BUREAUCRATS AS PURCHASERS OF HEALTH SERVICES: LIMITATIONS OF THE PUBLIC SECTOR FOR CONTRACTING

Contracting out of health services increasingly involves a new role for governments as purchasers of services. To date, emphasis has been on contractual outcomes and the contracting process, which may benefit from improvements in developing countries, has been understudied. This article uses evidence from wide scale NGO contracting in Pakistan and examines the performance of government purchasers in managing the contracting process; draws comparisons with NGO managed contracting; and identifies purchaser skills needed for contracting NGOs. We found that the contracting process is complex and government purchasers struggled to manage the contracting process despite the provision of well‐designed contracts and guidelines. Weaknesses were seen in three areas: (i) poor capacity for managing tendering; (ii) weak public sector governance resulting in slow processes, low interest and rent seeking pressures; and (iii) mistrust between government and the NGO sector. In comparison parallel contracting ventures managed by large NGOs generally resulted in faster implementation, closer contractual relationships, drew wider participation of NGOs and often provided technical support. Our findings do not dilute the importance of government in contracting but front the case for an independent purchasing agency, for example an experienced NGO, to manage public sector contracts for community based services with the government role instead being one of larger oversight. Copyright © 2011 John Wiley & Sons, Ltd.     

'TRADITIONS' AS CONTEXT IN THE HISTORY OF POLITICAL THEORY

Abstract An adequate methodology in the history of political theory is dependent on a adequate philosophy of history. Firstly, in the course of a critical consideration of other writers on methodology (principally W. G. Greenleaf and Q. Skinner) it is suggested that 'intellectual traditions', of two sorts, might provide an appropriate unit of context. Secondly, a broadly anti-naturalist philosophy of history is adopted, which makes use of Collingwood and Hegel, and it is argued that intellectual traditions are compatible with this view of historical knowledge. It is concluded that the opposition between the universalist text-orientated approach and the particularist historical approach to the study of the history of political theory is a false dichotomy. We can learn from past ideas as a traditional inheritance.     

THE USE OF MANDATORY SENTENCING LEGISLATION AS SYMBOLIC STATEMENTS

Mandatory sentencing legislation often results in laws which use provisions and set penalties in order to make strong symbolic and political statements. Thus, in addition to protecting society, they are powerful vehicles for expressing moral outrage. This is especially evident in mandatory sentencing for drug and alcohol offenses. The present research examines the consequences of that practice on one state's criminal justice system. Interviews with key actors along with examinations of official documents, newspaper publicity and media campaigns illustrate the political decisions and symbolic statements which pervade driving-while-intoxicated (DWI) legislation. The process is studied from before the lawls enactment through its subsequent outcome.     

THE COMPARATIVE POLITICS OF AGENDA SETTING: THE EMERGENCE OF CONSUMER PROTECTION AS A PUBLIC POLICY ISSUE IN BRITAIN AND THE UNITED STATES

This article compares the emergence of consumer protection as an issue on the public policy agendas of Britain and the United States in the 1960s. Similar forces caused the emergence of consumer protection in both cases. Governmental responses to consumer protection issues also have been similar, but distinctive features of each country's political system are evident as well. The analysis draws upon existing consumer protection literature for each country as well as the author's interviews with a number of Britons involved in this policy area. The principal conclusion is that consumer protection gained each country's policy agenda as a discretionary item. Events of the past few years demonstrate that it is not yet a durable agenda item in either case.     

PUBLIC POLICY AS THE CONTINUATION OF MORAL PHILOSOPHY BY OTHER MEANS

The paper suggests that the oldest and newest glsubfieldslg of political science—political philosophy and public policy analysis–share important features lacking in those areas of the discipline that have modeled themselves after the natural sciences. Both are incompatible with the belief social sciences can be "value-free" and both are legitimate academic pur- suits that aspire to systematic and rigorous analysis of significant questions or problems. Fundamental considerations link the two enterprises. (1) Public policy analysis as currently practiced i s based largely on economics which i s the instantiation of a particular moral philosophy. (2) Logical problems in the basic assumptions of applied economics and policy analysis require the kind of fundamental reexamination to which moral philosophy can contribute.
The second section uses three health policy examples–tax expenditures that promote the purchase of health insurance, euthanasia, and long-term institutional care for the elderly–to show how moral philosophy can help in policy analysis.
The third section, an examination of Graham Allison's three epistemological models for understanding public policy, demonstrates that work in public policy also should stimulate philosophical inquiry.     

THE COURTS AS A SOURCE OF REGULATORY REVITALIZATION: EXTERNAL AGENDA SETTING AND EQUAL EDUCATION PROGRAMS

The authors examine the relationship between the courts and HEW's Office for Civil Rights (OCR), to illustrate the effects of legal efforts to generate more vigorous agency enforcement. Opponents of racial and sex discrimination in public schools won a series of suits against OCR after it had ceased to effectively implement anti-discrimination legislation. As a result of court decisions, OCR has had its discretion over how it will carry out its legislative responsibilities curtailed.