Regional Offices in the New NHS: An Analysis of the Effects and Significance of Recent Changes

This article reports on a two-year, multi-method, qualitative study in two regional offices in the UK National Health Service of the changing role of the regional tier from the autumn of 1994. The nature of the changes from fourteen semiautonomous regional health authorities to eight regional offices of the NHS Executive, whose staff became civil servants, are described together with the way this reorganization changed the role and relationships of NHS Executive HQ, the regional offices and the field. By the end of our research in the autumn of 1996, the change from regional health authority to regional office had gone well in the two regional offices studied; they had become smaller organizations, had established closer working with HQ and believed they had more influence over policy, while retaining good relations with health authorities. Emerging issues from the changes and some of their implications are discussed, particularly the pressures towards greater centralization and the particular forms that these have taken, despite the aim, and in part the achievement, of greater devolution, and the cultural differences between the NHS and the civil service. We conclude by assessing what the future holds for regional offices, in the light of the recent NHS White Paper (Secretary of State for Health 1997)     

An Integrative Model of Empowerment and Individuals' In-Role and Extra-Role Performance in the Korean Public Sector: Moderating Effects of Organizational Individualism and Collectivism

ABSTRACT

While empowerment has emerged as a new management paradigm, virtually no research has combined structural and psychological approaches to develop an integrative approach. Moreover, prior research has not examined the effect of the cultural context on the relationship between empowerment and performance. Drawing on a sample of public employees working in the city of Seoul, the largest local government in Korea, this study examined the effects of structural and psychological empowerment on both in-role and extra-role performance, and the moderating effects of organizational individualism and collectivism. Of the 400 questionnaires, 191 usable respondents, combining employees' and managers' questionnaires, were returned. Data were analyzed using structural equation modeling (SEM). Results of the analyses indicated that psychological empowerment mediates the relationship between structural empowerment and extra-role performance, and that organizational collectivism moderates the relationship between psychological empowerment and extra-role performance. Based on these results, the implications of the findings are discussed.     

Anthropological Measurement of the Juvenile Clavicle Using Multi‐Detector Computed Tomography—Affirming Reliability

Currently, there is no standardized protocol for multi‐detector computed tomography (MDCT) measurement of juvenile remains. Using 33 juvenile clavicles, this paper investigates a protocol to allow MDCT measurements, comparable or supplemental with traditional osteometric measurements, to be acquired for application to previously published algorithms. The results illustrate that there is no significant difference between MDCT measurements and those taken by direct osteometric methods. By presenting such a protocol, this paper takes the first steps toward validation of the process of conversion from measurement of dry juvenile bone to MDCT compatibility and allows the forensic world to take a step forward in standardizing the way MDCT is used for forensic practice. This paper assesses the limitations and potential applications of this virtual approach and offers some suggestions for where further work might progress the conversion of these new approaches into legally admissible anthropological techniques of age estimation.     

Defining the Arts and Cultural Universe: Lessons from the Profiles Project

This article discusses state support of artists in the United Kingdom, focusing on the Arts Council England. To understand the present—or the future—support of visual artists, one needs to understand the past. Accordingly, the article begins with a brief history of the Arts Council of Great Britain from 1946, discussing Thatcher's reforms after the 1979 election. Tony Blair's New Labour continued many of the same strategies instituted by the Conservatives. At the same time as fiscal constraints and "enterprise culture" were imposed, the mission of the Arts Council was broadened to include both geographical representation and a more populist agenda. A review of the contemporary arrangements for state support of artists in the United Kingdom shows that many of the tensions that exist within today's Arts Council were institutionalized in its early days. The article concludes with a comment on what the current situation may portend for the future.     

Books received

The Economy of Bangladesh. By Azizur Rahman Khan. London : Macmillan and New York: St. Martins Press, 1972. Pp. xviii + 196; £4.95.

Matching Employment Opportunities and Expectations: A Programme of Action for Ceylon. Report by the International Labour Office. Geneva, 1971. Pp. xvii + 251; £1.60 and U.S.$4.

Price Consistency in Development Planning. By Peter A. Cornelisse. Rotterdam University Press, 1973. Pp. xiv + 154 n.p.

The Mexican Economy: Twentieth‐Century Structure and Growth. By Clark W. Reynolds. New Haven: Yale University Press, 1970. Pp. xxiv, 468; £6.05.

Nutrition, National Development and Planning. Edited by A. Berg, N. S. Scrimshaw and D. L. Call. Cambridge, Mass.: M.I.T., 1973. Pp. 400. £4–50.

The Nutrition Factor: its Role in National Development. By Alan Berg, Portions with Robert J. Muscat. Washington: The Brookings Institution, 1973. Pp. xii 4‐ 290, Tables, Figures. $8.95.

The Ecology of Malnutrition in Mexico and Central America. By Jacques M. May and Donna L. McLellan. New York: Hafner, 1972. Pp. xiii + 397, tables, maps; £7.50.

The Ecology of Malnutrition in the Caribbean. By Jacques M. May and Donna L. McLellan. New York: Hafner, 1973. Pp. viii + 490, tables, maps; £9.95.     

‘You're Just Treating Us as Informants!’ Roles,Responsibilities and Relationships in the Production of Children's Services Directories

Local authorities in England are required to make directories of services available to practitioners working with children and young people. This is against a background of continuing reforms intended to ensure that services are joined-up around the needs and choices of children, young people and their families. There are high expectations that more of these services will be delivered by organisations from theVoluntary and Community Sector (VCS), especially services for groups or communities that public sector agencies find hard to engage. This article reports and comments upon a regional study focusing on the production of children's service directories involving service providers and commissioners, as well as the producers of directories, in a series of facilitated workshop activities. The study highlights tensions between local authorities and service providers around how information about services is controlled, edited and accessed. We argue that current approaches to the provision ofdirectories are unlikely to have the transformational effects predicted by policy makers. This is partly because local authorities' traditional position (supported by the prevailing technologies) has meant that they have tended to monopolise the roles and responsibilities which in turn maintains their control of directory content. They do so in the face of increasing dissent from new and established providers. Moreover, current models of service directories fail to meet the emerging information needs of a range ofstakeholders including service providers, service commissioners and service users. Inconclusion we propose some questions to improve visibility and governance in the creation and maintenance of service directories.     

Going Public as Political Strategy: The Bush Administration,an Echoing Press,and Passage of the Patriot Act

Research suggests that political elites excel at controlling political and media information environments, particularly in times of national crisis, such as the events and aftermath of September 11. This study examines the creation and passage of the Patriot Act, which was proposed by the Bush administration following the terrorist attacks and quickly passed with strong support by the U.S. Congress. We argue that (a) the public communications of the Bush administration, particularly those by George W. Bush and John Ashcroft, and (b) news coverage about the legislation were instrumental in this outcome. Public communications by Bush and Ashcroft and news coverage about the Act were content analyzed to identify the timing of the messages and the themes and perspectives emphasized, and congressional debates and activities were examined for insight into their relation with administration and press discourse. Findings suggest that Bush and Ashcroft's communications, in combination with a press that largely echoed the administration's messages, created an environment in which Congress faced significant pressure to pass the legislation with remarkable speed.