GENERAL MANAGEMENT IN THE NHS: THE INITIAL IMPACT 1983–88

The Griffiths report of 1983 resulted in radical changes (to which the label 'general management' has been applied) to the formalities of organization and management in the national health service. We report the findings of a major study (involving more than 300 interviews) of the impact of these changes up to 1988. Although general management has been widely accepted in the service, and seems to have resulted in some improvements to management processes, there has been no substantial change in organizational culture. We conclude that the impact of the Griffiths model of management has been limited in comparison with the continued influence of medical autonomy and financial limitations.     

Performance pressure: Patterns of partisanship and the economic vote

Numerous studies have demonstrated a weakening identification of voters with political parties in Western Europe over the last three decades. It is argued here that the growing proportion of voters with weak or no party affinities has strong implications for economic voting. When the proportion of voters with partisan affinities is low, the effect of economic performance on election outcomes is strong; when partisans proliferate, economic conditions matter less. Employing Eurobarometer data for eight European countries from 1976 to 1992, this inverse association between partisanship and the economic vote is demonstrated. This finding implies a growing effect for the objective economy on the vote in Europe. It helps explain an important puzzle in the economic voting literature: Weak results in aggregate level cross‐national studies of economic voting may be attributable to characteristics of the electorate, not just to the characteristics of government.