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.     

The legality of employee attitude surveys in union environments

Employee attitude surveys are becoming an increasingly popular tool for employers. A host of legal implications, such as the circumstances under which they can be used, what they can ask, and whether or not they are a subject of mandatory bargaining, arise when surveys are conducted by companies that have an incumbent union or by companies that are involved in union-organizing campaigns. The following article describes the survey process, outlines some of the inherent advantages and pitfalls, and examines the legal questions raised when surveys are used by nonunion employers, by employers with incumbent unions, and by employers who are involved in union-organizing-campaigns. It concludes with recommendations for employers that undertake attitude surveys.     

The politics of management in health care: a British perspective

This paper discusses the contribution of organizational political perspectives to a better appreciation of policy implementation problems in health care. The context is the efforts of successive British governments to accord a higher priority to community health and long-stay services. The limited success of these policies owes much to continuing medical control of the philosophy of the organization and agenda, in spite of government responsibility for funding and providing health services. More effective policy implementation depends on a recognition of the "naturalness" of organizational politics, rather than treating them as constraints in an otherwise rational, managerial system.     

Health care policy: lessons from the past and issues of the future

Liberal distributional values, the increasingly powerful capacity of medicine to provide more and better care, and concern about the health hazards of an industrial society fueled the vast expansion of the health care sector during the last 20 years. That growth was facilitated by a growing economy. The current health policy debate at one level reexamines the distributional bases of entitlement programs, and at another seeks alternative resource allocation mechanisms to reduce the cost of health care. This article has two themes. First, distributional and allocational policies are shown to be intrinsically related, so that the health policy debate is fundamentally a clash between liberal and libertarian values. Second, the inexorable social forces driving the health care system are shown to be the aging of the population and the rapid expansion of technology. The resulting dynamics imply the further growth of the health sector, now in the environment of a sluggish economy. Future policies will have to struggle with how to ration scarce health resources and how to reorient the health care sector to the problems of the aged.     

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.