A Balanced Budget with Side Effects—A Case Study of Implementation of a Hospital Cost Savings Program in Sweden

This study examines the implementation of a hospital cost savings program in a Swedish county hospital to understand how and why a downsizing intervention works and what outcomes it produces. Data were gathered from interviews and documents. Substantial differences were found among the healthcare professionals’ perceptions of the downsizing process. These diverse perceptions likely limited the scope of staffs’ participation and innovations of new savings strategies. Our findings stress the need for impact analyses addressing both intended aims and unintended side effects. Full attention should be paid to communication processes required to establish a trustful and committed change climate.     

Introduction: rising powers and the future of global governance

There has been much debate over the extent to which the rising powers of the global South are challenging contemporary global political and economic governance. While some observers see an emancipatory potential in the redistribution of power among states, others see the rising powers as firmly located within the Western-centred neoliberal world order. This collection of papers seeks to go beyond the state-centrism of existing approaches by examining how challenges to global governance by rising powers are rooted in specific state–society configurations. Through studies of Brazil, India, China and other important developing countries within their respective regions, such as Turkey and South Africa, the papers examine the way domestic structures, arrangements, actors and dynamics influence the nature of the international interventions and behaviour of rising powers. They ask how their increased political and economic enmeshment in the international system impacts upon their own internal societal cohesion and development. By examining these issues, the papers raise the question of whether the challenge posed by the rising powers to global governance is likely to lead to an increase in democracy and social justice for the majority of the world’s peoples.     

Comprehensive Performance Assessment and Public Services Improvement in England? A Case Study of the Benefits Administration Service in Local Government

The purpose of this paper is to independently evaluate the impact of the Comprehensive Performance Assessment regime on one particular public service, namely the provision of council tax and housing benefits distributed by local authorities throughout the course of the regime. This service was assessed in every iteration of the CPA methodologies and it included one of the few key performance indicators (KPIs) where the definition of the performance indicator, the means of collection and the public reporting of its results, remained the same throughout the CPA period between 2002 and 2008.

The findings show that there were considerable and consistent improvements in benefits administration nationally within England and across all of its regions. The paper then investigates a series of propositions. Whether there was any significant variations in the performance of larger as opposed to smaller authorities, or between predominantly rural authority areas and urban authorities or between authorities with different party political control. Finding no significant differences the research suggests implementation of the CPA regime itself appears to have had a catalytic effect upon the performance of the benefit administration services within local authorities throughout this period. The paper therefore concludes with a brief discussion as to whether the findings support the theoretical position of proponents of neo-institutionalism isomorphism or more traditional rational actor theories of public choice.     

Law reform

This article provides an overview on the structure and guiding principles of the new Law Commission of Ontario and considers the present state of law reform at the provincial level. The author suggests that the establishment of the Ontario agency continues a trend that started about a decade ago with provincial governments reversing earlier decisions to either close down or cut funding to agencies. ^{1 1} Gavin Murphy, ‘The Rise, Decline and Current Status of Canada’s Law Reform Agencies’ (2004) 30 CLB 900. He indicates that the launch of the Law Commission of Ontario is a positive development and could signal further interest and renewed support for provincial law reform in Canada. The article also examines the history, mandate and work of the Scottish Law Commission and concludes that the challenges it faces are similar to those confronting Canada’s provincial law reform agencies.