David Steel

Nationalised industries: the search for control

Relations between central government and the nationalised industries are at an all‐time low. In pursuit of its policy of bringing down the public sector borrowing requirement, the Government has imposed strict cash limits on each industrys financing requirements. Yet, one after another, the nationalised industries have been authorised to breach their limit. The tool the Government chose was only one of a series of mechanisms put forward by the previous Labour Government when, in its 1978 White Paper, it sought to establish a coherent financial framework for the nationalised industries. But was that framework really all that coherent? And what should now be done to pick up the pieces of a policy that is clearly in ruins?

Making the governance of public bodies work: chair–chief executive relationships in practice

The importation, over the past 30 years, of private sector governance mechanisms into public sector bodies at arms-length from government has brought greater focus on the relationship of part-time non-executive chairs and full-time chief executives. This paper explores this relationship in 14 UK public bodies, based on in-depth interviews with chairs, chief executives and, as triangulation, audit committee chairs. The findings concern the negotiated differentiation of roles; the effects of the chief executives separate authority as accounting officer on internal governance; the management of external stakeholders; and how crises can affect roles and relationships. Improved processes of training and mentoring are proposed.

Scotland ‘Bold and Brave’? Conditions for Creating a Coherent National Healthcare Quality Strategy

Healthcare quality is an enduring and global concern, evidenced via supranational responses, such as those of the United Nation’s World Health Organization (Ovreveit, 2003, 2005, 2013), the OECD (Arah et al., 2003) and the European Union (Vollaard et al., 2013), as well as the policy responses of individual countries (Arah et al., 2003) and devolved regions (such as the Scottish example considered in this chapter1). The Institute of Medicine’s seminal report (IOM, 2001; Kohn et al., 2001) led to increasing recognition of the need for a systems focus in managing healthcare quality. However, a European Union (EU)-oriented analysis (Vollaard et al., 2013: 229) notes, ‘There is much variation [in national quality and safety strategies] between and within Member States and that therefore there is a large potential to learn from each other.’ In this chapter, we follow Ovreveit and Staines (2007) in purposively analysing an established system-wide approach to quality improvement. We consider the evolution of the policy process in Scotland — rather than evaluating its impact — and ensuing lessons for other contexts.

Managing health authorities: One member's view

Members of health authorities are part‐time, unelected, and unpaid. Does that mean that they are at the mercy of their officials, or do they have some scope for taking initiatives of their own?