32 resultados para health public policy
em Aston University Research Archive
Resumo:
Public policy becomes managerial practice through a process of implementation. There is an established literature within Implementation Studies which explains the variables and some of the processes involved in implementation, but less attention has been focused upon how public service managers convert new policy initiatives into practice. The research proposes that managers and their organisations have to go through a process of learning in order to achieve the implementation of public policy. Data was collected over a five year period from four case studies of capital investment appraisal in the British National Health Service. Further data was collected from taped interviews by key actors within the case studies. The findings suggest that managers do learn to implement policy and four factors are important in this learning process. These are; (i) the nature of bureaucratic responsibility; (ii) the motivation of actors towards learning; (iii) the passage of time which allows for the development of competence and (iv) the use of project team structures. The research has demonstrated that the conversion of policy into practice occurs through the operationalisation of solutions to policy problems via job tasks. As such it suggests that in understanding how policy is implemented, technical learning is more important than cultural learning, in this context. In conclusion, a "Model of Learned Implementation" is presented, together with a discussion of some of the implications of the research. These are the possible use of more pilot projects for new policy initiatives and the more systematic diffusion of knowledge about implementation solutions.
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Since the 1980s UK government enthusiasm for market reforms has reconfigured the nature and scope of public services. Initially the marketisation of public services changed how public services were provided, increasingly market reforms and pro business policies have also modified the formation and understanding of public policy problematics and how they ought to be resolved. This is particularly noticeable when markets work imperfectly or even fail. UK governments have shown their reluctance to employ regulatory instruments to change the behaviour of companies preferring instead to make use of softer interventions, by focusing on providing advice for consumers and urging individuals to act responsibly. The dilemmas of this approach are explored by discussing the UK's former Labour government's (1997–2010) response to the increase in the incidence of obesity and related health complications.
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In the UK academics are being urged to embrace interdisciplinarity in their research and teaching activities. In the case of public policy, there is a tension between the epistemological formations from the parent discipline of politics and garnering the benefits of interdisciplinarity. Furthermore, interdisciplinarity in public policy cannot and should not ignore cleavages in existing policy pathways. These concerns are discussed in the article by assessing the public policy of obesity in England and Wales.
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When Parties Matter looks at the extent to which political parties can make a difference to public policy, focusing on the regional level in Germany. Politicians of the left and the right sometimes have radically different views, but inevitably the combined forces of legal and financial constraints, bureaucracy, public expectations and the 'weight of history' restrict their ability to translate political disagreement into policy change. Giving a detailed examination of education policy, childcare and family policy, and labour market policy in three German regions between 1999 and 2006, this book provides insights into what politicians can and cannot achieve, in particular at the level below the nation-state.
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This paper discusses in way in which partisan influence upon public policy, and wider historical, political and institutional pressures, can operate on a regional level and can lead to divergent policies existing within a nation-state. It offers an empirical discussion of two policy areas (education and childcare) at the regional Level (the level of the Länder) in Germany, confirming that both the partisan composition of regional government, and also wider institutional and historical pressures, exert a clear influence upon policy, lead to sharply variations in policy within the nation state. Two conclusions can be drawn: that the region cab be an important unit of analysis in Political Science and Public Policy, and that scholars of policy change may find the regional level fertile ground in analysing wider political phenomena.
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As a contribution to current discussions about securing a legacy from the 2012 Olympic and Paralympic Games, this article considers whether there are lessons for public policy implementation around volunteer involvement. Drawing on the case of the Team London Ambassadors Programme which encompassed 8,000 volunteers during the Games period, the article considers the scope for an expanded role for UK public sector organisations in the recruitment, training and management of volunteers in the future.
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Purpose – This paper aims to investigate the manner in which technological innovation in the European electrical-grid sector has developed by focusing, in particular, on the effect of public policy on innovation. To achieve this aim, this paper highlights how technological innovation and development progressed from the 1960s to the 1980s, and contrasts this period with the deregulated/privatization environment. Design/methodology/approach – The paper is based on a series of in-depth multiple company case studies of grid companies, some of their suppliers and other actors in their broader business network. Empirical data were collected through 55 interviews. Findings – The authors find that a phase of mutual collaboration was encouraged in the first period, which led to strong technological innovation with a focus on product quality and the development of functionality. Buyers played a pivotal role in the development of products and posed technical requirements. In contrast, the current role of the buyer has transformed principally into one of evaluating competing bids for specific projects. Today, buyers face increasing pressure to substantially lower CO2 emissions and transform the energy grid system. These goals are difficult to achieve without a new way of thinking about innovation. Research limitations/implications – Models to achieve innovation must not only focus on individual research projects; instead, the innovation should be factored into normal business dealings in the supply chain. Practical implications – We propose that policymakers and regulators need to: accommodate for innovation and address the collaborative elements of innovation when developing policies and regulations. Furthermore, regulators have the option of either developing a strategic vision for the electrical-grid network or incorporating sustainability into the evaluation of electrical grids and, thus, consumers’ willingness to pay. Originality/value – This paper makes a distinctive contribution in the area of innovation for electrical grids. Our paper shows how innovation and the development of new technology for electrical grids changed over time. Furthermore, this paper describes the energy sector in terms of a business network comprising the different actors involved in innovation and development and, thus, their role in the energy supply chain.
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In the National Health Service (NHS) in England and Wales an oversight body, the Audit Commission (AC), defines the scope of the external auditors’ work, appoints the auditors and has oversight of their fees and audit quality. This heavily regulated audit regime mitigates some of the deficiencies observed in high profile corporate failures. Independence, it has been argued, is influenced by the total auditor remuneration paid by the client. In this study we examine total auditor remuneration in a regulated market which seeks to ensure audit independence and audit quality. In particular we undertake rigorous analysis of auditor remuneration by the type of auditor: We place emphasis on the differentiation between private sector firms and the AC’s in-house auditors (District Audit). Individual private audit firms charge premiums (up to 16%) for particular audit work in identified locations, but no premiums were found when we examined total auditor remuneration. The regime appears to permit efficient operation of the audit market while safeguarding both audit independence and standards.
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The most significant environmental change to support people who want to give up smoking is the legislation to ban smoking in public places. Following Scotland in March 2006, and Wales and Northern Ireland in April 2007, England moves one step closer to being smoke free on 1 July 2007, when it becomes illegal to smoke in almost every enclosed public place and workplace. Social marketing will be used to support this health promoting policy and will become more prominent in the design of health promotion campaigns of the future. Social marketing is not a new approach to promoting health but its adoption by the Government does represent a paradigm shift in the challenge to change public opinion and social norms. As a result some behaviours, like smoking or excessive alcohol consumption, will no longer be socially acceptable. The Department of Health has decided that social marketing should be used in England to guide all future health promotion efforts directed at achieving behavioural goals. This paradigm shift was announced in Chapter 2 of the “Choosing health” White Paper with its emphasis on the consumer, noting that a wide range of lifestyle choices are marketed to people, although health as a commodity itself has not been marketed. The DoH has an internal social marketing development unit to integrate social marketing principles into its work and ensure that providers deliver. The National Centre for Social Marketing has funding to provide ongoing support, to build capacity and capability in the workforce. This article describes the distinguishing features of the social marketing approach. It seeks to answer some questions. Is this really a new idea, a paradigm shift, or simply a change in terminology? What do the marketing principles offer that is new, or are they merely familiar ideas repackaged in marketing jargon? Will these principles be more effective than current health promotion practice and, if so, how does it work? Finally, what are the implications for community pharmacy?
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As public policy issues increasingly have a technical aspect to them an interactive relationship has developed between science and policy. The aim of this thesis is to investigate the two aspects of this relationship: the influence of science on policy and the influence of policy implications on science. Most existing studies in this area treat only one or other of these aspects. Furthermore, they tend to provide interesting case study material but very little theoretical analysis. This thesis attempts to overcome these problems by dealing with both aspects of the interaction between science and policy and by providing theoretical models of this relationship. The thesis combines the theoretical development of these models with the analysis of three empirical case studies: the controversy in Britain over smoking and health; the application of educational psychology to the development of education policy in Britain; the controversy over the health effect of lead in the environment. The theoretical models are developed in Part 1. In Part 2 the empirical case studies are presented and in Part 3 the theoretical material is assessed in the light of these case studies. The main thesis of this study is that there is a fundamental mismatch between science and policy-making. Criticism is always essential in science. However, when science is involved in the policy process, either scientific claims are not subjected to a significant level of criticism or they are scrutinized so closely that no view achieves general consensus and conflicting advice results. In this situation, contrary to the traditional view, science can generate uncertainty. The role which science plays in the policy process is influenced by this level of criticism, by the context of political power and by the progress of an issue through the various stages of the policy process.
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Although the last two decades have seen the healthcare systems of most developed countries face pressure for major reform, the impact of this reform on the relationship between empowerment, consumerism and citizen’s rights has received limited research attention. Globalisation, Markets and Healthcare Policy sets out to redress this imbalance. This book explores the extent to which globalisation and commercialisation relate to current and emerging health policies. It also looks at the implications for citizens, patients and social rights, as well as how policy making interacts with the interests of global and European trade and economic policies. Topics discussed include: •How the impact of globalisation on health systems is apparent in the influence of international actors and European policies. •How the impact of globalisation is mediated by national priorities and policies and is therefore reflected in diverse influences. •How commercialisation of health is presented as benefiting citizens and patients but has the potential to undermine the aims and values inherent in health systems. •How the role of citizens' interests, social rights, patient’s rights and priorities of patient and public involvement need to be separated from commercialisation, choice and consumerism in health care. Essential reading for policy makers and students of public policy, politics, law and health services, Globalisation, Markets and Healthcare Policy will also appeal to those interested in patient involvement international healthcare, international relations, trans-national organisations and the EU.
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Over the past fifteen years, an interconnected set of regulatory reforms, knownas Better Regulation, has been adopted across Europe, marking a significant shift in theway that European Union policies are developed. There has been little exploration of the origins of these reforms, which include mandatory ex ante impact assessment. Drawing on documentary and interview data, this article discusses how and why large corporations, notably British American Tobacco (BAT), worked to influence and promote these reforms. Our analysis highlights (1) howpolicy entrepreneurs with sufficient resources (such as large corporations) can shape the membership and direction of advocacy coalitions; (2) the extent to which "think tanks" may be prepared to lobby on behalf of commercial clients; and (3) why regulated industries (including tobacco) may favor the use of "evidence tools," such as impact assessments, in policy making. We argue that a key aspect of BAT's ability to shape regulatory reform involved the deliberate construction of a vaguely defined idea that could be strategically adapted to appeal to diverse constituencies.We discuss the theoretical implications of this finding for the Advocacy Coalition Framework, as well as the practical implications of the findings for efforts to promote transparency and public health in the European Union.