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 referral decision scale with mentally disordered inmates

Correctional facilities are increasingly burdened with mentally disordered offenders and are faced with the formidable task of effectively screening inmates for major mental disorders and suicide potential. Teplin and Swartz (1989) developed the Referral Decision Scale (RDS) as a rapid screen for schizophrenia and major mood disorders in jail populations. However, more recent research by Hart, Roesch, Corrado, and Cox (1993) has called into question the effectiveness of the RDS. In this study, we examined the convergent and discriminant validity of the RDS with the Schedule of Affective Disorders and Schizophrenia—Change Version (SADS-C) and the Personality Assessment Inventory (PAI) on a sample of 108 mentally disordered inmates. The RDS provided moderate evidence of convergent validity but failed to demonstrate acceptable discriminant validity, because of high intercorrelations on RDS subscales (heterotrait-monomethod coefficients). In comparison, the SADS-C yielded similar evidence of convergent validity and excellent discriminant validity.The authors would like to thank the Research Opportunities Program, University of North Texas for its grant support and Captain James Moore for his active cooperation.Tarrant County Mental Health and Mental Retardation Services.     

Dirty tricks of cross-examination

A mock jury study was conducted to test the hypothesis that perceptions of a witness can be biased by presumptuous cross-examination questions. A total of 105 subjects read a rape trial in which the cross-examiner asked a question that implied something negative about the reputation of either the victim or an expert. Within each condition, the question was met with either a denial, an admission, or an objection from the witness's attorney. Results indicated that although ratings of the victim's credibility were not affected by the presumptuous question, the expert's credibility was significantly diminished—even when the question had elicited a denial or a sustained objection. Conceptual and practical implications of these findings are discussed.This research was supported by funds provided to the first author by the Bronfman Science Center.     

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.     

Comparison of fingernail striation patterns in identical twins.

The fingernail ridge patterns of a pair of identical twins were compared to each other, their parents, and an unrelated subject. The patterns of the twins' nails showed regions of strong similarity but were distinguishable from one another. Fewer similarities were found when comparing the nails to those of the parents and the unrelated control. The twins were shown to be monozygotic by means of DNA profiling. This therefore represents the first demonstration of unique fingernail ridge patterns in subjects shown conclusively to be identical twins. When the fingernail ridge patterns were examined with a scanning electron microscope, the backscattered electron (BEI) images were found to have superior contrast when compared to the secondary electron (SEI) images.     

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.