A Study of the Organizational Effectiveness of Clinics Serving the Poor

This paper reports on a study of the organizational effectiveness of small human service organizations serving indigent clients. Four important organizational activities of public health clinics were evaluated, namely providing services acceptable to clients, obtaining and retaining clients, resolving tension and conflict among the members of clinic staff, and maintaining organizational flexibility. Within a goal framework based on the dual-goal concept, the activities were identified either as externally -or internally-oriented goal activities. The extent to which the clinics carried out these activities was investigated by administering questionnaires to 709 indigent clients and 133 members of clinic staffs at 18 clinics. Findings concern the attainment of organizational goals, the interrelatedness of achievements of various effectiveness measures, and structural and human characteristics of the clinic organizations associated with the achievements.     

Strategic planning in non-profits: profit from it

Non-profit human service organizations, both public and private, face unique challenges and opportunities in the climate of the 1990s as human needs are increasing, funding is decreasing, and threats to organizational well-being are encountered. The purpose of this paper is to describe, advocate for, and illustrate a strategic planning model which facilitates a proactive, energizing, futuristic vision as services are being planned and delivered. Three case examples are used: a large state-run county social services department; a small, private, sectarian agency that provides group home services for the developmentally disabled; and a medium sized federal public health hospital.     

Public Participation in the New NHS: No Closer to Citizen Control?

Over the last decade support for increasing public participation in decisions regarding the planning and delivery of health services has become a familiar feature of the policy agenda for the UK National Health Service. This paper reviews current Labour policy towards public participation and reports on the response of primary care groups (PCGs) to recent Labour directives to make patient and public involvement an integral part of the way they work, presenting the findings of a survey conducted in one English health region. The experience of these PCGs suggests that, despite the diverse backgrounds of board members, there is marked consensus between local and central decision makers as to their understanding of public participation. Whilst academic debates have tended to conceptualize participation in dualist terms as a form of consumerism or of citizenship, the survey data suggest that in the context of local implementation public participation is framed within a new public management perspective which values it as an aid to organizational learning. The findings of this study highlight obstacles to securing effective public participation, including a lack of substantive guidance regarding policy implementation that produces uncertainty amongst local decision makers as to how best to proceed. The inherent limitations of public participation within the new public management paradigm suggest that democratic renewal, one of the goals of the government's modernization agenda, is unlikely to be achieved.     

In the Eye of the Storm: Civil Servants and Managers in the UK Department of Health

In the wake of the 2008 financial crisis, the UK government faces some tough choices over public expenditure, and these choices will have important implications for both the future of health policy and the way in which health services are managed. In this article, we examine the organization and leadership of the UK Department of Health and weigh its suitability to meet such challenges. We find an organization that is culturally split between public servants and managers, highly reliant on the ability of its key personnel to bridge these divides, and extremely responsive to the political goals of government ministers. We explore the modern DH using three types of evidence. First, the history of the department shows clear political efforts to reduce civil service discretion and focus the DH on the management of the English NHS. Second, the recent organizational structures of the DH show a bifurcation between policy direction and NHS management tasks. Third, an analysis of the top ranks of the department since 2005 shows the implementation of political preferences that are consistent with managerialism but inconsistent with the perceived characteristics of traditional civil servants. The result is a department which has changed just as frequently as the health service it oversees – a department which has been moulded by successive ministers into one for the management of the NHS. Our findings raise important questions about the value and purpose of long‐term organizational knowledge in policy formulation.     

A Review of Institutional Reform over the Past 30 Years from the Perspective of Change Management

The Leading Group for Deepening Reform Comprehensively has been set up on the decision of the CPC Central Committee to be in charge of the overall planning of reform, taking a balanced and coordinated approach, advancing reform as a whole and supervising its implementation. This means that change management has become an important item on the agenda. Systematically reviewing and examining the course of the seven rounds of institutional reform introduced by the State Council since 1978 from the perspective of change management, we find that the reforms have advanced gradually and steadily, with functional transformation as the core feature and key to each round of reform. The transformation of government functions exhibits a marked two-phase character. The first phase focuses on change in government functions relating to economic management, while the second focuses on enhancing and improving macro-control systems to strengthen social management and public service functions. However, in terms of program design, the goals and measures of the past 10 years’ functional transformation have clearly not been specific enough to establish a clear relationship between the three rounds of institutional reform programs and the concrete measures and their effects. Therefore, the question of whether institutional reform itself needs reform has become a new proposition for practice, one that needs to be reviewed in terms of strategic orientation, mode of implementation, public responsibilities and overall design.     

Post-crisis learning in public agencies: what do we learn from both actors and institutions?

Post-crisis learning is a challenge for public organizations, and especially for agencies which handle health and environmental risks. This article investigates how the Belgian Food Safety Agency settles mechanisms for drawing lessons from crises while ensuring day-to-day routine. The framework by Crozier and Friedberg is used as a guideline to consider both the actors and the system, both strategic games and institutional constraints. The article helps in understanding the institutional logics underpinning how the public organizations learn from societal risk and crisis. Centralization and openness appear to be guiding principles, resulting from the learning games. They also generate tensions that the actors’ games manage by defining new rules for cooperation. Both the practice (through our case study) and the theory (combining actors and institutions) broaden the lens of policy analysis for what policy-making at organizational level concerns.     

When is a Health Department not a Health Department? The Case of the US Department of Health and Human Services

Given the current policy debate over health reform in the United States, it is not possible to describe the organizational structure that might emerge from this process. This article explores five of the attributes that underpin the context for a discussion of the structure and operation of a health bureaucracy in the USA. First, ambivalence in the US society about a public commitment to health and a general scepticism about a significant public sector in this area. Second, separation within the system between types of activities (e.g. health research activities, provision of services, and financing of health efforts). Third, the health system operates in the context of a government with shared powers as well as federalism and an assumption that some issues belong to states, and sometimes localities, and not to the federal government. Fourth, difficulty in the US system when it attempts to focus on prevention activities. And fifth, the structure of HHS creates tensions between management initiatives and professional expertise and standards. The article concludes with a discussion of possible organizational alternatives.     

突发事件与首都城市应急联动系统的构建

本文首先阐述了首都北京目前所面临的各种突发事件形态特点 ,在剖析北京城市应急联动系统的现状、问题与根源的基础上 ,提出了完善北京城市应急联动系统 ,尽快建立首都现代危机管理体系的相关建议     

我国社会慈善事业发展对策的思考

慈善事业作为我国社会保障体系的有机组成部分,是促进社会全面发展、构建社会主义和谐社会的一个战略选择。当前我国慈善事业发展中存在的问题主要表现在全社会尚未形成浓厚的慈善意识、慈善组织建设不够规范、组织自身能力建设不强、缺乏有效的管理与社会监督机制以及相关的法律法规不够健全。其相应的对策应是弘扬慈善文化、促进社会成员的普遍参与、加强慈善组织自身能力建设、完善社会激励机制以及健全政策法规制度。     

The effect of information system utilization and education and training on organizational innovation in public social welfare officers: Focused on the moderating effect of organizational trust

The purpose of this study is to investigate the impact of information system utilization and education and training on organizational innovation for public social welfare officers in Seoul and verify whether organizational trust plays a role as a moderator variable in these relationships. First, information system utilization and education and training have positive effects on organizational innovation. Second, as a result of investigating the moderating effects of organizational trust, organizational trust has a positive effect on the relationship between information system utilization and organizational innovation, as well as education and training and organizational innovation. Therefore, it is found that information system utilization and education and training are important for innovation of public welfare service. The stronger relationship we have, the higher organizational trust we acquire. Therefore, in order to innovate the organization, it is necessary to strengthen the education training that can utilize the network and the expertise to share information and communicate. It is also necessary to focus on enhancing organizational trust such as mutual consideration, information sharing, and assistance within an organization.     

我国社会慈善事业发展对策的思考

慈善事业作为我国社会保障体系的有机组成部分,是促进社会全面发展、构建社会主义和谐社会的一个战略选择。当前我国慈善事业发展中存在的问题主要表现在全社会尚未形成浓厚的慈善意识、慈善组织建设不够规范、组织自身能力建设不强、缺乏有效的管理与社会监督机制以及相关的法律法规不够健全。其相应的对策应是弘扬慈善文化、促进社会成员的普遍参与、加强慈善组织自身能力建设、完善社会激励机制以及健全政策法规制度。     

Management by Knowledge in Practice – Implementation of National Healthcare Guidelines in Sweden

In the last ten years, the concept of management by knowledge has gained growing attention in Swedish healthcare, as well as internationally. In Sweden, the most prominent example of management by knowledge is the National Guidelines, aimed at influencing both clinical and political decision‐making in the health sector. The objective of this article is to explore the response among four Swedish county councils to the National Guidelines for Cardiac Care (NGCC). Empirical material was collected through 155 expert interviews with the target groups of the NGCC, politicians, administrators and clinical managers. Analysis of the responses to this multifaceted policy instrument was addressed by drawing on implementation theory (Matland 1995) and institutional theory (Oliver 1991). The NGCC are primarily based on the voluntary diffusion of norms. The county councils are a long way from having adapted all the means suggested by the National Board of Health and Welfare (NBHW): explicit prioritization, healthcare programmes and dialogue between the various actor groups. The high degree of ambiguity in the content of the NGCC, the inherent conflict and the multiplicity and uncertainty in the context of the county councils, have often resulted in avoidance and compromise. The strategic responses we observe can be viewed as an attempt to balance multiple constituents and achieve the various internal organizational goals. The ambiguity and conflict inherent in the policy of the NGCC influence the strategic responses made by the organization. The question remains how far management by knowledge can be applied in a political context.     

Risk and Public Protection: Responding to Involuntary and ‘Taboo’ Risk

Growing media, political and public concern with high‐risk offenders in the community has focused policy attention on the concept of ‘public protection’. A notion that the public has the right to be protected, particularly from ‘monstrous’ offenders such as predatory paedophiles, has infiltrated much recent legislation and penal policy. This article will explore the critical factors in the ‘public protection’ trend and the framing of risk and risky offenders that has ensued. In particular, attention will be given to the new surveillance and intervention mechanisms under the Multi‐Agency Public Protection Arrangements (MAPPA) and whether these arrangements manage risk or displace it. To what extent are they driven by the ‘precautionary principle’ and defensive responses to risks that are over‐inflated? To what extent does this result in ‘perverse incentives’ to over‐manage certain risks and to over‐concentrate on restrictive risk management techniques such as electronic tagging, satellite surveillance and curfews rather than treatment? Does the system represent effective risk management or a system for dealing with risk anxiety – both of the public(s) and of politicians?     

社会管理的范围、价值与地位

虽然社会管理的任务已经从＂加强和改进＂上升到＂加强和创新＂,但是社会管理研究的基础性工作仍然是要认真探索社会管理的领域对象、核心价值和战略地位。弄清楚这一问题乃是发展社会管理理论和实践的基本前提。现代社会管理的领域是由民生社会、民间社会和公共事务社会所构成的,是一个处在发育中的人们生活的特定领域;当前社会管理的对象主要是民生社会、公民社会和公共事务社会中存在的问题、行为和利益。现代社会管理虽然与维持人类生活共同体的稳定和秩序密切相关,但是社会管理的核心价值取向应当是通过协调社会利益、规范社会行为、解决社会问题,以实现社会的公平和正义。在中国特殊的国情条件下,社会建设和社会管理已成为新的工作重心,已成为与经济建设同样重要的第一要务。     

Unemployment services for newly arrived migrants in Sweden: The privatization and rebureaucratization of the introduction programme

A recent policy reform in Sweden reorganized the management of newly arrived migrants' entrance into the labour market, which resulted in the Swedish Public Employment Service being given coordinating responsibility and introducing private service providers. Building on qualitative interviews with public employment officers and private actors, this study focuses on how the political contradictions in the new 2-year introduction programme are managed at the organizational level. In the article, it is argued that although both public employment officers and private actors experience difficulty separating unemployed migrants' need for social support from the workfare ambitions of the programme, aspects of privatization—such as freedom of choice and the service specification—further complicate this situation. Thus, the individualization aspects of the policy should be viewed as countering some of the more controlling aspects of the reform, thus, in effect, neutralizing its liberalizing tendencies.     

非政府组织与捐赠主体关系探讨

非政府组织作为国家和社会管理工作参与主体之一,与政府及一系列公共行为主体共同承担着对公共事务管理的责任,在促进政府执政能力的提高、优化政府政策制定、动员社会成员关注弱势群体、促进社会和谐和可持续发展等方面具有独特的作用。各捐赠主体对非政府组织捐赠的资金是非政府组织立足之本,正确理解政府、非政府组织、企业、社会公众之间的关系,有助于支持、培育和发展非政府组织。     

美、日地方政府债务管理及其对我国的启示

地方财政困难和债务危机是当前我国财政领域的一个突出问题,通过分析我国当前地方政府债务管理的现状,详细阐释美国和日本的地方政府债务管理特点和方式,认为我国应该从制度上建立健全完善的地方政府债务管理组织架构、债务预算管理模式和债务信息公开披露制度等。     

The Structure of Information in Organizational Frameworks--The Social Service Department

Correspondence to Yitzhak Berman, Director, Department of Planning and Social Analysis, Ministry of Labour and Social Affairs, PO Box 1260, Jerusalem, Israel. Summary Information application variables and organization informationvariables are identified from the literature. These variablesare applied to three levels of organizational implementation;strategic planning, management, and operational levels. It isfound that different types of information application and organizationinformation variables will be used on different levels of organization.A model of the various characteristics of information is presented,followed by its application to a social service department.     

新管理主义时代香港社会福利领域NGO之发展

全球第三部门正处在发展的十字路口,面临转型的挑战。本文运用个案研究方法,试图探讨20世纪90年代以来新管理主义如何影响香港社会福利领域NGO的发展。研究发现,尽管新管理主义的价值观已深植于NGO领域,但不同个案机构对其影响的回应不尽相同;组织的社会倡导价值对于市场化价值的妥协在本研究中虽有体现,但如何使商界更加关注社会福利的改善正日益成为香港NGO实践其倡导价值的新关注点。     

战略成本管理方法体系探索

战略成本管理的思想是成本管理与战略管理有机结合的产物,是传统成本管理系统对竞争环境变化所做出的一种适应性变革,是当代成本管理发展的必然趋势。战略成本管理方法可以分为基本方法和具体方法,这些方法还可进行整合。