Reinvigorating publicly funded medicare in Ontario: new public policy and public administration techniques

Abstract: In the increasingly complex and “horizontal” environment of Canadian governmental decision‐making, the ability of governments to advance a major new policy initiative can be compromised or impeded by the often cumbersome systems evolved to ensure both due diligence and a comprehensive approach. In Ontario, the urgent and multi‐faceted health care reform agenda has been implemented using a new set of policy‐development and program‐implementation techniques. This paper summarizes those reforms. In doing so, it outlines the degree to which the reform agenda has been implemented using techniques and processes that have been grafted onto or even short circuited existing decision‐making systems. The paper also draws conclusions about the potential utility of the Ontario experience both for health care reform and for developing new mechanisms to implement challenging, time‐limited reform agendas within parliamentary systems of government with politically neutral civil services. Sommaire: Dans le contexte de plus en plus complexe et “horizontal” de la prise de décisions gouvernementale au Canada, l'aptitude des gouvernements à promouvoir une nouvelle initiative politique majeure peut être compromise ou entravée par la lourdeur des systèmes élaborés pour assurer une diligence raisonnable et une approche exhaustive. En Ontario, le programme de réforme des soins de santé, urgent et polyvalent, a été mis en œuvre grâce à un nouvel ensemble de techniques d‘élaboration de politiques et de mise en œuvre de programmes. Le présent article résume ces réformes. Ce faisant, il souligne comment le programme de réforme a été mis en œuvre grâce à des techniques et processus qui ont été greffés, ou qui ont même court‐circuité les systèmes de prise de décisions existants. L'article tire aussi des conclusions sur l'utilité possible de l'expérience de l'Ontario en ce qui concerne la réforme des soins de santé mais aussi la mise au point de nouveaux mécanismes pour exécuter des programmes de réforme difficiles, à délai déterminé, au sein de systèmes parlementaires de gouvernement avec des fonctions civiles politiquement neutres.     

The psychodynamics of a work stoppage at the Tenth Pan American Games

A study of the various stressors faced by interns serving as security assistants at the Tenth Pan American Games and the coping mechanisms they utilized was undertaken during the months of July and August 1987. This study revealed that group development can be altered and maladaptive behavior can result among students experiencing high degrees of stress, frustration, and feelings of helplessness, who are subject to a leadership void. The data strongly support the need for planners of similar large-scale internship programs to consider group processes, organizational factors, and interpersonal relations if organizational goals are to be achieved, maladaptive coping mechanisms are to be avoided, and student stress is to be lessened.     

The relationship between education, experience, and police performance

This study used data from 299 police officers from 12 municipal police departments across the state of Virginia to determine the relationship between education and police performance. Performance was measured by supervisor evaluations of each officer's overall performance, communication skills, public relations skills, report writing skills, response to new training, decision making ability, and commitment to the police department. Significant correlations were found between education and most measures of performance. Most importantly, the results show a significant correlation between overall performance and education (r=24, p.<001). The only variables not proving to be significantly related to education were objective measures of the volume of arrests, number of times the officer required discipline, and number of accidents. Interestingly, the benefits of a college education do not become apparent until police officers gain experience. In addition, police, officers with only a high school diploma decreased in overall performance after five years of experience.     

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.     

Restoring accountability in pretrial release: the Philadelphia pretrial release supervision experiments

As drug arrests and jail overcrowding added pressure to increase pretrial release in localities during the 1980s and 1990s, the need to manage a larger and higher-risk pretrial population of defendants awaiting adjudication in the community became a high priority for justice agencies. In the late 1990s Philadelphia officials sought to discover the ingredients of a successful supervision strategy through four interlinked field experiments to provide an empirical basis for a major reform of the pretrial release system. The results of the linked randomized experiments question common assumptions about “supervision,” its impact and effectiveness, about the underlying nature of the noncompliant defendant, and deterrence implications. The study emphasizes the importance of interpreting the findings in the context of implementation of the policy reform. Findings suggest that facilitative notification strategies wield little influence on defendant behavior and that deterrent aims are undermined by the system's failure to deliver consequences for defendant noncompliance during pretrial release. The most significant contribution of the article is its illustration of a major evidence-based policy reform undertaken by a major court system.     

A CRITIQUE OF PROFESSOR CHURCH'S REPORT ON THE IMPACT OF VERTICAL AND CONGLOMERATE MERGERS ON COMPETITION

We discuss Professor Jeffrey Church's report to the EuropeanCommission in 2004 on the effects of vertical restraints andmergers. Although thorough and accurate, the report could bemisinterpreted by practitioners, as it does not emphasize thatmarket power is only a necessary condition for harm to competition,and that most vertical mergers that present the possibilityof competitive harm also present economic efficiencies thatare intrinsic to the integration.