Politiques publiques et santé:les dilemmes de I‘évaluation prospective

Sommaire: Depuis le milieu des années 1990, plusieurs gouvernements ont affirmé leur volonté de tenir compte des impacts de leurs actions sur la santé des populations. En juin 2002, le gouvernement du Québec met en vigueur l'article 54 de la Loi sur la santé publique (L.R.Q. chapitre S‐22, 2001). Cet article atteste de l'obligation pour les ministères de tenir dorénavant compte des impacts sociaux, environnementaux et économiques de leurs actions sur la santé. La mise en Oeuvre de cet article suppose l'intégration d'un processus d'évaluation prospective des politiques publiques dans l'appareil gouvernemental, remet en question le fonctionnement vertical des administrations publiques et souligne l'importance d'une gestion stratégique des connaissances dans un monde sans frontières. Dans ce contexte, quatre dilemmes sont soulevés. Les deux premiers dilemmes sont d'ordre interministériel. Ils concernent les relations qu'entretiennent les ministéres entre eux et avec les organismes centraux. Les deux autres dilemmes s'intéressent à la dimension intra organisationnelle, c'est‐à‐dire la maniére dont chaque ministère réagit face aux demandes d'évaluations prospectives de ses politiques ou programmes et répond aux exigences dc l'article 54. Des méthodes qui devraient permettre aux administrations publiques de remédier à ces différents dilemmes sont également présentées. Abstract: Since the mid‐1990s, several governments have declared their commitment to ensuring that the impact of their actions on the health of the population is taken into account. In June 2002 the Quebec provincial government implemented article 54 of the Public Health Act (R.S.Q., chapter 2.2, 2001). This article stipulates the obligation on the part of the government departments to take into account the social, environmental, and economic impacts of their actions on public health in the future. The implementation of this article means integrating a process for the prospective assessment of the government's public policies, and re‐examining the vertical model of operation of public administrations; it also underlines the importance of strategic knowledge management in a world without borders. Four dilemmas are raised within this context. The first two dilemmas are interdepartmental in nature, and involve the relationships the government departments have with each other and with the central agencies. The other two dilemmas fall within the intra‐organizational sphere ‐ that is, the way in which each government department reacts to the demands for the prospective assessment of its public policies or programs, and how each department responds to the requirements of article 54. Processes that should allow the public administrations to solve these various dilemmas are also presented.     

Planned complex suicide: an unusual case

Abstract:  We report an unusual case of planned complex suicide. The victim was a woman aged 67 years, who was found dead in her bath in a state of advanced putrefaction. A plugged-in hairdryer was submerged in the water and the electrical fuses in the room had short-circuited. A kitchen knife lay below the body of the victim, whose left forearm bore incisions suggestive of wrist-cutting. At autopsy, no sign suggesting electrocution could be observed because of the advanced state of putrefaction of the body. Toxicological analysis revealed massive ingestion of tianeptine (blood concentration 15.5 mg/L). Although the exact cause of death could not be determined because of the state of the corpse, meticulous examination of the scene and information obtained from the victim's relatives led to the conclusion of suicide.     

Rethinking the Notion of a ‘Higher Law’: Heidegger and Derrida on the Anaximander Fragment

The Anaximander fragment, in the readings of both Heidegger and Derrida, speaks of that which exceeds positive law. In this article, the author provides a detailed reading of Heidegger’s Der Spruch des Anaximander, showing how Heidegger relates this fragment to his thinking of Being, the latter having been ‘forgotten’ by metaphysics. Heidegger’s reading at the same time involves a contemplation of technology and of the ontological relation of beings to each other. Derrida’s reading of Heidegger’s Der Spruch highlights specifically those parts of Heidegger’s text where that which precedes Being’s gathering, Being’s disjoining or dissemination, is pointed to. This disjoining, Derrida contends, speaks of the gift of a day more ancient than memory itself and ties in closely with certain aspects of the thinking of Marx. Derrida’s focus on that which precedes Being is in turn related to his contemplation of the law or condition of possibility of technology and also of that which makes possible a relation to the other as other. This condition of possibility, or the gift of Being, which Heidegger’s text also speaks of, involves a ‘higher law’ which can serve as a ‘measure’ for the evaluation, interpretation and transformation of positive law.

La gestion du rendement à la croisée des chemins: entre la rigueur et le laxisme

Sommaire: Apparue dans la gestion publique pendant les années 1970, l'évaluation du rendement devait permettre aux organisations de mieux canaliser les énergies des gestionnaires vers les buts corporatifs, de fournir une mesure plus juste du rendement des gestionnaires et de contribuer à la détermination des salaires. Plusieurs ont déploré son formalisme superficiel et ses coûts organisationnels supérieurs à ses effets bénéfiques. Depuis quelques années, les programmes de gestion du rendement semblent se trouver dans une impasse: la réduction de formalisme rend le processus moins précis et utile alors que son maintien Crée des difficultés d'acceptation aux divers niveaux de cadres. En fait, la gestion du rendement fait partie intégrante de tout processus de gestion et nécessite, pour qu'il y ait réussite, une contribution réelle des organisations et des gestionnaires. Les premières doivent fournir tout le support organisationnel nécessaire au succès, tandis que les seconds doivent être capables de réaliser toutes les tâches de cette gestion (fixer des objectifs, superviser, développer des informations de gestion, réussir des communications “ face à face ”, poser des jugements évaluatifs et objectifs et enfin, envisager des moyens de correction). Ils doivent aussi accepter d'y consacrer le temps et l'énergie nécessaires. Nous avons interviewé un échantillon de cadres de huit organismes publics oeuvrant au Québec aux paliers municipal, provincial, fédéral, et dans les domaines scolaire et de la santé, ceci afin de vérifier le degré de conformité de l'application du modèle classique d'évaluation du rendement et les impacts observés. Il s'agissait de savoir s'il existe une relation entre le degré de conformité et l'ampleur des impacts positifs. Abstract: Introduced in public management during the 1970s, the purpose of performance evaluation was to enable organizations to channel better managers' energy towards corporate goals, to provide the means required for a more accurate measurement of manager performance, and to help determine remuneration. Its superficial formalism and the fact that its organizational costs were greater than its benefits have been often criticized. For the last few years, performance management programs appear to have been stuck in a dilemma. Reducing formalism renders the process less precise and less useful, while its own existence makes it difficult to be accepted by the various executive leveis. In fact, performance management is an integral part of any management process: to be successful, it requires an actual contribution from organizations and managers. Organizations must provide all the organizational support required for successful performance management, while managers must be able to fulfil all the tasks involved in its management (setting objectives, supervising, developing management information, communicating successfully “face to face,” making sufficiently objective evaluation judgments, and propcbsing corrective measures). They must also be prepared to devote to it the time and enf'rgy required. We have interviewed a sample of executives of eight public agencies operating in Quebec at the municipal, provincial, federal, and school and health administration level in order to check the application of the conventional performance evaluation model and the impacts noted. The purpose was to ascertain whether there was a relationship between the appropriateness of the implementation and the magnitude of the positive impact.     

Policy representation

This paper examines the extent to which conditions for the 'representative party government' model of representation exist in the EU. It suggests that, although application of the model is obviously limited, there is some support for its relevance. Using surveys of voters and candidates for the European Parliament the paper shows that some policy positions of representatives are constrained more by their party group than their nationality, and to some degree there is obvious congruence between the opinions of candidates and their voters. This is particularly so with respect to left–right orientation; far less with respect to European Monetary Union where elites appear much more enthusiastic than their electorates.