The micro-politics of operational adjustment:veto players and the consolidation of demand in the NHS

Recent reports about procurement within the NHS have been highly critical. One problem identified in the reports is the fragmentation of NHS demand across an unnecessarily large number of suppliers. This fragmentation is said to increase transaction costs, reduce opportunities for scale economies and reduce NHS leverage over suppliers. It has been suggested, therefore, that an important way of improving procurement in the NHS is the better consolidation of demand with a lower number of preferred suppliers. However, such a policy, because it will create ‘winners’ and ‘losers’ within NHS organisations, has political as well as technical and practical ramifications. In this article, the authors present a model, the Veto Players Model, in order to assist managers to address these political ramifications. In the article, the authors not only demonstrate the utility of this model with regard to demand consolidation policies, but also argue that the model provides useful lessons for change management initiatives more generally.

Extreme events, organizations and the politics of decision making

Purpose – Threats of extreme events, such as terrorist attacks or infrastructure breakdown, are potentially highly disruptive events for all types of organizations. This paper seeks to take a political perspective to power in strategic decision making and how this influences planning for extreme events. Design/methodology/approach – A sample of 160 informants drawn from 135 organizations, which are part of the critical national infrastructure in the UK, forms the empirical basis of the paper. Most of these organizations had publicly placed business continuity and preparedness as a strategic priority. The paper adopts a qualitative approach, coding data from focus groups. Findings – In nearly all cases there is a pre-existing dominant coalition which keeps business continuity decisions off the strategic agenda. The only exceptions to this are a handful of organizations which provide continuous production, such as some utilities, where disruption to business as usual can be readily quantified. The data reveal structural and decisional elements of the exercise of power. Structurally, the dominant coalition centralizes control by ensuring that only a few functional interests participate in decision making. Research limitations/implications – Decisional elements of power emphasize the dominance of calculative rationality where decisions are primarily made on information and arguments which can be quantified. Finally, the paper notes the recursive aspect of power relations whereby agency and structure are mutually constitutive over time. Organizational structures of control are maintained, despite the involvement of managers charged with organizational preparedness and resilience, who remain outside the dominant coalition. Originality/value – The paper constitutes a first attempt to show how planning for emergencies fits within the strategy-making process and how politically controlled this process is.

The politics of remote sensing with particular reference to Developing Countries

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Bonfires and barbecues:coalition governance and the politics of Quango reform

The use of arm's-length bodies to deliver certain services, to regulate certain sectors or to assume responsibility for particularly salient political issues is neither new in historical terms or a feature unique to the UK in comparative terms. What is particularly distinctive, however, is the Coalition Government's attempts since 2010 to reduce the number of ‘quangos’ while also strengthening the capacity of the core executive and sponsor departments to control and co-ordinate this dense and fragmented sphere of delegated governance. Drawing upon the findings of the first research project to analyse the current Public Bodies Reform Agenda, this article provides an account of the ‘filling-in’ of the ‘hollowing out’. It argues that when viewed through a historical lens, the Coalition Government has adopted a distinctive approach to ‘the quango problem’.

From the medicalisation of dementia to the politics of memory and identity in three Spanish documentary films:Bicicleta, cullera, poma, Las voces de la memoria and Bucarest: la memòria perduda

This paper explores how the concept of Alzheimer’s disease (AD) is constructed through Spanish media and documentary films and how it is represented. The article analyses three documentary films and the cultural and social contexts in and from which they emerged: Solé´s Bucarest: la memòria perduda [Bucharest: Memory Lost] (2007), Bosch´s Bicicleta, cullera, poma [Bicycle, Spoon, Apple] (2010) , and Frabra’s Las voces de la memoria [Memory´s Voices] (2011). The three documentary films approach AD from different perspectives, creating well-structured discourses of what AD represents for contemporary Spanish society, from medicalisation of AD to issues of personhood and citizenship. These three films are studied from an interdisciplinary perspective, in an effort to strengthen the links between ageing and dementia studies and cultural studies. Examining documentary film representations of AD from these perspectives enables semiotic analyses beyond the aesthetic perspectives of film studies, and the exploration of the articulation of knowledge and power in discourses about AD in contemporary Spain

The meaning of ‘place’ in families’ lived experiences of paediatric outpatient care in different settings:a descriptive phenomenological study

Health service reforms in the United Kingdom have sought to ensure that children and young people who are ill receive timely, high quality and effective care as close to home as possible. Using phenomenological methods, this study examined the experience and impact of introducing new, community-based paediatric outpatient clinics from the perspective of NHS service-users. Findings reveal that paediatric outpatient ‘care closer to home’ is experienced in ways that go beyond concerns about location and proximity. For families it means care that ‘fits into their lives’ spatially, temporally and emotionally; facilitating a sense of ‘at-homeness’ within the self and within the place, through the creation of a warm and welcoming environment, and by providing timely consultations which attend to aspects of the families’ lifeworld.

Place-renewing leadership:trajectories of change for mature manufacturing regions in Europe

The forces of globalisation now impacting on local economies pose threats to the existing paradigm of competences and routines, yet simultaneously offer opportunities to integrate new knowledge and learning. This is particularly pertinent with respect to Europe’s ‘mature regions’, which are undergoing a major economic restructuring by trying to shift from traditional manufacturing activities to hybrid activities that comprise a combination of manufacturing and a higher component of intangible inputs and related knowledge service activities. The objective of the article is to discuss the concept of ‘place leadership’ by looking at how the embedded skills, knowledge and cumulated learning of a place can be used by its institutional infrastructure to identify sustainable growth trajectories. In other words, its aim is to explore how the economic, social, institutional and cultural aspects of places shape the opportunities for upgrading and renovation drawing upon their historical specialisation. The conceptual contribution of the article draws on two case studies, in the West Midlands, UK and in Prato, Tuscany, where we study the processes of decision-making, forms of leadership and ultimately the nature of local leadership.

Developing and applying a place brand identity model:the case of Slovenia

This paper reviews the concept of place brand identity within the supply side aspect of place branding. With no widely accepted model of place brand identity, the paper proposes a new model, which has its roots in marketing, tourism and sociological theory. The model focuses on the country brand of Slovenia, representing the first systematic branding process in Slovenia's short history. The development of a research program followed a holistic approach involving key influencers and enactment stakeholders. This novel approach has several advantages over the previously uncoordinated country branding attempts. © 2012 Elsevier Inc.