Jill Schofield

Time for a revival? Public policy implementation: a review of the literature and an agenda for future research

This paper argues that there is not a vigorous contemporary literature in the UK which addresses implementation studies as part of the public policy process, whereas this is not the case in the USA. A review of the literature is presented, and a critique of the more traditional thematic groupings used to review the literature is given. A revised thematic review of the literature is presented based on the four themes of: (1) the role of knowledge and learning in policy implementation; (2) the processes of policy implementation; (3) the role of actors and agents in implementation; and (4) the role of bureaucratic discretion. The paper argues for a revival of research into public policy implementation and suggests a research agenda for the future which can use the aforementioned themes from the literature.

The Old Ways are the Best? The Durability and Usefulness of Bureaucracy in Public Sector Management

The paper addresses the paradoxical question of why, given two decades of ideological and structural reforms in the public sector, has bureaucracy survived both as a concept and in practice. The findings of research conducted in the British National Health Service suggest that bureaucracy is both useful and durable because it means that governments can rely upon the obedience of bureaucrats. In turn, it is suggested that this obedience is a function of bureaucratic vocation, the protection of professional reputation and a form of instrumental motivation. In conclusion, there is a theoretical discussion about the relevance of using Labour Process Theory to explain how state workers (bureaucrats) have experienced social and cultural adaptation to public sector reforms.

The Role of Capital Investment Project Teams in Organisational Learning

The management and organisation of capital projects in the British National Health Service (NHS) is dependent upon project teams. An analysis of four case studies shows how these teams also act as agents of learning for individuals and the organisation. This article considers the process by which learning came about. In particular it identifies the ability of the project teams to develop a parallel organisation within a wider organisational context. These teams develop specific rules, roles and relationships which help individual project team members to more effectively share their knowledge with others and their organisation.

Health network culture and reform

For policy-makers who favour health system marketization, that is the re-structuring of health systems to mimic the organizational structures and inter-organizational relationships found in markets, networks offer a surrogate governance structure in those parts of a ‘hollowed-out state’ where direct hierarchical control of individuals or organizations has been removed (Etzioni, 2001; Rhodes, 1997), supplementing hierarchies and markets as a ‘third way’ governance structure. Health care networks have correspondingly proliferated and now include professional (’expertise’) networks: clinical referral (’care’) networks; project networks; programme (linkage’) networks such as WHO-style programmes; ‘experience’ networks of users and carers; policy networks (including policy ‘communities’ as a special case); learning networks; and interest networks which promote particular policy or interest-group (Southon, Perkins and Galler, 2005). Meantime, ‘reforms’ of health-care bureaucracies have proceeded apace in many countries as have attempts to re-introduce or extend health-care markets.

Leading Health Care Organisations

in public management, organizational behavior, and organizational theories. It addresses a missing link in the study of political science, sociology, management and public administration: ‘Can the concepts of citizenship behavior and other political-oriented behaviors be brought together and exported effectively into the world of work and management?’ (p. xiii). The chapters are intellectually simulating to read because they pull together different literatures in very effective ways, they give such a comprehensive treatment of the topic that readers interested in this area of research will be greatly prepared, and they present or apply concepts that are so innovative in public management studies that readers can easily come up with new ideas of their own. It is a must-read for public management students if they are not familiar with the published articles.

Va Va Voom, Size Doesn’t Matter: Form and Function in the NHS

This chapter presents a synthesis of a research project funded by the British National Health Service (NHS) Service Delivery and Organization (SDO) R and D Programme of Research on Organizational Form and Function that addresses the relationship between organizational form and performance (Sheaff et al. 2004) using a meta-analysis of the literature. Readers are referred to the full report for a comprehensive coverage of all sections. This chapter describes briefly the structure of the overall project paying particular attention to one analytical element — namely, what the evidence says about the nature of organizational structure and healthcare. The discursive focus concerns the issue of organizational size as a specific element of organizational structure.