'Designing Better Health Care in the South': A Case Study of Unsuccessful Transformational Change in Public Sector Health Service Reform

This article presents a case study of a project known as 'Designing Better Health Care in the South' that attempted to transform four separately incorporated health services in southern Adelaide into a single regional health service. The project's efforts are examined using Kotter's (1996) model of the preconditions for transformational change in organisations and the areas in which it met or failed to meet these preconditions are analysed, using results from an evaluation that was commenced during the course of the attempted reform. The article provides valuable insights into an attempted major change by four public sector health organisations and the facilitators and barriers to such change. It also examines the way in which forces beyond the control of individual public sector agencies can significantly impact on attempts to implement organisational change in response to an identified need. This case study offers a rare glimpse into the micro detail of health care reform processes that are so widespread in contemporary health services but which are rarely systematically evaluated.     

Do school accountability systems make it more difficult for low‐performing schools to attract and retain high‐quality teachers?

Administrative data from North Carolina are used to explore the extent to which that state's relatively sophisticated school‐based accountability system has exacerbated the challenges that schools serving low‐performing students face in retaining and attracting high‐quality teachers. Most clear are the adverse effects on retention rates, and hence on teacher turnover, in such schools. Less clear is the extent to which that higher turnover has translated into a decline in the average qualifications of the teachers in the low‐performing schools. Other states with more primitive accountability systems can expect even greater adverse effects on teacher turnover in low‐performing schools. © 2004 by the Association for Public Policy Analysis and Management.     

‘Fat cat’ lawyers and ‘illegal’ migrants: the impact of intersecting hostilities and toxic narratives on access to justice

ABSTRACT

This article examines how three spheres of hostility intersect to prevent effective access to justice for those living with insecure immigration status. The neoliberal governance model, the barren justice landscape and the hostile environment are supported by the cynical construction of the ‘fat cat’ lawyer and the toxic ‘folk devil’ narrative of the ‘bogus’ asylum seeker. To the extent that the judiciary have frustrated the more obvious, ideologically driven, attempts to restrict access to justice for migrants, the austerity predicated measures pursuant to the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO) have completely altered the legal landscape. The analysis is informed by the findings of the ‘Legal advice and support for persons with insecure status’ project (hereafter LAPIS) in Nottingham which explores the challenges faced by service providers and the lived experiences of those with insecurity of status. It is clear that access to justice is a passport to the realisation of other rights, yet participants struggled to access a remedy because legal advice is too often out of reach.     

The play of approved method and authorized value in the administration of public issues

The goal of this piece is to construct a model for policy analysis that provides analysts with conceptual tools for studying policy as a discursive practice. Policy formulation is viewed as a generative process, as social relations set in the play of larger social formations. Fiction and non-fiction examples are used to develop a mode of analysis using Bourdieu's notion of discursive economies. These include The Milagro Beanjield War and an illustrative case study of the administration of CDBG's in a mid-sized city. The argument is made that this approach leads to a highly politicized view of the administration of public issues as the play between approved method and authorized value. Finally, the approach is connected to current policy-making tactics at the federal level.