Policy emergence and policy convergence: the case of 'scientific-bureaucratic medicine' in the United States and United Kingdom

This article examines how the rather similar approaches to the management of medical care (which here we term 'scientific-bureaucratic medicine') emerged within the public-policy agendas of both the United Kingdom and United States during the 1990s. In particular, we address the theoretical puzzle of how explanations of policy emergence in single countries can be reconciled with policy convergence between two countries.     

A longitudinal study of moral and ego development in young adults

The purpose of this study was to investigate the longitudinal changes in moral judgment and ego development in a young adult sample when a concurrent measure of verbal ability was used as a statistical control. Sixty-one late adolescents and young adults, representing three educational groups, were tested in 1977 and 1979 on the Defining Issues Tests, a measure of moral judgment (Rest), the Sentence Completion Test of Ego Development (Loevinger and Wessler) and Terman's Concept Mastery Test, a measure of verbal ability. No group or time differences were found in ego development. A significant increase was found between the 1977 and 1979 moral judgment scores,p<0.05, and between groups at both testing,p<0.001. Sex differences were found,p<0.01, with females scoring higher than males, which were statistically accounted for by verbal ability. These findings suggest that moral development continues into the young adult years and that verbal ability may moderate sex differences in moral judgment.     

Designing Health Service Organization in the UK, 1968 to 1998: from Blueprint to Bright Idea and ‘Manipulated Emergence’

Four sets of reforms of the National Health Service are employed to illustrate the changing character of policy making in this sector over a thirty year period, from the production of a carefully developed technocratic blueprint for its organization to the promulgation of a series of bright ideas accompanied by incentives for local actors to develop them into concrete organizational arrangements consonant with these ideas. We term this latter approach ‘manipulated emergence’ and relate it to the literatures of organizational culture and of post-Fordism. The approach adopted by the 1997 Labour government is largely, though not wholly consistent with this, and it remains to be seen whether the high-water mark of manipulated emergence has passed.     

Protecting Intellectual Property on The Internet. Experience and Strategies of Trade Mark Owners in a Time of Chance

It is often stated that the protection of names, brands and trade marks on the Internet is a critical issue for intellectual property (IP) owners. However, while tales of infringement abound, there have been few court cases. IP specialists looking to establish a policy for the protection of names on the Internet need to assess the scale of the problem. What evidence of infringement or abuse exists? How are trade marks at risk-just in the domain name system or on other parts of the Internet? Can the courts or registration authorities be relied upon to support intellectual property owners? Is affordable net protection a myth or a reality for trade mark owners? This article attempts to quantify the risk of infringement or abuse of intellectual property, to examine measures of control proposed by the World Intellectual Property Organization (WIPO) and to suggest policies that can be adopted to minimise the risk of infringement and to maximise the chance of successful action against infringers.     

Cutting the bars: thoughts on ‘prisoners and escapees’ in Bangladesh

The idea that problems in governance have deep roots in social structure has been revisited by Geof Wood in a recent article in this journal. His article takes a position in relation to an ongoing debate about how to improve public administration and management in Bangladesh, a debate that seems to be almost as ‘imprisoned’ in incompatible values and premises as, he argues, are the various Bangladeshi actors in society. But behind this debate are some very practical issues about how the administration there might be persuaded to work better. Key to his contribution is the idea of ‘room for manoeuvre’ or conditions for ‘escape’. This article argues that embedded institutions and values matter but that behaviour is also responsive to opportunity. ‘Old’ values can be put together into new institutional complexes if given a chance. The key to successful institutional change is effectiveness. ‘Escape’ is not only, or even primarily, a matter of changing values but of responding to circumstances and changing institutions—cutting the bars. A close look at institutional and organizational reform in any country, including the UK, shows that, whatever moral language and posture inform the reform agenda, it is constructive compromise that produces the structure that works. Copyright © 2002 John Wiley & Sons, Ltd.