Egészségügyi reform Horvátországban (Health reform in Croatia)

A horvátországi egészségügyi reform célja a decentralizáció elvén alapuló egészségügyi rendszer létrehozása volt. Az egészségügyi szolgáltatások költségnövekedése által okozott terheket a központi költségvetés helyett egyre nagyobb mértékben a lakosság viseli, miközben kiegészítő biztosítás létrehozásával megkísérelték csökkenteni a változások nemkívánatos következményeit. A gyógyszer-finanszírozási rendszer átalakításával a költségcsökkentés mellett el akarták érni, hogy a betegek nagyobb arányban jussanak hozzá a modern, innovatív gyógyszerekhez. ________ The Croatian health care system faced great challenges during the1990s. The aim of the paper is to review some important aspects of the Croatian health care reform. Establishing a decentralized health care system was an important section of the reform. As a new element of the health insurance system, burdens generated by the increase of costs of health services have fallen on the society increasingly, while complementary health insurance tried to decrease the undesirable consequences of the changes. The objective of the drug-financing reform was to reduce the costs and improve access to innovative medicines as well. As regards the success of the reforms, besides increasing incomings, the method and result of the spending of the health insurance funds is crucial.

Schizophrenic Public Administration Reform in Hungary. Tension between anti-NPM systemic and pro-NPM organizational reforms

The aim of this paper is to shed the light on the relationship between New Public Management and Hungary’s Zoltán Magyary Public Administration Development Programme. As will be shown, the Magyary Programme has a dual structure. The systemic reforms run counter to the NPM philosophy because the main goal is the centralization of public administration, while NPM clearly advocates decentralization. At the same time, reform proposals on the organizational level conform to NPM. The inconsistencies in the Magyary Programme itself and the probable political and organizational resistance towards its proposals could delay the introduction of reforms on the organizational level.

Schizophrenic public administration reform in Hungary. Tension between anti-NPM systemic and pro-NPM organizational reforms

The aim of the paper is to highlight the main characteristics of the recent Hungarian public administration reform, as well as to reveal the inconsistent nature of some of its elements and to describe the connected risks. The starting point of the article is the Magyary Zoltán public administration development programme. The reform steps are compared to the ideal type NPM approach. The Hungarian public administration reform can be characterized by strong centralization and the revitalization of Hungarian anti-liberal traditions at macro level, and by the support of the enhancement of market rules and management at micro level.

Tradition, innovation and reform in local development. Conference proceedings

Understanding Local Development as the interaction of a complex mosaic of measures, resources and actors requires having an interdisciplinary perspective.‘Local’ means small-scale, focused, and within reach - one would suggest -, while comparing or understanding inter-regional dynamics (putting what we mean by ‘locality’ on the global map) is what brings into sight traits, which can be treated as universal, typical or individual. The sections of the conference tackled this kaleidoscope of themes that has evolved around tradition, innovation and reform, with roots in both academia and policy-making connected to entrepreneurship, governance, economic and social structure, the labor market and human capital.

Process of privatization: Benefits of *reform in management of public housing

The study of the private management of public housing is an important topic to be critically analyzed as the government search for ways to increase efficiency in providing housing for the poor. Public Housing Authorities must address the cost for repairing or replacing the deteriorating housing stock, the increase in the need for affordable housing, and the lack of supply. There is growing pressure on efficient use of public funds that has heightened the need for profound structural reform. An important strategy for carrying out such reform is through privatization. Although privatization does not work in every case, the majority position in the traditional privatization literature is that reliance on private organizations normally, but not always, results in cost savings. ^ The primary purpose of this dissertation is to determine whether a consensus exist among decision-makers on the efficiency of privatizing the management of public housing. A secondary purpose is to review the techniques (best practices) used by the private sector that results in cost-efficiencies in the management of public housing. The study employs the use of a triangulated research design utilizing cross-sectional survey methodology that included use of a survey instrument to solicit responses from the private managers. The study consists of qualitative methods using interviews from key informants of private-sector management firms and public housing agencies, case studies, focus groups, archival records and housing authorities documents. ^ Results indicated that important decision-makers perceive that private managers made a positive contribution to cost-efficiencies in the management of public housing. The performance of private contractors served as a yardstick for comparison of efficiency of services that are produced in-house. The study concluded that private managers made the benefits of their management techniques well known creating a sense of competition between public and private managers. Competition from private contractors spurred municipal worker and management productivity improvements creating better management results for the public housing authorities. The study results are in concert with a review of recent research and studies that also concluded private managers have some distinct advantages to controlling costs in the management of public housing. ^

Women and peace in a divided society:peace-building potentials of feminist advocacy and reform in Bosnia and Herzegovina

Despite an improving international rhetoric highlighting the necessity of women’s participation in postwar settings, women still tend to be disadvantaged in peace-building processes (Chinkin and Charlesworth, 2006; United Nations, 2002). This chapter argues that women’s struggles for rights entail important potentials for peace-building in divided postwar societies. Women frequently are among the first who cooperate across ethnic divisions established and hardened during ethno-political wars. Feminist policy reforms often strengthen common state structures and their legitimacy, contributing to the overcoming of ethnic divisions. Women’s participation and contributions should, therefore, be much more recognized and promoted in peace-building processes. However, it is feminist advocacy that is key, not women’s participation per se. Women have often promoted nationalistic and violent agendas; yet, only if they champion the rights of women independent of their ethnic and political differences can peace-building potentials come into effect.

Who Governs Educational Change? The Paradoxes of State Power and the Pursuit of Educational Reform in Post-Neoliberal Ecuador (2007-2015)

This study identifies and compares competing policy stories of key actors involved in the Ecuadorian education reform under President Rafael Correa from 2007-2015. By revealing these competing policy stories the study generates insights into the political and technical aspects of education reform in a context where state capacity has been eroded by decades of neoliberal policies. Since the elections in 2007, President Correa has focused much of his political effort and capital on reconstituting the state’s authority and capacity to not only formulate but also implement public policies. The concentration of power combined with a capacity building agenda allowed the Correa government to advance an ambitious comprehensive education reform with substantive results in equity and quality. At the same time the concentration of power has undermined a more inclusive and participatory approach which are essential for deepening and sustaining the reform. This study underscores both the limits and importance of state control over education; the inevitable conflicts and complexities associated with education reforms that focus on quality; and the limits and importance of participation in reform. Finally, it examines the analytical benefits of understanding governance, participation and quality as socially constructed concepts that are tied to normative and ideological interests.

Human resource management reform in the Indonesian civil service : towards strategic fit?

Studies of strategic HRM have dominated HRM research over the last three decades. Focusing on the HRM-organisation performance relationship, researchers take various themes and perspectives in their approach to strategic HRM. Among these themes, two contrasting approaches of strategic HRM continue to flourish: first, the best practice approach suggests that certain HRM practices will have the same effect irrespective of context and, second, the best fit approach suggests that the choice of HRM practices should be designed in accordance with an organisations’ specific context. While there is little consensus on what constitutes strategic HRM, the most common feature agreed in this field is the notion of the strategic integration; aligning HRM practices with organisations’ overall strategic objectives (vertical fit) and with each other (horizontal fit). Utilising the best fit approach as its theoretical framework, this study examines how vertical and horizontal fit is practised in the Indonesian civil service and what factors likely influence the prevalence of vertical and horizontal fit in the Indonesian civil service context. This study is significant for two important reasons. Firstly, the literature suggests that there are limited studies examining the best fit concept in the civil sector despite its implementation in the private sector positively contributing to organisational performance improvement. Secondly, the study provides enlightenment on how the best fit approach could contribute to performance improvement in the Indonesian civil service. This is in line with the fact that negative images of the Indonesian civil service are continuously highlighted although various HRM reform initiatives have been put in place. To achieve the objectives of the study, the qualitative case study approach accompanied by semi-structured interviews was employed involving 53 senior officials and one focus group discussion from eight Indonesian government agencies, consisting of three central agencies mandated to manage human resources, the National Bureaucratic Reform Team and four line agencies from both central and local governments. Thematic analysis was employed for data analyses and NVIVO software was used to manage the data. The study suggests three main findings. First, various HRM initiatives in relation to the HRM reform have been introduced in the Indonesian civil service differentiating them from the old HRM practices. However, the findings indicate that some HRM policies are still contradicting and hinder vertical and horizontal fit. Second, despite the contradictory policies, vertical and horizontal fit can be seen in the line agencies which have been acknowledged as ‘reformed agencies’. This demonstrates that the line agencies play an important role in aligning HRM practices with the line agencies’ goals and objectives and with one another although they are bounded by HRM policies that are unlikely to support the vertical and horizontal fit concept. Third, factors influencing the prevalence of vertical and horizontal fit include knowledge of contemporary HRM in both central agencies and line agencies, commitment from the line agencies’ leaders, devolvement of HRM to the line agencies and the socio-political and economic environments of the Indonesian civil service. The findings of the study raise policy, practical and theoretical implications. In terms of policy implications, the study highlights the importance of fit in HRM policies to support the achievement of the line agencies’ goals. Therefore, when formulating an HRM policy, the central agencies need to ensure that the HRM policy is linked to line agencies’ goals and to other HRM policies. This is to ensure synchronisation among the policies and thus maximising the achievement of the line agencies’ goals. From the practical perspectives, the study highlights important points which can be learned by the central agencies in carrying out their strategic role with regard to the formulation of HRM policies; by the line agencies in maximising the contribution of HRM to the achievement of the goals and objectives of the agencies through the implementation of the best fit concept, and by the leaders of the agencies in providing continuous support to each of the involved parties in the line agencies and involving the HRM department in all agency’s strategic decision-making. In relation to the theoretical implication, it is clear that the best fit approach is not thoroughly applied due to factors discussed previously. However, this does not mean that the best fit concept cannot be implemented. As argued by McCourt & Ramgutty-Wong (2003), instead of adopting the whole concept of best fit, a modulated approach reflecting the best fit concept, such as selecting individual HRM practices and experimenting with devolution, is possible for civil service organisations which still embrace centralised HRM systems. As demonstrated in the findings, some of the line agencies being studied seem to be ready to adopt the best fit approach given that they have knowledge of the best fit concept, strong support from the top leader, less political intervention and less corruption, collusion, and nepotism practices in their HRM practices.

Land Reform, Latifundia and Social Development at Local Level in Colombia, 1961-2010

The paper analyzes the effects of land reform on social development – poverty and land distribution-at the local level. Land reform in Colombia, understood as the allocation of public land to peasant, has granted 23 million hectares which comprises around 20% of Colombian territory and about 50% of usable productive land. Theoretically, the net impact of land reform on development is the combination of a poverty effect and a land distribution effect. Our findings suggest that land reform from 1961 onwards has slightly reduced poverty and mildly improved land distribution. Nonetheless,municipalities with strong presence of latifundia prior to1961 have experienced both a slower drop in poverty and a weaker improvement of land distribution .This paper finds that prevalence of latifundia partially offset the positive effect of land reform in promoting social development.

Out of hours service in Denmark: evaluation five years after reform

Objective: Five years after its introduction, to evaluate the 1992 reform in the out of hours service in Denmark.

Public Lawyers and Marijuana Regulation

Although 23 states and the District of Columbia have now legalized marijuana for medical purposes, marijuana remains a prohibited substance under federal law. Because the production, sale, possession and use of marijuana remain illegal, there is a risk of prosecution under federal laws. Furthermore, those who help marijuana users and providers put themselves at risk — federal law punishes not only those who violate drug laws but also those who assist or conspire with them to do so. In the case of lawyers representing marijuana users and businesspeople, this means not only the real (though remote) risk of criminal prosecution but also the more immediate risk of professional discipline. Elsewhere, we wrote about the difficult place in which lawyers find themselves when representing marijuana clients. We argued that while both the criminal law and the rules of professional conduct rightly require legal obedience from lawyers, other countervailing factors must be considered when evaluating lawyers’ representation of marijuana clients. In particular, we asserted that considerations of equity and access to justice weigh dispositively in favor of protecting lawyers who endeavor to help their clients comply with state marijuana laws, and we suggested means of interpreting relevant criminal law provisions and rules of professional conduct to achieve this result. This article builds on that analysis, taking on the particular issue of the public lawyer’s’ role in marijuana regulation. For government lawyers, the key issues in exercising discretion in the context of marijuana are not clients’ access to the law and equality but rather determining the clients’ wishes and serving them diligently and ethically. Lawyers representing state agencies, legislatures and the executive branch of government draft and interpret the rules and regulations regarding marijuana. Lawyers for federal, state and local governments then interpret those rules to determine the obligations and responsibilities of those they represent and to help their clients meet those obligations and carry out their required tasks. Both state and federal prosecutors are charged with determining what conduct remains illegal under the new rules and, perhaps more importantly, with exercising discretion regarding whom to prosecute and to what extent. Marijuana regulation is not a niche area of government regulation; it will influence the practice of virtually every public lawyer in the years to come. Public lawyers must understand the changes in marijuana law and the implications for government clients. Given the pervasiveness of the modern regulatory state, the situation is no easier — and, in many ways, it is more complicated — for public lawyers than it is for private ones. Public lawyers face myriad practice challenges with respect to marijuana law reform, and while we do not purport to identify and resolve all of the issues that are sure to arise in this short paper, we hope that the article helps alert public lawyers to some of the risks involved in participating in marijuana regulation so that they can think carefully about their obligations when these issues arise.