The failure of local government modernization in Britain: a critique of functionalism

Abstract. Modernizing local government systems to meet changing needs and urbanization is common to most Western democracies. This article examines the British local government modernization which, it argues, placed far too much emphasis on improving the system's functional capacity and too little to improving its democratic quality. The overemphasis on functionalism has been most decisive in relation to creating wider areas for planning and transportation and creating more populous local units so as to exploit economies of scale. The result is a system with some of the largest local units among Western democracies. The new system is also very unpopular. Yet, even when judged in functional terms it has serious weaknesses especially in regard to its failure to recognize the different functional needs of urban and rural areas. The article makes a strong plea for the restoration of democratic as opposed to functional criteria in the design of local government systems and notes the contribution that public choice theory can make to local government reorganization by its insistence on distribution efficiency as opposed to production efficiency. Sommaire. La modemisation des systèmes de gouvemement local pour répondre à de nouveaux besoins et aux exignences de l'urbanisation est commune à la plupart des démocraties occidentales. L'auteur de cet article étudie la modemisation du gouvernement local britannique qui, à son avis, a trop porté sur l'amélioration de la capacité fonctionnelle du système et pas assez sur sa qualité démocratique. La trop grande importance accordée au fonctionnel a joué un rôle particulièrement décisif en créant de grandes régions pour la planification et le transport et des unités locales à très forte densité de population de façon à profiter des économies d'échelle. Le résultat, c'est un système qui compte certaines des unités démographiques les plus fortes dans les démocraties occidentales. Ce nouveau système est aussi très impopulaire. Etmême lorsqu'on le juge du point de vue fonctionnel, il accuse une très grave faiblesse en ne distinguant pas entre les besoins fonctionnels différents des régions urbaines et rurales. L'auteur plaide en faveur de la restauration de critères démocratiques plutôt que fonctionnels pour la conception de systèmes de gouvemement local et il indique la contribution que pourrait apporter la théorie du choix public à la réorganisation du gouvernement local grâce à son insistance sur l'efficacité de la distribution plutôt que sur l'efficacité de la production.     

Rational planning and responsiveness: the case of the HSAs

American government in the twentieth century has been faced with a serious value conflict between the need for rational allocation of scarce resources through planning, and the need to be responsive to a diverse society. Two ideal types of planning correspond to these two values. Rational planning emphasizes the importance of the planner's expertise in achieving the "best" path to socially defined goals. Advocacy planning emphasizes the importance of responsiveness to group interests since all planning decisions are basically a matter of value choice. Citizen participation in planning often combines elements of these two models, embodying the value conflict in planning agency procedures. Health systems agencies are examined as a typical case of such planning. Their failure to build a constituency is viewed as a consequence of role conflict reduction strategies by representatives who did not know whether to play the planner or the advocate role, and how to play either.     

Industrial rationalization of a cottage industry: multi-institutional hospital systems

The environment facing hospitals, generally supportive until the 1970s, may now be characterized as complex, turbulent, and constrained. In response to such environmental conditions, hospitals have adopted new strategies and structures. The strategies, described as corporate rationalization, have led away from the traditional structure of freestanding, autonomous hospitals and toward the formation of multi-institutional systems. These systems are designed to provide sufficient strength to cope with the environment, to acquire scarce and valued resources, to allow organizational stability, to achieve organizational purpose, to enable growth and/or survival, and to enhance market position. The impact of multi-hospital systems is viewed in two major areas: acquisition, retention, and utilization of economic and human resources, and organizational, political, and social factors.