The influence of institutions and culture on health policies: different approaches to integrated care in England and The Netherlands

The concept of integrated care has assumed growing importance on the policy agendas both in England and The Netherlands and elsewhere. It is characterized as health and health care-related social care needed by patients with multi-faceted needs. This article compares policy approaches to integrated care in England and The Netherlands. Differing political strategies and conditions for integrated care correspond to the dissimilarities in the institutional structure and culture of their health care systems. Health care systems are understood as specific national and historical configurations. We review the last decade's relevant policy processes, using the concepts of hierarchy, market and network. The state health care system in England relies mainly on hierarchical steering, thus creating tight network structures for integrated care on the local level. The Netherlands, with its health care system in a public-private mix, has set incentives for voluntary, loosely coupled and partly market-driven cooperation on the local level. Implications for success or failure are mixed in both configurations. Policy recommendations have to be tailored to each systems' characteristics.     

Democratic Legitimacy and the 2000 Election

Law and Philosophy -     

Mass Administrative Reorganization,Media Attention,and the Paradox of Information

How does media attention influence government decisions about whether to terminate independent administrative agencies? The authors argue that an agency's salience with partisan audiences has a direct effect, but a high media profile can disrupt normal government monitoring processes and obfuscate termination decisions. This argument is evaluated in the context of a recent mass administrative reorganization by the British coalition government using probit and heteroscedastic probit regression models. The evidence suggests that termination is less likely for agencies salient in newspapers popular with the government's core supporters but not those read by its minority coalition partner. We also find that agencies with greater overall newspaper salience as well as younger agencies have a higher error variance.     

The Effect of Associative Issue Ownership on Parties’ Presence in the News Media

Some studies suggest that challenger parties push new issues onto the agenda, especially when they ‘own’ these issues. Others claim that established parties largely determine how prominent issues appear on the agenda. This article contributes to this debate by focusing on an issue on which challenger parties have most ‘ownership’: immigration. Political claims on this issue made by political parties in newspapers in seven West European countries after three events that could potentially trigger attention to immigration were studied. Large and government parties appear most prominent in the news. However, findings show a significant, positive effect of associative issue ownership on claims-making in the news, while controlling for party size and government status. So, when challengers have issue ownership they appear as claim-makers on the issue. These results paint a balanced picture of the role that challenger and established parties have in setting the agenda.     

Community rehabilitation workers as catalysts for disability: inclusive youth development through service learning

This paper explores access to health and education for disabled youth in sites with and without community rehabilitation workers (CRWs). A cross-sectional survey using a structured questionnaire was undertaken in nine sites in South Africa, and a snowball sample of 523 disabled youths of both sexes, aged between 18 and 35 years, was selected. The survey found that a significantly larger proportion of disabled youth living in sites with CRWs were seen by health care workers at home, and that there was a large difference in educational access between sites with and without CRWs. CRWs are well positioned to promote equal citizenship for disabled youth through service learning with occupational therapy final year students to improve access to health and education, so that barriers to their participation in economic development are removed.