T.L.C.M. Groot

New Public Management's Current Issues and Future Prospects

In this paper we describe the main characteristics of NPM and illustrate the current state of affairs in three main areas: (a) the effectiveness of NPM reforms, (b) NPMs impact on planning and control in government entities, and (c) the implementation and use of accrual accounting methods in government. We use the responses of 105 (mostly Dutch) practitioners in government and non-profit organizations. Most respondents recognize performance improvements, but only a minority attribute these improvements directly to NPM reforms. Improved planning and control systems are seen to have only a limited impact on the work of professionals, while accrual accounting is considered to have only limited potential to support political decision making.

Auditors’ Professional Skepticism: Neutrality versus Presumptive Doubt†

Although skepticism is widely viewed as essential to audit quality, there is a debate about what form is optimal. The two prevailing perspectives that have surfaced are ‘neutrality’ and ‘presumptive doubt’. With neutrality, auditors neither believe nor disbelieve client management. With presumptive doubt, auditors assume some level of dishonesty by management, unless evidence indicates otherwise. The purpose of this study is to examine which of these perspectives is most descriptive of auditors’ skeptical judgments and decisions, in higher and lower control environment risk settings. This issue is important, since there is a lack of empirical evidence as to which perspective is optimal in addressing client risks. An experimental study is conducted involving a sample of 96 auditors from one of the Big 4 auditing firms in the Netherlands, with experience ranging from senior to partner. One of the skepticism measures is reflective of neutrality (the Hurtt Professional Skepticism Scale - HPSS) whereas the other reflects presumptive doubt (the inverse of the Rotter Interpersonal Trust scale - RIT). The findings suggest that the presumptive doubt perspective of professional skepticism is more predictive of auditor skeptical judgments and decisions than neutrality, particularly in higher risk settings. Since auditing standards prescribe greater skepticism in higher risk settings, the findings support the appropriateness of a presumptive doubt perspective and have important implications for auditor recruitment and training, guidance in audit tools, and future research.

Municipalities' Contracting Out Decisions: An Emperical Study on Motives

Municipalities have various motives behind their decisions about the modes of their task execution. Empirical studies have not yet provided a fully satisfying explanation for municipalities’ contracting out decisions. Therefore, we interviewed several Dutch principal municipal managers to evaluate the causes and motives for the choices of the current structures for the delivery of their services. This study investigates the relevance of common public choice and transaction cost motives on contracting out and explores the relevance of additional institutional and pragmatic motives. We found that municipalities do not regularly evaluate the service provision of their activities and the potential benefits of outsourcing. In fact, if the activity has an adequate performance level and complaints from municipal employees, local politicians or inhabitants do not occur, a catalyst for a discussion on the contracting out of this activity is, in general, lacking. Principally in the case of structural underperformance municipalities consider a change of service provider, and then the efficiency motive is most relevant. Thereby, institutional motives – such as the stability of service provision – and pragmatic motives are also relevant. Institutional pressures in particular initiate the evaluation of organisational performance, whereas both economic motives as institutional and pragmatic motives are used to compare alternative service providers.

Competition in the Dutch hospital sector: an analysis of health care volume and cost.

This paper evaluates the impact of market competition on health care volume and cost. At the start of 2005, the financing system of Dutch hospitals started to be gradually changed from a closed-end budgeting system to a non-regulated price competitive prospective reimbursement system. The gradual implementation of price competition is a ‘natural experiment’ that provides a unique opportunity to analyze the effects of market competition on hospital behavior. We have access to a unique database, which contains hospital discharge data of diagnosis treatment combinations (DBCs) of individual patients, including detailed care activities. Difference-in-difference estimates show that the implementation of market-based competition leads to relatively lower total costs, production volume and number of activities overall. Difference-in-difference estimates on treatment level show that the average costs for outpatient DBCs decreased due to a decrease in the number of activities per DBC. The introduction of market competition led to an increase of average costs of inpatient DBCs. Since both volume and number of activities have not changed significantly, we conclude that the cost increase is likely the result of more expensive activities. A possible explanation for our finding is that hospitals look for possible efficiency improvements in predominantly outpatient care products that are relatively straightforward, using easily analyzable technologies. The effects of competition on average cost and the relative shares of inpatient and outpatient treatments on specialty level are significant but contrary for cardiology and orthopedics, suggesting that specialties react differently to competitive incentives.

Controlling the Efficiency of University Research in the Netherlands

In order to evaluate government funding of university research in the Netherlands, the Association of Dutch Universities uses a system of periodic evaluations. Review committees of international experts assess each research program. In 1995, the Association published statistics on the performance of 90 programs in economics and econometrics during a preceding five-year period. The difficulties of statistical evaluation and assessment of academic research programs are well known. There are few objective measurements of performance. Bibliometric data, such as the number of journal articles or dissertations published, give only indirect indication of the importance of the research results. In the present case, however, the review committees of international experts were asked to evaluate each program with respect to four characteristics: scientific quality, scientific productivity obtained, relevance, and long-term viability. The assessment of each of these characteristics was expressed in a single score. Drawing on the data published by the Association, the authors have used Data Envelopment Analysis (DEA) to evaluate and rank the research programs. The results of the full study are being published elsewhere. The present paper discusses in depth the results for three typical programs.

Contracting Out, an Empirical Study on Motives

Municipalities may have various motives for decisions on the mode of their task execution. Empirical studies – based on both public choice and transaction costs theory - have not yet provided a fully comprehensive explanation for municipal contracting out decisions. Therefore, we held interviews with Dutch municipal managers about the motives for the actual mode of service provision. This study provided the opportunity to investigate the relevance of motives on contracting out, to explore of additional motives and to test these statistically. As we find, municipalities do not regularly evaluate the service provision of their activities. Only in case of structural underperformance, municipalities consider a change of service provider, and then, the efficiency motive is most relevant. However, we conclude that institutional motives – as the stability of service provision - are relevant for contracting out decisions as well.