EQUAL OPPORTUNITIES FOR WOMEN IN THE NHS: THE PROSPECTS OF SUCCESS?

The position of women in the NHS suggests widespread latent discrimination. The prospects of developing equality of opportunity are not promising, as neither external agencies nor internal managers are capable of bringing about the necessary changes. However, changing demographic factors might result in enlightened personnel policies which will assist the development of equal opportunities.     

MANAGING INFORMATION SYSTEMS IN UK PUBLIC ADMINISTRATION: ISSUES AND PROSPECTS

The record on the development and use of information-based technologies in UK public administration is reviewed and distinctive risks identified. Risk levels associated with computerization may be increasing rather than abating as a result of both the content of New Public Management initiatives, and also how they are being introduced and applied. This article considers ways forward from the point of view of improving how informatization can proceed, and also how markets can be used to provide information-based services for public administration.     

CHANGE IN THE CIVIL SERVICE: RETROSPECT AND PROSPECTS

The type of civil service modelled on the principles of the Victorian reformers survived virtually unscathed into the post-1945 era of the welfare state and managed economy. Criticism of its qualities and performance resulted in a programme of changes associated principally with the Fulton Report (1968). This initial reform phase identified a shift to more active management of personnel, resources and policies as the primary need, but its practical effects were muted by optimistic assumptions relating to the rate of economic growth and the benefits to be derived from continued extension of governmental responsibilities. Since 1979 the context of civil service reform has changed, imposing much stronger pressure in favour of a managerialist view of civil service functions, of a career in the civil service, and of the ethos of the profession. Despite ambiguities of purpose and constraints within the political system the course of change is likely to continue in the direction, pointing towards a civil service substantially different at the end of the century from that which has been familiar in British thinking about the character and status of officials.     

RETHINKING POLICY OPTIONS FOR INDUSTRY: APPROPRIATENESS IN POLICIES FOR INDUSTRY AND UK FARMING AND FOOD

This article assesses the appropriateness of lean supply and partnership relationship management policies as a means of invigorating industry, using the example of the UK pig and beef industry. The analysis assesses the extent to which it is operationally feasible, and with what commercial consequences, in UK pig and beef supply chains and markets. The analysis demonstrates that the lean and partnering approach is not always operationally feasible. Furthermore, when it is operationally feasible dominant players only – such as multiple retailers – appear to benefit commercially from its adoption. Given this, alternative policy options may be required in the future for such reinvigoration of industry. A framework to guide policy selection is provided.     

CONTRACTING IN THEORY AND IN PRACTICE: SOME EVIDENCE FROM THE NHS

The contract is the main mechanism for governing transactions within public sector'quasi markets'. This article explores the nature of the contracting process in the light of new empirical data from a qualitative study of the development of contracting for hiv / aids services within the National Health Service. These data are compared with four possible models of the contracting process emerging from the academic literature, classical, relational, regulated and pseudo contracting.
The White Paper on the nhs reforms uses a classical concept of contracting, in which purchasers are represented as making well informed and unrestricted choices between competing options. This bore little relation to the process observed within the four purchasing organizations studied. Instead, elements of all the models were observed, with the dominance of any one model varying with different situations, times and localities. Competition was only patchily evident, with purchasers more commonly encouraging co-operative relationships between providers to preserve stability. Attempts to utilize the contract process to mould and reconfigure services were often hampered by restrictions imposed by regulations and slow implementation of new mechanisms. Contracting was also adversely affected by rapid organizational change and lack of adequate information. It is concluded that contracting in the nhs is an evolving process and has yet to achieve its full potential as a management mechanism.     

UNEQUAL PARTNERS: THE IMPLEMENTATION OF EQUAL OPPORTUNITIES POLICIES IN WESTERN EUROPE

As a general principle, equality of opportunity attracts considerable support. However, such agreement does not extend to definitions of equal opportunity policies or to the need and manner for their implementation. These policies have a variety of both ideological and historical aspects, and patterns of implementation are politically and culturally conditioned. To highlight different approaches to equal opportunity implementation, three countries are compared: France, the United Kingdom and Sweden. Indices of progress for women are presented and performances assessed, as are the instruments and mechanisms of implementation preferred under different regimes. In addition, the influence and actions of the European Community (EC) are considered. Three distinct but not mutually exclusive models of implementation are observed, each with particular benefits and drawbacks. Sweden emerges with the most sustained and effective public policy on equal opportunities, France demonstrates the value of a Ministry of Women, while the potential inherent in Britain's Equal Opportunities Commission and local authority endeavour is thwarted by a lack of political will at central government level.     

THE IMPACT OF OPEN DATA IN THE UK: COMPLEX,UNPREDICTABLE, AND POLITICAL

This article examines the democratic impact of the UK coalition government's Transparency Agenda, focusing on the publication of all local government spending over £500 by councils in England. It looks at whether the new data have driven increased democratic accountability, public participation, and information transmission. The evidence suggests that the local government spending data have driven some accountability. However, rather than forging new ‘performance regimes’, creating ‘armchair auditors’, or bringing mass use and involvement, the publication creates a further element of political disruption. Assessment of the use and impact of the new spending data finds it is more complex, more unpredictable, and more political than the rhetoric around Open Data indicates. The danger is that the gap between aims and impact invites disappointment from supporters.     

NEW MODES OF GOVERNANCE IN ITALY AND THE NETHERLANDS: THE CASE OF ACTIVATION POLICIES

This article discusses the growing importance of operational reforms in the context of welfare state transformation processes, and the role that principles of new governance play in shaping these reforms. It focuses specifically on one social policy area considered crucial in reforming welfare states: the provision of activation services that aim at increasing the employability and labour‐market participation of people dependent on benefits or social assistance. The article argues that besides the reforms of the programmatic aspects of social policies and social services (formal policy reforms), reforms of the way in which policies and services are organized, administered and delivered (operational policy reforms) have received increasing attention as a ’second strand’ of welfare state reforms. It illustrates this by analysing and comparing reforms of the provision of activation services in two European countries: Italy and The Netherlands. The article not only reveals the growing emphasis in both countries on operational policy reforms which are to an important degree inspired by principles of new governance, but also shows significant similarities and differences in their concrete manifestations, which could be interpreted as pointing out processes of ‘path‐dependent convergence’.     

REFORMING PUBLIC SERVICES IN THE UK: BRINGING IN THE THIRD SECTOR

In the UK, the government continues its project to reform public services. Earlier projects have focused on the modernization of public sector organizations; in the latest round of reform, New Labour has focused on widening choice and the personalization of services. To this end, the government has been working with Third Sector (TS) organizations to expand their role in shaping, commissioning and delivering public services. The government’s vision is predicated on a normative assertion, that, unlike traditional public sector organizations, TS bodies create public value by being more innovative, are inspired by altruistic aims and values, and have greater commitment to their clients. This paper reviews recent policy and questions whether the government’s policy is flawed, contradictory and risks damaging the attributes of the TS admired by New Labour.     

GENERAL MANAGEMENT IN THE NHS: THE INITIAL IMPACT 1983–88

The Griffiths report of 1983 resulted in radical changes (to which the label 'general management' has been applied) to the formalities of organization and management in the national health service. We report the findings of a major study (involving more than 300 interviews) of the impact of these changes up to 1988. Although general management has been widely accepted in the service, and seems to have resulted in some improvements to management processes, there has been no substantial change in organizational culture. We conclude that the impact of the Griffiths model of management has been limited in comparison with the continued influence of medical autonomy and financial limitations.     

DEVELOPMENTS IN THE PURCHASING PROCESS IN THE NHS: TOWARDS AN EXPLICIT POLITICS OF RATIONING?

The introduction of the internal market to the National Health Service in Britain marks a major change in the form of provision of health care interventions. This article reports the findings of independent research into the development of the purchasing process in eight purchasing authorities (which collectively purchase health care for 5 per cent of the population of Britain), and considers the extent to which this has led to an explicit politics of rationing in British health care. The structure and organization of purchasing organizations is described, along with their relationship with providers of health care. The ability of purchasing organizations to assess the health needs of the populations for which they purchase health care services, and their ability to influence change in the nature of the services provided, is also examined.     

THE RISE OF THE INTERMEDIATE LEVEL INSTITUTION IN BRITISH PUBLIC ADMINISTRATION: THE CASE OF THE ARTS AND TRAINING

During the 1980s there was both centralization and decentralization in the British policy process. The centre was to be responsible for broad policy whilst the institutions in closest contact with those who consumed or used a service were to be responsible for implementation. This style was, in part, a reaction to the perception that organized interests acted as a severe restraint on the centre. Experience, however, demonstrated government's dependence on the cooperation of organized interests and their intermediate organizations. This article argues that effective policy-making requires the formation of intermediate organizations linking macro- and micro-institutions. These organizations are vital for communication, representation and negotiation and therefore they inevitably constrain the centre's freedom. Effective policy requires a partnership between the centre and sub-centre via intermediate institutions and these institutions are likely to become more important as decentralization continues. The role of intermediate institutions are explored via case studies of training and arts policy.     

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.     

POLICY TRANSFER IN PRACTICE: IMPLEMENTING SUPPLIER DIVERSITY IN THE UK

This article draws on the policy transfer literature to examine a UK‐based initiative to promote supplier diversity and provides insights into three areas neglected in current research, namely: the dynamics of non‐governmental policy transfer; the factors that mediate policy transfer in different jurisdictions; and the integration of research and practice in small business related policy transfer. To this end, an innovative action research approach is deployed with the dual purpose of effecting practical change and advancing knowledge. This comprises two phases: first, a realist analysis of the US National Minority Supplier Development Council (NMSDC), an exemplar intermediary; and second, the implementation and concurrent realist evaluation of a supplier diversity initiative modelled on NMSDC, referred to as ‘Supplier Development East Midlands’ (SDEM). The findings provide lessons for academics and practitioners dealing with small and medium‐sized enterprise (SME) policy transfer in general and supplier diversity intermediaries in particular.     

PERFORMANCE, EVALUATION AND THE NHS: A CASE STUDY IN CONCEPTUAL PERPLEXITY AND ORGANIZATIONAL COMPLEXITY

This paper adopts a comparative perspective towards the analysis of performance evaluation in the National Health Service. The NHS, it is argued, is best seen as an organization which is not unique but which ranks high on a number of dimensions: uncertainty about the relationship between inputs and outputs; heterogeneity of activities and aims; the ambiguity of the available information. These factors help to explain why performance evaluation in the NHS is both conceptually and organizationally problematic, and fragmented and professionalized in practice. By looking at the same factors in other organizations, it may be possible to start constructing a framework for examining the problems of performance evaluation in different settings.     

RECENT TRANSITION IN GOVERNANCE IN SOUTH ASIA: CONTEXTS,DIMENSIONS, AND IMPLICATIONS

There has been a paradigmatic shift in the mode of governance in capitalist nations, developing countries, and postcommunist states. Under the newly emerging neoliberal state, which has largely replaced other state formations, public governance has undergone significant transformation. In comparison with the earlier mode, the new mode of governance has the objective of narrow economic growth rather than overall development, the role to support rather than lead service delivery, the structure of managerial autonomy rather than accountability, and the standards based on business norms rather than public ethics. This mode of governance, which emerged in advanced industrial nations, has been extended to most developing countries, including those in South Asia. This paper explores the origins and trends of recent changes in governance in South Asian countries, and evaluates the critical implications of such changes for various dimensions of society in these countries.     

PLANNING AND CONTROLLING PUBLIC EXPENDITURE IN THE UK, PART I: THE TREASURY'S PUBLIC EXPEIWITURE SURVEY

The Treasury's annual survey of public expenditure is the central element in planning and controlling public expenditure. While its purpose remains similar to that in the 1970s, the principles governing its preparation, the methodology employed and the conduct of negotiations between the Treasury and the departments have changed with successive attempts to control both the total and programme allocations more effectively. This article examines and explains the process of preparing the survey, through the main stages from the decisions about the size of total public spending in the context of the government's macroeconomic strategy to the announcement in the Autumn Statement of the planned totals and allocations for the next three years and finally to the publication in February of the departmental Public Expenditure Chapters. Part I1 [Summer issue] analyses the effects and effectiveness of the survey processes, and discusses whose interests have been best served.