Internal markets in the public sector: the case of the British National Health Service

This article discusses the application of internal markets to the publicly financed British National Health Service (NHS). The objective of internal markets is to obtain, through the stimulus of competition, greater efficiency, effectiveness, and responsiveness to consumer needs than would be obtained through continued direct government provision. There have been real advances in the NHS attributable to the internal market, not the least of which is a growth of debate, dynamism, experimentation, and entrepreneurial attitudes that contrasts sharply with the glacial pace of change prior to 1990. However, there is also a sense in which the reforms have, thus far, failed to achieve all their promoters hoped for. It is far from clear that efficiency gains exceed the high transaction costs associated with the reform. Competition remains restricted, information is inadequate, and the regulatory and legal framework is flawed. Lack of transparency and a clear publicly stated ‘end vision’ of the reform process, together with a refusal to evaluate it systematically, have heightened already intense controversy. This has blurred the fact that the internal market is not a panacea and cannot alone be expected to solve the problems of a health service where demand is accelerating faster than the resources available through taxation. (© 1997 by John Wiley & Sons, Ltd.)     

Street-Level Bureaucracy, Interprofessional Relations, and Coping Mechanisms: A Study of Criminal Justice Social Workers in the Sentencing Process

This article builds on the work of Michael Lipsky and develops an argument about the significance of interprofessional working for street-level bureaucracy. It presents an ethnographic analysis of criminal justice social workers writing presentence reports for the Scottish courts. Social workers' report writing for judges brought into relief issues of relative professional status. Social workers were uncertain of their place within the legal domain and concerned about their credibility as criminal justice professionals. Reports were written, in part at least, as a way of seeking esteem and credibility in the eyes of judges—a motivation that undermined the policy objectives of social enquiry in sentencing. Applying the conceptual tools of Bourdieu to our findings, we argue that street-level bureaucrats who have to work across bureaucratic "fields" may find, or fear, that the cultural and symbolic "capital" they retained within their own field is undervalued in the symbolic economy of new fields, putting them in a position of relative inferiority. This issue of relative professional status, and how officials respond to it, is significant for our understanding of street-level bureaucracy.     

ON IRON CAGES AND SUBOPTIMAL CHOICES: AN EXPERIMENTAL TEST OF THE MICRO-FOUNDATIONS OF ISOMORPHISM IN THE PUBLIC SECTOR

This study integrates experimental and qualitative data from a sample of public employees to investigate the micro-foundations of the isomorphic pressures that may lead to suboptimal decision making in the context of public administration. When asked to choose between two equally performing systems, subjects in our sample were inclined to favor the alternative that was encouraged by either a coercive, a mimetic, or a normative pressure. Participants tended to give in to isomorphic pressures, even when informed that the encouraged option was inferior. However, letting subjects autonomously infer the inferiority of the encouraged option from numerical data—rather than through an explicit textual prompt—proved effective in neutralizing the risk of sub-optimal decisions under isomorphic pressures. A consequent qualitative inquiry revealed that trust in the recommending institution or group, speculation about alternative performance dimensions, and compatibility with existing standards were the main drivers of suboptimal decision making.     

HOW POLICY‐MAKERS (REALLY) UNDERSTAND GLOBALIZATION: THE INTERNAL ARCHITECTURE OF ANGLOPHONE GLOBALIZATION DISCOURSE IN EUROPE

There is a growing acceptance in the literature of a potentially significant causal role for ideas about globalization in shaping the trajectory of policy and institutional reform in contemporary Europe. Yet we still know remarkably little about policy‐makers' understandings of globalization, save those they choose to declare publicly. This paper contributes to the important task of operationalizing empirically this key set of ideational variables. Using factor analysis of new survey data collected by the authors it maps and compares UK and Irish policy‐maker's understandings of, and orientations towards, globalization. The analysis reveals considerable similarities in the ordering of assumptions and attitudes towards globalization between the two country cases and between civil servants and parliamentarians. Yet it also shows some subtle and intriguing differences between policy‐makers' responses in the UK and Ireland and between elected and unelected officials. Intriguingly, it also suggests a significant disparity between politicians' private understandings and public discourses of globalization, with the former less necessitarian in tone than the latter. Above all, it suggests that Anglophone globalization discourse in Europe is principally structured in terms of a number of dimensions which relate to the acceptance or rejection of a series of core neoliberal premises. In effect, the terms and internal architecture of globalization discourse in the UK and Ireland are defined by neoliberal assumptions, to the extent that they provide the core point of reference and orientation for even the most sceptical and critical of views.     

CELEBRATING ADVERSITY: INTER‐ORGANIZATIONAL DEPENDENCE AND PUBLIC SECTOR PERFORMANCE REPORTING IN THE AUSTRALIAN FEDERAL POLICE

Many aspects of public policy delivery involve complex networks rather than independent agencies. Yet little work has been done to understand the nature of performance measurements in settings where the performance of one agency is heavily dependent on the activities of other agencies. The issue of dependence has implications for operational and reputational risks. Our case study is focused on performance reporting by the Australian Federal Police (AFP). Our findings indicate that performance reporting remains heavily focused on input and process measures with relatively few output or outcome measures. Contrary to expectation, the AFP did not claim credit for success and attribute poor performance to other stakeholders. However, a higher than expected proportion of the dependent performance measures were positively framed.     

WHAT IS GOVERNANCE IN THE ‘PUBLIC INTEREST’? THE CASE OF THE 1995 PROPERTY FORUM IN POST‐CONFLICT NICARAGUA

‘Public interest' (synonymous here with ‘common good’ and ‘public good’) is a central concept in public administration. In an important, basic sense, we evaluate the effectiveness of governments in terms of whether their policies are detrimental to, or benefit, public interest. However there are problems operationalizing public interest: it seems a concept that is simultaneously indispensable yet vague. While difficulties operationalizing public interest are widely understood, a further problem is insufficiently acknowledged. This is that many features underpinning public interest (a tradition of citizenship, stable government, a rule of law, basic infrastructures) are taken for granted in established democracies. However, in other contexts we cannot assume these. Examining what public interest means in developing countries can be useful to identify these taken for granted assumptions, and to re‐examine this ubiquitous and enduring concept. We do this through a case study of land rights reform in post conflict Nicaragua.     

A Regulatory Analysis of International Climate Change Regulation

The political challenges impeding the negotiation of a comprehensive multilateral agreement on international climate change have received a great deal of attention. A question that has gone somewhat overlooked is what essential components an effective regulatory scheme to reduce greenhouse gas emissions should contain. The objective of this article is to examine the regulatory architecture of current international arrangements relating to global climate change regulation. A systematic analysis of the structure, substantive composition, and administrative characteristics of the UNFCCC and Kyoto Protocol is undertaken. The analytical standard against which the agreements are examined is whether current international regulatory arrangements satisfy the basic requirements of regulatory coherence. The analysis identifies how the present scheme consists of a complex institutional structure that lacks a substantive regulatory core. The implications of the absence of functional and effective mechanisms to govern greenhouse gas emission reductions are considered in relation to the principles of good regulatory design. This, in turn, provides useful insights into how a better regulatory scheme might be designed.