Marketization, Managers and Moral Strain: Chairmen, Directors and Public Service Ethos in the National Health Service

Survival of the public service ethos in Britain has been called into question following introduction of the 'new public management' and marketizing reforms in much of the public sector. This article examines how these developments have occurred in the NHS, using survey data to analyse NHS board members' substantive ethical values. Unexpectedly the results suggest that NHS board members with a predominantly NHS background appear less ethically conservative, more flexible and less risk–averse than those recruited from non–NHS backgrounds; and that as yet the NHS management 'culture' is not very homogenous in respect of 'business ethics'. The NHS reforms also appear to accentuate the tensions between transparent public accountability in NHS management and incentives not to publicize certain types of information. Recent codification of NHS 'business ethics' can be understood as an attempt to buttress the public service ethos against the increased moral strains of a quasi–market.     

Decision Making in Autocratic Regimes: A Poliheuristic Perspective

This paper applies the poliheuristic theory of foreign policy decision making to non-democratic states. Poliheuristic theory asserts that state leaders assign primary importance to their political survival; however, the meaning of "the political" varies dramatically from country to country. Furthermore, the types of actors who hold leaders politically accountable also vary between countries. Consequently, leaders often pursue vastly different means of ensuring their political survival. The author uses the common distinction between single-party, military, and personalist autocracies to show that apparently arbitrary differences in autocratic leaders' political concerns actually vary in systematic and potentially predictable ways. Because this argument is generalized to non-democratic states as a whole, it has important implications for the ways in which democratic states craft their policies toward autocracies.