CONSULTATIVE PROCESSES IN HEALTH POLICY IN THE UNITED KINGDOM: A VIEW FROM THE CENTRE

Health policy at national level is the product of a series of continuous and complex interactions between interest groups operating both inside and outside government. It is generally thought that these consultative processes are closed, elitist and dominated by the prestigious medical specialties. Yet there has been a rapid growth in the number of groups representing various interests, professions and care groups. Drawing on recent examples from the national health service, the paper explores the extent to which consultative processes in health policy have remained closed or have been opened up to new influences. The analysis suggests that consultation within the health department is more pluralistic than is usually appreciated. Also, while the closed, elitist mode of consultation with external interests has been eroded marginally, it remains more or less intact. Nevertheless, the ability of powerful medical interests to get their own way to the exclusion of other interests depends on the resources and sanctions available to other groups and on the particular policy issue. It can no longer just be assumed.     

INFORMATION SYSTEMS AND NEW PUBLIC MANAGEMENT - A VIEW FROM THE CENTRE

The combination of new public management reforms and 'informatization' is presenting opportunities for the re-engineering of government business activities. Awareness and debate about the implications of this are limited however. Structural reforms to public services need to take account of the notion of information stewardship, and an essential competence of public officials is to manage and use information held in trust. Public service reforms which lead both to fragmentation and to the contract culture have implications for information systems development and implementation. Whilst new technology can be used to alter radically the administrative and service delivery systems of government, technical possibilities must be set alongside issues such as the privacy of the individual and the protection of public interest. The article also discusses the role of the Office of Public Services and Science, and HM Treasury, in stimulating appropriate strategies to cope with these dilemmas.     

PRIVATE INITIATIVE AND COMMUNITY RESPONSIBILITY: A STRATEGY FOR THE BLACK COMMUNITY

In Britain black leaders are generally less well integrated into community agencies and local administration than their counterparts in the United States. This is partly explained by reference to the American 'arms length' approach to funding community development which, in contrast to the more centralized British approach, enables black leaders to work 'within the system' apparently without sacrificing too much of their political independence. In this context the paper views the activities and funding of the US community action and development agencies and British community relations councils.     

POLICING WITH A SMILE: NARRATIVES OF CONSUMERISM IN NEW LABOUR'S CRIMINAL JUSTICE POLICY

A recurrent theme in New Labour's public service reforms has been a tendency to orient services to the user as a consumer or customer of those services. However a consumerist approach – and particularly the 'customer is always right' imperative – appears problematic in relation to criminal justice. This article uses content analysis to explore the use of consumerist narratives by selected members of the UK criminal justice policy network (Prime Minister, Home Office and local government). It finds that the terms customer and consumer are used less in relation to criminal justice than they are in relation to other public services. When used, it is 'law-abiding citizens', particularly victims and witnesses, that are the priority customers of the service. Customer-orientated policing is primarily about standardizing services and encouraging more coproductive behaviours. The language of choice and personalization, which has come to characterize New Labour's approach to public service reform, has as yet had little penetration into criminal justice. However, the policy network is fragmented, with different narratives of consumerism emerging from Tony Blair (the then Prime Minister), the Home Office and local government, demonstrating the contingent ways in which policy-makers draw on historical traditions.     

ENGINEERING A CONSENSUS: FROM THE FINNISTON REPORT TO THE ENGINEERING COUNCIL

It is now widely accepted that British governments find radical policy change difficult to Secure – especially where such change threatens to disturb a well-developed interest group network. The Report of the Committee of Inquiry into the Engineering Profession (19801, chaired by Sir Monty Finniston, Engineering Our Future, was interesting because it proposed a very radical change in the way in which the engineering profession was organized and regulated. In essence, Sir Monty wished to displace the established engineering institutions. A study of the long and complex saga following the publication of the Finniston report is a good test of the system's capacity for policy innovation as well as an illustration of the common conflict between state intervention and professional self-regulation. What finally emerged, The Engineering Council, can be seen as the outcome of a process of bargaining, which preserved the power of the professional institutions.     

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.     

PLANNING: LESSONS FROM THE PORTS

The National Ports Council, created in 1964 and abolished in 1982, was engaged in one of the rare sustained attempts at planning in Britain. This article explains the Council's decision not to carry out full-scale planning because of the difficulties of collecting information, assessing technological and economic changes, and reconciling rational economic planning with short term political pressures.     

PRIVATE LEGISLATION AS A STRATEGY OF POLITICAL NEGOTIATION

This article contributes to the perception of the role of the legislator as political initiator in modern parliamentarianism. Most of the research literature relates to the parliament member as a ‘eam player’ of their faction and party. This research was conducted into the functioning of the Israeli parliament The Knesset and into private members' legislation. The article examines in an innovative way the act of legislation, not only as a judicial or procedural process but as a process of political negotiation. The concept and findings that arose from the study of the role of the legislator as initiator of bills and negotiator with the government gives important knowledge and perspective on legislation as a political negotiation process.     

PUBLIC AND PRIVATE SECTOR MANAGERS OVER 20 YEARS: A TEST OF THE ‘CONVERGENCE THESIS’

This paper sets out to test the ‘convergence thesis’ in respect of managers in the public and private sectors in Britain. New Public Management (NPM) initiatives have had the objective of making managerial behaviour in public sector organizations more similar to that in the private sector. Based on unique national surveys undertaken in 1980, 1990 and 2000, using quite large random samples of fellows and members of the Chartered Management Institute (CMI), comparisons are made to investigate whether ‘convergence’ between public and private sector managers has actually occurred. The patterns are found to be complex and, although there are some signs of convergence, the two sectors continue to exhibit similarities, persistent differences and parallel movements evident in managerial attitudes, behaviour and experiences.     

THE PRACTICE OF CONTRACTING IN PUBLIC PRIVATE PARTNERSHIPS: TRANSACTION COSTS AND RELATIONAL CONTRACTING IN THE IRISH SCHOOLS SECTOR

This paper explores the practice of contracting in public private partnerships (PPP). Focusing on the first Irish PPP to provide secondary schools, it draws on perspectives from transaction cost economics and socio‐legal theory. It finds that the ex ante contractual setting was undermined by pushing forward with the PPP before conducting an adequate level of project appraisal. It explores the experiences of key stakeholders in the ex post contracting stage and concludes that the conduct of contracting practice was not characterized by the shift to relational contracting expected under PPP. Whereas this approach to contractual governance did not hinder the development of broadly trusting relations between the client and contractor, this was not manifest in terms of relations between the contractor and schools. A significant degree of conflict was evident in some schools‐contractor relations, something which can be attributed to sources of transaction costs, including incomplete information, bounded rationality and uncertainty.     

THE EFFECTIVENESS OF RELATIONAL CONTRACTING IN A TEMPORARY PUBLIC ORGANIZATION: INTENSIVE COLLABORATION BETWEEN AN ENGLISH LOCAL AUTHORITY AND PRIVATE CONTRACTORS

This article evaluates the factors that shaped the effectiveness of three strategic contracts pursued with private firms by a local authority in the English West Midlands. The contracts generated highly political outputs that supported the council’s defence of the core interests of local residents. The analysis explores the form taken by the contracts; the mechanisms that delivered and integrated them; and the wider structural factors that helped to secure apparently benign contractual outputs. The evaluative yardsticks used to support the analysis were: relationality; flexibility; and performativity. The article argues that relationality is crucial in determining quality in temporary, project‐based organizations. Relationality yields flexibility and effective performance, based on mutual regard and loyalty. The case study highlights the need to explore perceptual gaps between the parties; the importance of the time‐path of relationality; the significance of ‘value residuals’ in incentivizing substantive loyalty; and the potential contribution of zones of flexibility to performance.     

GOVERNING WITHOUT GOVERNMENT? THE PRIVATE GOVERNANCE OF FOREST CERTIFICATION IN SWEDEN

The role and capacity of the state are changing. Some researchers argue that the state is transforming, strategically adapting to new circumstances, while others see a development of governing arrangements that are autonomous from the state, governing 'without' government. This article assesses the governing without government thesis through the case of forest certification introduced in Sweden in the late 1990s. This is a case of private governance, the governing capacity of which is based on voluntary self-regulation rather than government authority, seemingly a prime example of governing without government. The results show that government nonetheless is involved with forest certification through governance-oriented modes of governing: enabling and influencing the arrangements. Thus, what appeared to be a prime example of governing 'without' government is better understood as governing 'with' government.