in policy‐making. These conclusions can also generally be supported by evidence from Lithuania and Poland. In addition, the coercive elements of Europeanization interacted with the temporarily high bureaucratic autonomy in Slovakia to ‘open’ non‐coercive channels of Europeanization of agricultural subsidies and beyond.