Events,Politics and Patterns of Policy‐Making: Impact of Major Incidents on Health Sector Regulatory Reforms in the UK and Japan

This article examines the major malpractice incidents in the late 1990s through early 2000s in the UK and Japan, comparing how these incidents opened up pathways for a new type of hospital regulation in each case. Applying John Kingdon's three‐stream model of agenda‐setting and policy change, the article argues that governance arrangements as well as the policy instruments that a government has at its disposal determine how an event could be translated into a political agenda by throwing light on the problems within the public domain. The long‐term effect of such adverse events is therefore determined by how open the relevant institutional arrangements are, and is enhanced if actors constantly scrutinize the system by proactively setting the agenda. A higher level of political accountability in the UK led to British politicians taking a greater role in promoting patient‐led reforms than Japanese counterparts. However, a political system with clear accountability is more conscious of its own involvement and any potential blame it might receive for policy failures. Therefore, the political class could become more engaged in continuous reforms and the delegation of tasks rather than a constant search for remedial actions. The article sheds light on the interactive aspects of the particular triggering events discussed through the decade of regulatory developments in the two health‐care systems.     

Unravelling the Politics of Activation Reforms: Exploring the Unusual Israeli Trajectory

Contemporary active labour market (ALM) reforms are pivotal in the reorganization of the welfare state as they challenge and threaten some of the fundamental achievements of labour in capitalist societies: social programmes and entitlements that compensate for unemployment, and governance arrangements in which the social partners share authority and responsibility with the state. Consequently, ALM reforms may give raise to social unrest and political struggle that involves the state (the main proponent of ALM reforms), trade unions and political parties. These conflicts are important in the politicization of reforms, i.e. raising public awareness of and engagement with controversies of welfare state change. In this article, we use a non‐European perspective to ask more generally how distinct historical institutions create separate ‘politicization trajectories’ of ALM reforms, which in turn produce different policy designs and outcomes. Centring on the case of Israel, in which historically ‘abnormal’ class politics fostered indifference to the reform in both trade unions and political parties, we maintain that the preliminary de‐politicization made it possible for bureaucrats to control the reform, leading to an intra‐state conflict between competing agencies over its design and implementation. The usurpation of the reform by the Ministry of Finance made it conspicuously unbalanced, provoking many grievances. Paradoxically, the de‐politicization of the reform advanced its re‐politicization, led by non‐governmental advocacy organizations in civil society. These uncommon political actors in the politics of ALM reforms were able to lead a counter‐coalition, delegitimize the reform, and mobilize politicians to eventually terminate activation     

Accountability to Welfare Service Users: Challenges and Responses of Service Providers

Influenced by the consumerist sentiment in New Public Management,the last decades have witnessed a revival of the call for accountabilityto service users in the public service sector. As an act ofaccountability, social care and health care professionals areincreasingly obliged to involve their service users in the serviceplanning and monitoring process. Despite the popularity of thisaccountability and user involvement rhetoric, critics have,however, been skeptical of the prevailing user involvement initiativesas an effective measure of accountability to service users (Barnes and Wistow, 1994a,1994b; Bowl, 1996; Peck et al., 2002; Rea, 2004). Based on astudy of user involvement in the welfare sector of Hong Kong,this paper argues that the discourse of accountability to theservice users can be a source of unrest for welfare professionals,in the manifestation of accountability as a power relationship.Their ensuing response is to accommodate the ensuing challengearising from the demand for accountability to service usersby manoeuvring the accountability discourse. It is the contentionof this paper that the institutional inclusion of welfare serviceusers into a discursive space is a necessary but not sufficientcondition for the realization of a mandate of accountabilityto welfare service users.     

The Changing Governance of Welfare: Recent Trends in its Primary Functions, Scale, and Modes of Coordination

This paper discusses four dimensions of the capitalist state's role in economic and social reproduction: its economic and social policy roles, the scales on which these roles are performed, and the modes of governance with which they are associated. It describes the typical postwar welfare regime on these dimensions, analyses the crisis in the governance of welfare that began to emerge in the late 1970s and 1980s, and characterizes the new regime that is tendentially replacing the postwar welfare state.     

NAPLAN data: a new policy assemblage and mode of governance in Australian schooling

ABSTRACT

As part of a policy assemblage, the National Assessment Program – Literacy and Numeracy (NAPLAN) is representative of a new mode of governance for Australia's schooling systems, indicative of international trends in educational accountability based on testing. The policy assumption was that the introduction of a national performance measurement system would tightly couple school practices to national agendas targeted at improving learning outcomes. This paper presents a comparative case study of two primary schools within a single Queensland region to interrogate how coupling and decoupling strategies are enacted in respect of the policy usage of NAPLAN data. The granular analysis of the governance relationship between the school principals and their supervisors is set against the politics, policies and pressures of NAPLAN that recast the initiative as high stakes for systems, schools and their leadership. Specifically, we argue that Queensland's choice and enactment of policy instruments have produced a new mode of governance of principal conduct, but one mediated by the specific contexts of the two schools. The analysis shows how this mode has precipitated two types of decoupling.     

Traits of a representative welfare state: the Swedish example

Järkestig Berggren U, Blomberg S, Petersson J. Traits of a representative welfare state: the Swedish example Int J Soc Welfare 2010: 19: 402–411 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. The care manager reform and the case manager reform are new reforms in the social care services in Sweden, which are evolving during the 2000s. Together they shape the social care services introducing a new way of decision‐making where representatives for the organisation (care manager) and the users (case manager) negotiate. The reforms have been analysed in two studies with results presented in this article. Using the concepts of role, orientation, function and assignments, it is argued that the managers come to the negotiations on rights from different positions that are both conflicting and complementary. They further mediate the development towards a welfare mix, where the market, social networks and users interact to obtain the public welfare provision. Through this negotiated rights model, it is argued that traits of a representative welfare state emerge, with the distinction of moving the focus to the administrative practices and their differences away from political ideologies.     

Linking macro‐level mechanisms to street‐level accountability practices. A cross‐national case study of street‐level accountability of social workers in government funded homeless shelters

Available studies on the accountability relation between social work and the government are mainly conducted in Anglo‐Saxion countries. This limits the generalizability of these findings to other countries. Moreover, these studies hardly descent to the street‐level, making the perceptions and actions of social workers barely visible. To address this gap, this article explores how three elements of governance interact with street‐level accountability of social workers in homeless care in three country cases (the Netherlands, Belgium and Germany). The data (N26) was gathered by means of a mixed method design (interviews, focus groups and document analysis). By combining a street‐level bureaucracy research approach with a relational definition of accountability, we opened up the black box of what happens in these organizations and bridged the gap between macro‐level mechanisms and street‐level accountability. Our study adds three important insights to street‐level research of accountability in social work. First, elements of governance cannot be studied in isolation. Mechanisms should always be explained in relation to the context in which they are embedded. Second, the social workers in our cases do not perceive their accountability to the government as a professional obligation. They see it as a strategic mechanism to secure funding. Third, interaction is an important condition for the engagement of the social workers in their accountability relation with the government. More research is needed to develop a multi‐level theory that identifies which mechanisms play a role in the accountability relation between the government and social workers.     

Accountability in research using persons with mental illness

Although medical research involving the use of persons with mental illness is critically important, in order for the research to be ethical and legal there are certain considerations and restrictions which should be immediately readdressed in order to insure that the welfare of these vulnerable research subjects is protected, and their best interests are assured. A brief historical examination of medical research codes, guidelines, recommendations and Federal Regulations reveals the various considerations and restrictions on informed consent and accountability applicable to the use of persons with mental illness in medical research. Several concerns are raised about how these considerations and restrictions have been interpreted, and specific recommendations are offered to improve them immediately by means of representation from consumers and/or their families, and organizations, e.g., NAMI members.     

基层信访治理中的“包保责任制” 实践逻辑与现实困境 以鄂中桥镇为例

本文以桥镇为个案,运用国家、基层政权和农民博弈关系的三层分析框架,阐释了乡村基层信访治理中“包保责任制”的实践逻辑和现实困境。研究发现,尽管“包保责任制”能够强化包保责任人的责任意识,并在一定程度上缓解信访治理工作难题,但监控环境与空间隔离、监控技术与社会基础、监控强度与道义压力这三大矛盾使得这一制度的运行陷入困境,滋生了越来越多与制度设计初衷相悖的“目标替代”行为。在此基础上,本文阐释了中国科层制运作的三大矛盾,即理性科层制与非理性运作的矛盾、专业化与综合性的矛盾、常规运作与非常规任务的矛盾,并给出了相应的理论解释。本研究强调,在中国基层权力运作中,长期而广泛存在的名实分离的矛盾现象,不仅仅是科层体制内部各行动主体博弈的结果,也不纯粹是一个组织激励问题,而是由科层体制与乡村社会的合力所催生。由此,在推进基层政权现代化建设进程中,就不能局限于制度建设层面,还要考虑是否具备支撑现代基层政权的社会基础和制度环境。     

When standardization becomes the lens of professional practice in child welfare services

This paper examines the relationship between professional work and standardization. There has been an increase in the use of standardized programmes in child welfare services (CWS) in Western society. Some researchers have criticized standardized programmes suggesting that they undermine professionals expertise and threaten their position, whereas others argue that such programmes strengthen professional practice. In this paper, we examine how standardized tools, in this case, a standardized parenting programme and a standardized Norwegian assessment tool, influence professional roles as experienced by child welfare workers (CWS professionals) in Norway. Semistructured individual and group interviews were conducted with 31 frontline workers in two CWS agencies. Our findings suggest that standardized tools increase the social workers experienced professional competence but challenge their professional knowledge base, reflective practice, and professional accountability. Professional and practical implications for CWS work are discussed in the light of these findings.     

The Welfare State and the Life Course: Examining the Interrelationship between Welfare Arrangements and Inequality Dynamics

The transformation of welfare state arrangements in European countries during the last two decades can not only be described as realizing an activating welfare state, but also as centred on specific life course transitions which are considered as critical. A number of new welfare arrangements have been set up or older ones have been modified taking into account the critical phases of the life course. These new welfare arrangements attribute new rights over resources to well‐specified groups in terms of their life course events. The article first presents a selective overview of new welfare arrangements which are (in explicit or implicit ways) linked to specific phases and transitions of the life course in the different European countries; and, second, it analyzes the consequences of these new welfare arrangements on inequality. These arrangements establish (mostly implicitly) norms, which appear to define a role of an active, responsible and ‘able’ employee and citizen for everybody. However, the general starting positions of various groups of the population (such as women) and the existing welfare provisions constitute an obstacle to providing equal starting positions and an equal opportunity for pursuing one's life course according to the established norms. Therefore, the effects of these new welfare arrangements can have significant impacts on outcomes, and can therefore transform substantially the existing picture of inequalities.     

Local Participatory Democracy in Britain's Health Service: Innovation or Fragmentation of a Universal Citizenship?

A political emphasis upon the devolution of governance and management in the British National Health Service has, since 1997, been paralleled by an apparent concern to reinvigorate patient and public involvement in aspects of planning and decision‐making. A quasi‐communitarian rhetoric and echoes of nineteenth‐century welfare mutualism have accompanied significant reform of arrangements for patient and public involvement. This article considers the degree to which this fusion of normative exhortation and structural reform heralds a marked evolution in the principles and practice of participatory democracy in the planning and governance of health care. The reforms, in historical perspective, appear to constitute a significant extension of the arenas within which citizens can explore and debate issues pertaining to the health service. But selective political recourse to quasi‐communitarian sentiment points to an embryonic policy discourse that links entitlements to obligations on the part of those reliant on the NHS. This may be of considerable significance in a system of health care to which entitlement has, historically, been cast as a right of citizenship.     

Regulating Philanthropy The Legal and Accountability Framework for Singapore Charities

The Charities Act in Singapore provides a systematic approach to public accountability by promoting good governance of non-profit organizations. This paper focuses on the rise of philanthropy and the development of a regulatory framework to ensure public accountability of charities in Singapore. There is a need for greater transparency, communication, information, and support from the various systems, including the revenue and government authorities, as well as the stakeholders.     

Social exclusion in Europe: some conceptual issues

In the late 20th and early 21st century, social exclusion has become something of a trope around which is pegged justifications for various reforms. The notion of social exclusion has found its way into the lexicon of all major global governance institutions. How has this happened, and what are its implications for scholars of contemporary welfare reforms? In this article, we consider the ‘rise and rise’ of the discourse of social exclusion, with particular reference to its development as a policy paradigm within the European Union. We note that its initial iteration was anchored in a functionalist discourse of social organisation but that this was quickly challenged both by post‐structuralist and post‐colonial perspectives and by research findings that undermined the view of mainstream institutions as fundamentally integrative and inclusive in nature. The debate about social exclusion, we suggest, is simultaneously a debate about the historical and social dynamics of European modernity.     

Digital by default? A qualitative study of exclusion in digitalised welfare

Digitalisation reforms have become increasingly pervasive across European welfare agencies and public sector institutions. As welfare provision becomes premised on the use of digital technologies, often in the form of “self‐service” solutions, new demands are imposed on citizens, including already disadvantaged groups. Although existing research has showcased how digitalisation often reproduces existing lines of stratification, little to no work has been conducted on such processes in the context of welfare provision and public administration. Through a study of citizen service centres in Denmark, based on ethnographic observations and qualitative interviews, this article analyses the new exclusionary mechanisms that emerge at the frontline of the digital agenda. The article argues that digitalised welfare agencies simultaneously sustain existing lines of social stratification and enhance these by producing new forms of digital exclusion. Taken together, the article contributes with new knowledge on the impact of digitalisation policies and their exclusionary consequences for disadvantaged citizens.     

Patterns of Governance: The Curious Case of Non-profit Community Services in Australia

"Community" has taken on a new significance in Australian social policy discourse. Seemingly sound and morally justifiable, in the context of neo-liberalism the language of community positions non-profit delivery of services as superior to state-provided services. As a consequence, non-profit community services are being centrally positioned to mediate the relationship between the state and citizen subjects. In the first part of this paper we trace some of the key historical developments in Australia's welfare state and patterns of governance that are propelling the non-profit sector from the margins to the centre. The second section examines the relationship between Australia's shifting political landscape and the emerging welfare regime. One key feature of this new regime is the attempt to relocate citizenship away from the domain of the state and into that of civil society. The article concludes by sketching out some research themes, focusing, for example, on the impact of devolution of governance in terms of client rights and public accountability.     

Neoliberal Knowledge: The Decline of Technocracy and the Weakening of the Montreal Protocol*

Objective. The turn to participatory, stakeholder modes of governance has been accompanied by the legitimization of a new “particularist knowledge regime” emphasizing the knowledge claims made by private interests and local voices. It has also tended to de‐legitimize the ways of knowing that had characterized central state governance, namely, state expertise based on general welfare analytics such as cost‐benefit analysis. This turn away from state expertise, what we call the “anti‐technocratic consensus,” while stemming from democratic motivations, may actually make environmental governance less democratic. Method. We examine the problems that arise from the abandonment of general welfare economic analytics and technical expertise—the anti‐technocratic consensus—through a specific case study: the recent handling of “critical use exemptions” to the ban on methyl bromide under the Montreal Protocol, a treaty that mandates the elimination of methyl bromide in order to protect the ozone layer. We show that decisionmakers specifically rejected general welfare analytics as a basis of regulatory action in favor of a particularist form of analytics based on measuring market disruption. Results. This case illustrate how the de‐legitimization of technical expertise can weaken the effectiveness of an environmental agreement in meeting its regulatory mandate. Critics have often criticized technical expertise as supporting the economic status quo. However, in the case of methyl bromide and the Montreal Protocol, technical experts using general welfare analytics represented a challenge to U.S. regulatory officials who supported industrial interests and their request for significant exemptions to the ban. Conclusion. The legitimization of a particularist knowledge regime opens up policy making to domination by private interests playing the stakeholder game. Stakeholder input and particularist knowledges are important to democratic decision making. However, technical expertise, despite all its weaknesses, is a form of knowledge that remains necessary to the protection of the environment and public health.     

实现政治问责的三条道路(英文)

建立一个对人民负责的政府是现代国家治理的核心问题。实现这一目标，需要解决两个最基本的问题：谁来使用权力？如何使用权力？选举制度是解决前一问题相对较好的制度，而预算制度是解决第二个问题最好的制度。通过历史比较分析，可以总结出三条实现政治问责的道路：19世纪的欧洲道路、从建国到进步时代改革的美国道路以及雏形初现的中国道路。这意味着，西方经验并不是唯一的实现政治问责的道路。相对于西方经验来说，中国20世纪80年代以来的国家转型具有极大的特殊性。尽管面临各种挑战，但一条政治问责的中国道路正在形成。     

行政问责制的约束软化问题研究

2003年至今,我国的行政问责制一直存在着问责主体不明确、问责法律体系不健全、问责信息缺失、问责文化滞后等问题。以S市近年来的行政问责情况进行分析,呈现出行政问责的约束软化问题,通过分析表现影响、原因,提出了应对行政问责制约束软化的对策。