TACKLING HEALTH INEQUALITIES IN POST‐DEVOLUTION BRITAIN: DO TARGETS MATTER?

Since devolution in 1998, many aspects of public policy in Great Britain have diverged between England, Scotland and Wales, including how targets and performance assessment are used in the National Health Service and local government. Health inequality is an example where all three countries have recognized a need to act but approaches to performance assessment differ. Based on interviews with senior managers, the complexity of health inequality as an object of local intervention is explored and compared. Despite contrasting approaches to targets, local discourses in all three countries had significant similarities. Health inequality had to compete against a preoccupation with improving access to acute services generally and balancing budgets over the short term. There was a bias in the interventions described towards targeting health behaviours, but with limited use of evidence about efficacy, and indications that measuring progress with reducing health inequalities was starting to lead to an emphasis on ‘quick wins' from pharmacological interventions.     

“YOUTH IS ENMESHED IN A HIGHLY DYSFUNCTIONAL FAMILY SYSTEM”: EXPLORING THE RELATIONSHIP AMONG DYSFUNCTIONAL FAMILIES,PARENTAL INCARCERATION,AND JUVENILE COURT DECISION MAKING*

Although prior work has substantiated the role of external attributes in juvenile court decision making, no study to date has examined how family situational factors as well as maternal and paternal incarceration affect juvenile court officials' responses to troubled youth. Using quantitative and qualitative juvenile court data from a large urban county in the southwest, this study draws on attribution theory to examine how family structure, perceptions of family dysfunction, and parental incarceration influence out‐of‐home placement decisions. Findings reveal that juvenile court officials' perceptions of good and bad families inform their decision making. This study emphasizes the need to unravel the intricate effects of maternal and paternal incarceration and officials' attributions about families and family structure on juvenile court decision making.     

Testing the input-process-output model of public participation

The characteristics of participatory institutions can be articulated in three main dimensions: input, process and output. The common assumption is that a dependency relationship exists, with process serving as a mediator between input and output. This paper puts the model to a rare empirical test drawing on a unique dataset of 70 Spanish advisory councils. Through a combination of exploratory factor and path analyses, we analyse the dimensionality of input, process and output and investigate the direct and indirect impact of inputs on process and outputs. Our analysis provides evidence that input factors have a direct impact on the output factor transparency, but their impact on effects on policy and participant satisfaction is mediated by the process factor deliberation. Further, the capacity of the public administration to steer the advisory council (wardship) mediates negatively the impact of input variables on transparency. The analysis provides a nuanced account of how different input and process design characteristics of participatory institutions have profound direct and indirect effects on their outputs.     

Government reform in Canada

Today the Canadian federation is facing various challenges. External factors such as globalization, changing markets and the revolution in communications, as well as internal factors such as a growing deficit and debt, provinces wanting more autonomy and uncontrolled government spending are some of the pressures Canada is facing. In 1994 the government launched the most important review of federal policies and programmes since the early 1950s. This article examines how Programme Review, the most important of these activities, is helping to refocus the role of the federal government in a way that would be meaningful to all Canadians. The implementation of the combined results of policy and programme review will involve reductions in government programmes, the development of new delivery agencies, the launching of new partnerships, and the achievement of greater efficiencies. The article also looks at the important role the Public Service of Canada is playing in responding to the need for change. (© 1997 by John Wiley & Sons, Ltd.)