MULTI‐LAYERED ACCOUNTABILITY. PERFORMANCE‐BASED FUNDING OF UNIVERSITIES

In most Western countries there has been an increasing demand for new and different types of audit, evaluation and reporting systems that reveal the output of public sector organizations ( Pollitt and Bouckaert 2000 ). Quality assessments have had a profound impact on the funding of university research, most visibly in the UK. However, the relationship between qualitative and quantitative indicators of research performance has been an ongoing source of debate ( Bence and Oppenheim 2004 ). By exploring four different types of accountability relations, this paper investigates different stakeholders' perceptions of whether or not performance funding increases accountability and transparency, and poses the following questions: Does performance funding result in high accountability and high transparency? Does high accountability imply high transparency? Does high transparency lead to low accountability? Three main empirical sources have been utilized: a comprehensive survey of faculty at Norwegian higher education institutions, a stakeholder survey, and data from case studies of four universities.     

THE EUROPEANIZATION OF HEALTH CARE GOVERNANCE: IMPLEMENTING THE MARKET IMPERATIVES OF EUROPE

The paper examines the Europeanization process and the impact of the European Union (EU) on national healthcare policies, using the example of Denmark. The analysis reveals that although health policy formally falls within the competence of member states, the impact of the EU is becoming increasingly conspicuous and has contributed to a gradual restructuring of healthcare boundaries as well as of some of its organizing principles. Furthermore, the process and impact have a de‐structuring effect on the more traditional governance tools used in relation to healthcare. The paper concludes that the EU has a significant impact and that we may be witnessing the formation of a new institutional legacy that represents the initiation of a Europeanized healthcare model: a model emerging around a new set of stakeholders, principles and structures, which includes the market, principles of free movement, patient choice and patient rights institutionalized and safeguarded by the EU.     

MANAGERIAL GOALS IN A PERFORMANCE‐DRIVEN SYSTEM: THEORY AND EMPIRICAL TESTS IN HIGHER EDUCATION

Factors influencing managerial goals and decision‐making processes have been debated for decades among public administration scholars. Previous literature has explained goal setting through theories of performance gaps, bureaucratic control, and isomorphic rationality. However, there exists no direct empirical test of these theories to determine which theoretical expectation may have more or less weight with managers when setting organizational goals. Using an original survey of university presidents, this study tests how public managers prioritize competing performance goals. Findings suggest that the goal setting decisions of these public managers is primarily driven by political control mechanisms.     

RENEWING POLICY TO SUPPORT EVIDENCE‐BASED HEALTH CARE

Health systems internationally have developed policies to support evidence‐based health care (EBHC) for over a decade. As this article shows, the time is ripe to review current policy frameworks in an evidence‐based manner. We summarize key themes deriving from qualitative research on the UK EBHC implementation and draw out implications for policy renewal. Our diagnosis is different from current UK NHS (National Health Service) policy since we stress local capacity building rather than top‐down frameworks, standardized tools and guidelines. As other jurisdictions demonstrate alternative EBHC policy frameworks, more international comparison and mutual learning is needed.     

SELF‐SERVICE SOCIETY: PARTICIPATIVE POLITICS AND NEW FORMS OF GOVERNANCE

The purpose of this paper is to identify ‘participative politics' and what is here called ‘self‐service politics' as distinct political themes in many advanced democracies, in order to investigate their main elements and chart their interrelationships. These two themes are examined from the viewpoint of politicization and depoliticization tendencies. Participative politics consists of three main forms, defined as active citizenship, citizen networks and co‐production. Self‐service politics, in turn, connects each of these forms to a larger political transformation by pitting themes of activating politics, social governance and accountability against them. The paper investigates what bearing participative politics, and self‐service politics as its inevitable attendant, have on the sphere of democratic deliberation.     

THE FUTURE OF NETWORK GOVERNANCE RESEARCH: STRENGTH IN DIVERSITY AND SYNTHESIS

The popularity and scope of network governance research and practice continues to expand from its divergent foundations, assumptions and methodological positions. This paper introduces a symposium of papers on this substantial sub‐field by first summarizing the sprawling research endeavour that comprises it. The main theoretical and empirical approaches that have been used to guide it to date are then briefly described, emphasizing recent debates about interpretivism and decentring. Next, it suggests that a robust and interesting future for network governance requires diversity, rather than adherence to a single approach. It is argued that more sophisticated approaches for examining network governance are fashioned through a synthesis of ideas and methods to create an analysis of networks as networks. This is especially the case where some formal analysis of network structure is used in concert with an interpretive examination of action and process. Finally, the papers in the symposium are introduced.     

IMPLEMENTING CHANGE IN HEALTH SYSTEMS: MARKET REFORMS IN HEALTH SYSTEMS IN THE UNITED KINGDOM,SWEDEN AND THE NETHERLANDS

IMPLEMENTING CHANGE IN HEALTH SYSTEMS: MARKET REFORMS IN HEALTH SYSTEMS IN THE UNITED KINGDOM, SWEDEN AND THE NETHERLANDS
Michael I. Harrison
Sage, 2004, 256 pp., £21.99 (pb) ISBN: 0761961763     

META‐GOVERNANCE: VALUES,NORMS AND PRINCIPLES,AND THE MAKING OF HARD CHOICES

Meta‐governance – or governance of governance – is a concept that raises questions regarding how values, norms and principles underpin governance systems and governing approaches. Values, norms and principles pertain both to substantive governance issues, for instance, related to sustainable resource use, and to governance system issues in themselves, for instance, regarding their institutional design. This article deals primarily with the latter. Thus the interactive perspective serves as basis for developing a coherent set of meta‐governance principles. We argue that an explicit, deliberated and decided upon set of meta‐governance principles as an integral part of governance can help in making hard substantive governance choices easier. Interactive learning plays a key role in governance processes when public and private governing actors have to make such hard choices. In the article, examples from natural resource governance will serve as illustrations for the more conceptual argumentation and reasoning.     

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.     

PERSUASION AS GOVERNANCE: A STATE‐CENTRIC RELATIONAL PERSPECTIVE

Debates about governance and the relationship between governance and government have focused upon markets, hierarchies and networks as principal modes of governance. In this paper we argue that persuasion constitutes a further and distinctive mode of governance, albeit one which interpenetrates other modes of governance. In order to assess the nature, limitations and scope of persuasion and the complex relationships between markets, hierarchies, networks on the one hand and persuasion on the other, we interpret persuasion through the prism of two theoretical perspectives on governance. We argue that the society‐centred perspective usefully draws our attention to the role played by non‐state actors in the exercise of governance through persuasion but that a state‐centric relational account can help us to better understand important facets of persuasion as a mode of governance.     

PUBLIC MANAGEMENT FOR GOOD GOVERNANCE: REFORMS,REGIMES, AND REALITY IN BANGLADESH

Bangladesh, a relatively young country, emerged with expectations of charting a new course in departing from its traditional and rigid system of public administration that prevailed during its existence as a part of British India and later as a province of Pakistan. The evolution of public administration in Bangladesh was profoundly influenced by the legacy of Pakistani rule, and subsequent efforts at reform hardly had any impact in breaking up the domination of the bureaucracy, which thrived under a pseudo-democratic and military-led government. Several factors contributed to the breakdown of administrative governance and the problem was reflected in poor performance, high incidence of corruption, and a lack of direction in the administrative system. A number of internal and external factors have exerted pressure for improving the system, but all efforts have yielded little result. Consequently, the achievement of good governance remains a distant dream in the absence of a vital and effective tool of public management.     

RAPID RURAL APPRAISAL: ITS USE AND VALUE FOR HEALTH PLANNERS AND MANAGERS

Rapid appraisals have proliferated in the field of health in the past decade because of their perceived promise of obtaining information for planning and managing programmes cheaply and quickly. This article examines one type of appraisal, Rapid Rural Appraisal ( rra ) in order to assess the contribution of this approach. The background to its development is described, highlighting the relevance to primary health care ( phc ). Its two essential characteristics – qualitative inquiry and community participation are noted. The approach is examined, the techniques described and case studies which have used the approach are presented. The strengths and weaknesses of the approach based on these examples are assessed. The article concludes that the rra approach should not be seen merely as an approach to get information for the planning process but rather as an integral part of the process itself. Its contribution is to improve the quality of the information planners obtain and to develop plans of action by using qualitative inquiry and involving the community in this process.