What to Do When Stakeholders Matter: The Case of Problem Formulation for the African American Men Project of Hennepin County, Minnesota

We propose a series of stakeholder analyses designed to help organizations—especially governments—think and act strategically during the process of problem formulation in order to advance the common good. Specifically, we argue that at least five sets of analyses are necessary, including the creation of (1) a power versus interest grid; (2) a stakeholder influence diagram; (3) bases of power–directions of interest diagrams; (4) a map for finding the common good and structuring a winning argument; and (5) diagrams indicating how to tap individual stakeholder interests to pursue the common good. What the analyses do is help to transform a seemingly "wicked problem"—for example, how to produce better outcomes for African American men aged 18–30—into something more tractable, and therefore amenable to collective action. In other words, stakeholder analysis can be used to link political rationality with technical rationality so that support can be mobilized for substantive progress.     

Competition, Productivity and the Cult of 'More is Good' in the Australian Health Care Sector

Economic policy discussions emphasise growth, the maximisation of output, efficiency and the pursuit of rational self-interest. Many policymakers, bureaucrats and managers in health care have been influenced by economists who believe that competition and the marketplace will provide maximum output and efficiency. Thus, for some, health care involves treating more and more patients for the same money. They argue for strategies such as reducing waste, lowering costs, increasing inpatient throughput and introducing competition between providers, especially hospitals, in order to stimulate productivity to achieve their aim. Yet in health care more is not necessarily good. Embracing the culture of the marketplace in a predominantly publicly funded system runs the risk of failing to distribute health care services equitably, and leads to more inappropriate and unnecessary care. An approach that merely strives to treat more patients and lower costs should be rejected in favour of a health system that values effectiveness, health outcomes, quality and the public good, and is patient-centred not delivery system-centred.     

The Recruitment of Women Cabinet Ministers in the Canadian Provinces

Although there have been several studies of women in legislatures in Canada, a cabinet position is a much stronger position from which to wield power in an executive-centered and party-disciplined parliamentary system. In the past decade, the increase of women's share of legislative seats, for majority parties as well as others, has led to more women being appointed to cabinet portfolios. This article utilizes data from the ten Canadian provinces over an 18-year period, from 1976 to 1994, to assess patterns of such appointments by province, party, percentage of women in the governing party, and percentage of women in the legislature. The proportion of women in the governing party far outweighs other variables in its impact on the percentage of women in the cabinet, in contrast to a previous study of West European cabinets which found that more women in the legislature was of greater importance. Although a high level of multicollinearity indicates caution in attempting to distinguish between the impact of these two variables, the differences in these studies may be due to Canadian provinces having single-party majority governments while West European cabinets are often coalitions.     

Review Article

Book reviewed in this article:
Neal Blewett, A Cabinet Diary: A Personal Record of the First Keating Government     

Family Representative Payeeship and Violence Risk in Severe Mental Illness

Although representative payeeship is prevalent among people with mental illness and shows promise to positively influence clinically relevant outcomes, research also suggests this legal mechanism could be implemented in ways that are problematic. The current study examined whether family representative payeeship was associated with elevated risk of family violence perpetrated by persons with severe mental illness (SMI). Data were collected every 4 months for 1 year in structured interviews with N = 245 persons with SMI who received disability benefits. Multivariate analyses showed that substance abuse, history of violence, frequency of family contact, and family representative payeeship were associated with elevated odds of family violence. Analyses also showed family contact and family representative payeeship had a cumulative effect on increasing the predicted probability of family violence (controlling for covariates such as violence history and substance abuse). The data shed light on the potential for family representative payeeship to be associated with increased risk of interpersonal conflict and violence in SMI.