Contracting–out social services

Abstract: Despite the enormous share of social services in government spending and the strong incentives on government to rationalize services, the alternative service delivery (asd) literature has given little attention to social–service delivery. In our paper, we review current approaches taken to social–service delivery in Ontario by the Ministry of Community and Social Services (mcss). Although the mcss retains responsibility for the social–services system, it provides social services almost exclusively through private non–profit agencies under purchase of service contracts. Two themes emerge from our examination of these relationships. First, the standard privatization model has limited application to social–services delivery. Contracts are generally not awarded in a competitive fashion, and contract termination discipline is rarely applied. Given the inadequacies of current performance measures for social services, monitoring contract performance is difficult. Second, the success of attempts to shift provision to private non–governmental entities is intimately linked to the effectiveness of accountability mechanisms, especially outcome–based performance measures. Improving performance measurement is therefore an important priority. In addition to advocating further research into the effectiveness of social services, one interesting mcss initiative has been to look to client communities to help monitor the performance of agencies. We conclude that among the different institutional approaches to social–service delivery, contracting with non–profits is the one that currently seem most appropriate. Sommaire: Malgré la part énorme des dépenses gouvernementales consacrée aux services sociaux et malgré les efforts gouvemementaux pour rationaliser les services, les ouvrages publiés sur la prestation de services par des moyens de rechange n'ont consacré que peu d'attention à la prestation des services sociaux. Nous examinons dam cet article les méthodes adoptées pour la prestation des services sociaux en Ontario par le ministére des Services sociaux et communautaires (mssc). Même s'il retient la responsabilité du réseau des services sociaux, le mssc foumit les services sociaux presque exclusivement par I'intermédiaire d'organismes privés à but non lucratif, en vertu de contrats d'achat de services. En examinant ces rapports, nous en dégageons deux thémes. Premiérement, le modéle de privatisation standard ne s'applique que de maniére limitée à la prestation des services sociaux. Les contrats ne sont généralement pas accordés de maniére concurrentielle, et on n'utilise que rarement la résiliation de contrats en tant que mesure disciplinaire. II est difficile de surveiller la qualité d'exécution des contrats, vu l'insuffisance des mesures de rende–ment actuelles concernant les services sociaux. Deuxièmement, le transfert de I'exé–cution aux organismes privés non gouvernementaux ne peut réussir qu'en présence de mécanismes de responsabilisation adéquats, et en particulier de moyens permet–tant de mesurer le rendement en fonction des résultats obtenus. I1 importe donc d'améliorer les moyens de mesure du rendement. Selon le mssc, en plus des recher–ches suppéementaires concernant l'efficacite des services sociaux, il faut faire appel aux groupes de clients pour aider À surveiller le rendement des organismes. En conclusion, parmi les diverses méthodes institutionnelles de prestation des services sociaux, la sous–traitance faisant appel aux secteurs à but non lucratif semble çtre aujourd'hui la plus appropriwaee. [I]t is no exaggeration to say the state and local governments tend not to know what results their social service contracts are buying. Because competition is low, they have little opportunity to test the market to see what alternatives they have. Few resources are spent to look past what contractors themselves report. The political system has few incentives to dig deeper and many more incentives to maintain the status quo— The problems with oversight underline earlier observations: whatever advantages contracting–out for social services might produce, greater efficiency through market–tested competition is not one of them. State and local governments are engaging in the equivalent of a shopping trip while blindfolded, with little effort spent to squeeze the tomatoes or thump the watermelons     

The Quality of Terror

I present a model of the interaction between a government, a terrorist organization, and potential terrorist volunteers in which, as a result of an endogenous choice, individuals with low ability or little education are most likely to volunteer to join the terrorist organization. However, the terrorist organization screens the volunteers for quality. Consequently, the model is consistent with two seemingly contradictory empirical findings. Actual terrorist operatives are not poor or lacking in education. And yet lack of economic opportunity and recessionary economies are positively correlated with terrorism. The model also endogenizes the effect of government counterterrorism on mobilization. Government crackdowns have competing effects on mobilization: they decrease the ability of terrorists to carry out effective attacks (making mobilization less attractive), and they foment ideological opposition to the government and impose negative economic externalities (making mobilization more attractive). This provides conditions under which government crackdowns increase or decrease mobilization.     

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.     

Who are the Darfurians? Arab and African identities, violence and external engagement

This article examines processes of identity formation in Darfur,now part of the Republic of Sudan, over the last four centuries.The basic story is of four overlapping processes of identityformation, each of them primarily associated with a differentperiod in the region's history: namely, the ‘Sudanic identities’associated with the Dar Fur sultanate, Islamic identities, theadministrative tribalism associated with the twentieth-centurySudanese state, and the recent polarization of ‘Arab’and ‘African’ identities, associated with new formsof external intrusion and internal violence. It is a story thatemphasizes the much-neglected east-west axis of Sudanese identity,arguably as important as the north-south axis, and redeems theneglect of Darfur as a separate and important locus for stateformation in northern Sudan, paralleling and competing withthe Nile Valley states. It focuses on the incapacity of boththe modern Sudanese state and international actors to comprehendthe singularities of Darfur, accusing much Sudanese historiographyof ‘Nilocentrism’, namely, the use of analyticalterms derived from the experience of the Nile Valley to applyto Darfur.     

Explaining differences in productive efficiency: An application to Belgian municipalities

The purpose of this paper is to measure and explain variations in productive efficiency of municipal governments in Belgium. Technical efficiency is evaluated using a non-parametric method based on the Free Disposal Hull (FDH) reference technology. We first calculate input, output, and graph Farrell efficiency measures for a cross-section of all 589 Belgian municipalities. In a second stage of the analysis we explain the calculated differences in efficiency in terms of variables related to the structural characteristics of municipalities and to the institutional environment.     

The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies

Interpreting a myocardial inflammation as causal, contributory or as of no significance at all in the cause of death can be challenging, especially in cases where other pathologic and/or medico-legal findings are also present. To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases. We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death. Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations, the predominant inflammatory cell type, and the presence of inflammation-associated myocyte injury, fibrosis, edema and hemorrhage. Next, the cases were divided over three groups, based on the reported cause of death. Group 1 (n = 27) consisted of all individuals with an obvious unnatural cause of death. Group 2 (n = 29) included all individuals in which myocarditis was interpreted to be one out of more possible causes of death. Group 3 (n = 23) consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy, and no other cause of death was found. Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation (Group 1) or a potentially significant one (Groups 2 and 3). No other histological parameter showed significant differences between the groups. Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a (potentially) significant one.     

‘The time of storms’: managing bourgeois girls’ puberty in France, 1800–1870

This article examines the medical literature published in France in the period 1800–1870 on the subject of puberty and menstruation to argue that, in conjunction with the extension of school life for bourgeois girls, the period saw the emergence of a distinctive conception of feminine adolescence that pre-dates the better-known concepts articulated in the late nineteenth century. It goes on to look beyond the scientific discourse to ask what impact this new medical understanding had on the management of girls’ puberty, examining first the way it affected school practice, before using a detailed case-study of the life of Solange Dudevant to highlight the ways in which medicalised understandings of puberty and menstruation co-existed with other forms of knowledge.