'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.     

From Cash to Accrual Budgeting and Accounting in the Public Sector: The Dutch Experience

Traditionally, governments used to deploy input‐based budgeting systems and cash‐based accounting systems. However, these systems do not provide the information that is necessary for a government to operate efficiently and effectively. Therefore, a growing number of countries have already shifted or are planning to shift from cash‐based to some form of accrual accounting in the public sector. Usually, the implementation of some accrual‐based system is linked to wider financial management reforms including performance management requiring information on cost. This paper focuses on the Dutch experience with the shift from cash‐based accounting and budgeting systems to an accrual‐based system.     

EU issue voting and the 2014 European Parliament elections: a dynamic perspective

EU issue voting in European Parliament elections has been shown to be highly conditional upon levels of EU politicization. The present study analyzes this conditionality over time, hypothesizing that the effect of EU attitudes on EP vote preferences is catalyzed as EP elections draw closer. In contrast to extant cross-sectional post-election studies, we use a four-wave panel study covering the six months leading up to the Dutch EP elections of 2014, differentiating between party groups (pro, anti, mixed) and five EU attitude dimensions. We find that EU issue voting occurs for both anti- and pro-EU parties, but only increases for the latter. For mixed parties we find no effect of EU attitudes, yet their support base shifts in the anti-EU direction as the elections draw closer. The overarching image, however, is one of surprising stability: EU attitudes form a consistent part of EP voting motivations even outside EP election times.