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INTERROGATING INSTITUTIONAL CHANGE: ACTORS' ATTITUDES TO COMPETITION AND COOPERATION IN COMMISSIONING HEALTH SERVICES IN ENGLAND
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DOROTA OSIPOVIČ PAULINE ALLEN ELIZABETH SHEPHERD ANNA COLEMAN NEIL PERKINS LORRAINE WILLIAMS MARIE SANDERSON KATHERINE CHECKLAND 《Public administration》2016,94(3):823-838
Since the beginning of the 1990s the public healthcare system in England has been subject to reforms. This has resulted in a structurally hybrid system of public service with elements of the market. Utilizing a theory of new institutionalism, this article explores National Health Service (NHS) managers' views on competition and cooperation as mechanisms for commissioning health services. We interrogate the extent of institutional change in the NHS by examining managers' understanding of the formal rules, normative positions and frameworks for action under the regime of the Health and Social Care Act 2012. Interviews with managers showed an overall preference for cooperative approaches, but also evidence of marketization in the normative outlook and actions. This suggests that hybridity in the NHS has already spread from structure and rules to other institutional pillars. The study showed that managers were adept at navigating the complex policy environment despite its inherent contradictions. 相似文献
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BARBARA ANN STOLZ 《Law & policy》1983,5(2):157-180
Even when federal authorities were legally empowered to impose a death sentence, the sanction was rarely carried out. Between 1930 and 1976, there were only 33 such executions. During the past decade, bills, both imposing and abolishing capital punishment, have been introduced repeatedly in the U.S. Congress. Furthermore, certain members of Congress have demonstrated intense interest in such efforts. The continued debate and interest is better explained by the symbolic rather than tangible components of such legislation. This article examines four aspects of the symbolic component of federal death penalty legislation: reassurance function, moral-educative function, model for the states, and the deterrence debate. 相似文献
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Scholars have long argued that delinquency is a group phenomenon. Even so, minimal research exists on the nature, structure, and process of co‐offending. This investigation focuses on a particular void, namely the stability of 1) co‐offending and 2) co‐offender selection over time, for which divergent theoretical expectations currently exist that bear on issues central to general and developmental/life‐course theories of crime. By relying on individual‐level, longitudinal data for a sample of juvenile offenders from Philadelphia, we find that distinct trajectories of co‐offending exist over the course of the juvenile criminal career. This inquiry also develops an individualized measure of co‐offender stability, which reveals that delinquents generally tend not to “reuse” co‐offenders, although frequent offenders show a greater propensity to do so. The discussion considers the theoretical and policy implications of these findings as well as provides some avenues for future research. 相似文献
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More than 20 years after an expansion of juvenile transfer policies, questions remain regarding the specific deterrent effect of juvenile waiver given the singular focus on the court of jurisdiction and neglect of other critical aspects of the provision, such as the incapacitation experience. Prior research has also not been focused on identifying the mediating mechanisms that produce criminogenic, null, or deterrent effects. We use data from the Pathways to Desistance Study, propensity score methodology, and mediational analyses to examine how and why the waiver‐incapacitation experience is related to recidivism rates during emerging adulthood. We find that the prior focus on a binary “waiver effect” is potentially misleading as it masks meaningful variation. Furthermore, we find that the path to increased recidivism in emerging adulthood is indirect and we identify stymied educational attainment as a mediator. Our discussion is focused on the criminogenic effects of incapacitation for juveniles and its implications for juvenile transfer research. The discussion also calls for future research to explore treatment heterogeneity further. 相似文献