Public Administration Service Research Articles

Roles That Are about to Be Accomplished by Nurses Who Function as Public Administration Service in Today's Japan

Roles That Are about to Be Accomplished by Nurses Who Function as Public Administration Service in Today's Japan

Las estructuras de salud pública en España: un panorama cambiante

In the last years the health care system in Spain has undergone very important transformations. However, the public health services have not followed a comparable process. Until 1979 public health structures were based in central services and their provincial units, on one side, and in the resources of local governments on the other. From then on began the process of transferring responsibilities and resources to the regional governments of Autonomous Communities (AC), which today manage most public health services, while the central government keeps as its responsibility the development of basic norms, the administration of public health services at borders and customs, and the general health coordination. The situation in 1995 resembles that of a Federal Country, although the Kingdom of Spain is not formally defined as such. The role of central government services is visibly reoriented towards coordination and the building of consensual and shared structures for health information, for need evaluation, and for policy formulation and evaluation. Although the General Health Law of 1986 considered public health as a main axis for all health agencies, its actual development has been more patchy. Several AC with an Autonomous Health Service have kept public health services separated from it. Besides, many public health functions and activities are developed today from other structures. The processes of change reveal two contradictory aspects. On one side, structures have been upgraded after decentralization, and teams reinforced, with trained and full-time staff. However, there is some dilution of public health responsibility in the periphery, and a lower visibility of the health authority.

Representing Homeless Families: Repeat Player Implementation Strategies

The leverage provided by litigation depends on its strategic combination with inputs at other levels. The question then is whether the organization of the profession permits lawyers to develop and employ skills at these other levels. (Galanter 1974:151)Without any ability to pose a credible political threat, poverty lawyers have become adept at squeezing resources out of hostile agencies and legislative bodies at all levels of government. (Diller 1995:1427)In mounting reform suits, Legal Services lawyers are not properly understood as autonomous, outside agents attempting to impose rationality on the administration of public welfare services over the opposition of a universally hostile state. (Katz 1984:189)In 1974, Marc Galanter examined the strategic role of public interest lawyers in helping the “have nots” come out ahead in the legal system. Galanter argued that, to become agents for social change, lawyers must recognize that their role as advocates extends beyond the courtroom into the implementation process (Galanter 1974:151). This article analyzes the efforts of one group of public interest lawyers—those working in Legal Services agencies dedicated to law reform—to influence the implementation of redistributive programs for a particular group of “have nots”: homeless families or those on the brink of losing their housing. Based on my studies, I argue that by skillfully combining adversarial legal tactics with collaboration, poverty lawyers can transform judicial decisions into “symbolic resources” to leverage the implementation of redistributive remedies. When the reform lawyers have the authority to participate in the process of administrative rule making during the implementation process, they can reshape the norms and organizational infrastructures within state agencies.

A survey of the Hong Kong health sector: Past, present and future

This paper considers the involvement and performance in the health sector of the Hong Kong government prior to and beyond the transfer of sovereignty from Britain to China in July 1997. The paper commences with a historical survey of health services development, which provides insights into why the health system functions in its present haphazard manner. This section culminates by discussing the 1991 establishment of the statutory Hospital Authority which was an attempt to alleviate escalating problems in the administration of hospitals and public health services. Next, the paper surveys the present, discussing, respectively, the roles of government and private service providers, health care outcomes and the contribution of traditional Chinese medicine. Finally, the paper outlines a range of pressing issues which Hong Kong's future policy-makers will need to confront: the organization of the health sector, health financing and the health policy deficit. In the conclusion, it is posited that there is a need for government to formulate a health policy and to clarify its role in the provision of services.

The Cardoso Government's Reform Agenda: A View from the National Congress, 1995–1998

Reform agendas are no novelty in Brazilian politics. Perhaps the first agenda was foisted on Brazil by the Marquis de Pombal during the colonial period (Maxwell 1995). In the independence period during the Second Empire (1840-89), reforms were frequent, especially after the Triple Alliance War in the 1870s and 1880s, as successive cabinets labored under strong pressures for change. With enhanced political autonomy granted to state governments by the constitution of the First Republic (1889-1930) and a concentration of national power in the hands of the mineiros and paulistas-the governors of Minas Gerais and Sao Paulo-in their cafe cor leite power-sharing arrangement, reform, especially of the economic system, became synonymous with enhancing profits for those elites. In the late 1920s, when demands for political, social, and economic reforms came mostly from urban workers and an incipient middle class, punctuated by minor (1922) and major (1924) military revolts, the decadent First Republic elite was incapable of change or even of perceiving the need for same (M. C. C. Souza 1974). Modern Brazil's most thoroughgoing reforms were executed during the first presidency of Getfilio Vargas (1930-45). The national armed forces finally consolidated their power over state military organizations. Import substitution began in earnest, and the state launched a broad intervention in the nation's economy. The so-called question was incorporated (coopted) into the reform agenda; modern social and labor legislation was adopted, complete with labor courts, retirement and health care systems, and workers' compensation. Vargas created the DASP, or Public Service Administration, in 1936, charging it to reform and modernize public administration, and the first comprehensive civil service laws were passed (Graham 1968). Luciano Martins (1995) believes that this important attempt at modernization was tempered by a strong culture of patrimonialism and clientelism that even the military regime of 1964-85 was unable to alter substantially. That regime resorted to parallel recruitment via the CLT (the 1943 Labor Code) and state enterprises. Until 1945, most reforms came almost totally from the initiative of the executive branch with very little input from the Congress. After the 1946 ardoso Government's Reform Agenda: ie from the National Congress,

The Quality of Surgical Care Project: a model to evaluate surgical outcomes in Western Australia using population-based record linkage.

The aim of this study is to establish a model to evaluate surgical outcomes and, where indicated, recommend changes to improve the quality of surgical care in Western Australia (WA). Open resection for aneurysm of the abdominal aorta was the first procedure evaluated and the results are reported in an accompanying paper. The Quality of Surgical Care Project (QSCP) is conducted under the aegis of the Royal Australasian College of Surgeons (RACS) in WA, and brings together a multidisciplinary team of surgeons, public health researchers and health service administrators. The Western Australia Health Services Research Linked Database (the WA Linked Database) is used to provide linked chains of patients records residing in the state health department from the following sources: hospital morbidity data system, birth and death records, mental health services data, cancer registrations and midwives' notifications. This links 16 years of population-based patient records from 1980, including all public and private hospital admissions and re-admissions. The Quality of Surgical Care Project was established to use and to correlate the data from the WA Linked Database. The result is a powerful database for a contained population that is available for scientific analysis by a multidisciplinary team of clinical epidemiologists, surgeons and health service managers. Users will have the ability to establish benchmark standards for the outcomes of surgical procedures in WA for use in quality improvement programmes run by the College and will facilitate self-directed performance auditing activities as a commitment to greater community accountability. The Quality of Surgical Care Project provides a potential model of benefits to be realized by both the medical profession and the community through multidisciplinary collaboration supported by adequate information. Although migration from WA is relatively low, future linkage to the state electoral roll will allow correction for any population change.

The European model of service delivery: a partnership approach in Northern Ireland

The volatile political and security environment of Northern Ireland has for 26 years focused attention on tackling the, so far, intractable constitutional question of its position within the United Kingdom and the island of Ireland. The collapse of the IRA ceasefire in February 1996 and fears of a possible return to violence by Protestant paramilitaries have heightened tensions. This protracted period of violence has deflected attention away from a system of public service administration in Northern Ireland characterized by serious problems of accountability. Essential public services operate under the aegis of appointed boards, and the major repository of power, under a system of Direct Rule from Westminster, is the Secretary of State for Northern Ireland, a British Cabinet Minister. Under a recent European initiative (the EC Peace and Reconciliation Programme, 1995) an alternative model of service delivery provides a major opportunity for administrative reform in Northern Ireland. This model is based on a partnership approach in which councillors, the private and voluntary sectors collaborate to deliver services. Although still in its early stages, this approach could sever the link between political progress and administrative change which has contributed for too long to the ‘democratic deficit’ in Northern Ireland. © 1998 John Wiley & Sons, Ltd.

The European model of service delivery: a partnership approach in Northern Ireland

The volatile political and security environment of Northern Ireland has for 26 years focused attention on tackling the, so far, intractable constitutional question of its position within the United Kingdom and the island of Ireland. The collapse of the IRA ceasefire in February 1996 and fears of a possible return to violence by Protestant paramilitaries have heightened tensions. This protracted period of violence has deflected attention away from a system of public service administration in Northern Ireland characterized by serious problems of accountability. Essential public services operate under the aegis of appointed boards, and the major repository of power, under a system of Direct Rule from Westminster, is the Secretary of State for Northern Ireland, a British Cabinet Minister. Under a recent European initiative (the EC Peace and Reconciliation Programme, 1995) an alternative model of service delivery provides a major opportunity for administrative reform in Northern Ireland. This model is based on a partnership approach in which councillors, the private and voluntary sectors collaborate to deliver services. Although still in its early stages, this approach could sever the link between political progress and administrative change which has contributed for too long to the ‘democratic deficit’ in Northern Ireland. © 1998 John Wiley & Sons, Ltd.

Back pain in the working population: prevalence rates in Dutch trades and professions.

An analysis of three health surveys in the Dutch working population is described, aimed at the identification of Dutch trades and professions with relative high and low prevalence rates of back pain. The sample was representative of the working population in the Netherlands and consisted of 5840 men and 2908 women. The analysis included 33 trades and 34 professions, with at least 50 respondents for each. A total of 26.6% of the workers reported back pain quite often. Almost 2% reported absence from work in the last two months, and 4% considered their back pain to be a chronic disabling disease. There was a substantial variation in prevalence rate of low-back pain between trades and professions ranging from 12% to 41%. Trades with relatively high prevalence rates were found to be the building materials industry, the construction industry and road transportation, and the wholesale industry. Trades with relatively low prevalence rates were found to be banking, public administration and commercial services. Workers in the construction industry and supervisory production workers, plumbers, drivers and cleaners have a relatively high prevalence rate of back pain. Chemists, scientists, bookkeepers, secretaries and administrative professions have a relatively low prevalence rate of back pain. It is concluded that high prevalence rates of back pain are found in particular in non-sedentary professions. Priorities in prevention of back pain should be directed towards the group with relatively high prevalence rates identified above.

Reform with Chinese Characteristics: The Context of Chinese Civil Service Reform

an article in 1887, Woodrow Wilson called for a discipline of public administration separate from political science. He argued that Americans should look to European governments for administrative structures. He spent much of the article justifying the concept that a democracy should seek advice on how to govern from authoritarian European regimes. is possible that Wilson emphasized the separation between politics and administration to support his argument that Americans could borrow administrative techniques from countries whose politics they abhorred. Wilson wrote, If I see a murderous fellow sharpening a knife cleverly, I can borrow his way of sharpening the knife without borrowing his probable intention to commit murder with it... (Wilson, 1887; 24). a metaphor more appropriate to this article, Wilson also wrote, borrowed rice, but we do not eat it with chopsticks (p. 23). Today, Communists studying capitalist civil service systems have been making a similar point. Deng Xiaoping has said, in reference to economic reforms, It doesn't matter if the cat is black or white, as long as it catches mice. The current civil service reform (CSR) is an adjunct to the economic reforms begun in 1978. By 1988, the personnel function of the Ministry of Labor and Personnel was transferred into its own Ministry of Personnel. Regional and city governments, as well as a few national ministries, began experimenting with Western civil service techniques (particularly the use of examinations for selection). With United Nations' help (United Nations Development Program, 1987, 1989), the have been bringing foreign personnel experts to China and sending administrators abroad to study Western personnel technology. Although they are studying foreign systems, in the end, they insist that they will adopt a system with distinct Chinese characteristics. What are characteristics? Just as a foreigner would have difficulty understanding the current American debate over health care without knowing American economic, social, and political traditions, foreigners unaware of traditions will miss much when approaching China's public administration and civil service. We will highlight characteristics that we found to be either particularly confusing in our initial interviews with officials or especially enlightening in our follow-up research. We believe that the factors we have chosen play important, often unspoken, roles affecting the design and implementation of civil service reform in China. Our goal is not to give a detailed description of civil service reform (CSR) (there already exist excellent sources for that),(2) but to identify and explain a few characteristics that are particularly important in understanding China's CSR. Even this is a formidable task in a short article. To live in China is to live in a different reality. The rules, rewards, and sanctions are different. In Asia ... you either lose your inner moorings, start to sink, go some kind of crazy, and just let it happen, or you will leave sooner than you expected and not learn anything (Holm, 1990; 20). This advice is contrary to our academic training. Yet to understand China, we must suspend our paradigmatic preconceptions. Deductively applying Western models to describe China's CSR is misleading. Foreign experts with little knowledge of China cannot even take their interpreter's words at face value.(3) These difficulties impose limitations on us as interpreters of CSR. They make descriptive study most realistic and useful. Even so, our words also should be taken tentatively. Three Basic Values in Tension Suzanne Ogden (1989) proposes that three basic competing values underlie all decisions of the government: traditional culture, socialism, and development.(4) As the political winds change, the priority of the values changes. CSR reflects the tensions among these values. …

The political economy of city life cycles: a comparative analysis of services, expenditures and revenues

This paper updates and expands Norton's 1979 study of the political economy of city life cycles in thirty jurisdictions. Using 1970 and 1976 fiscal data, Norton had found that older cities of the Northeast and North Central states provide a more extensive range of services and have a stronger commitment to social welfare functions than younger cities of the South and Southwest. A thirty-five city survey using 1991 data generally confirms his findings. We found significant differences in the service mix, spending patterns and revenue sources of older and younger cities. Older cities offer a broader mix of services with the most dramatic differences among redistributive and safety functions, and notable differences in the public works and administrative services categories. Older cities expend more per capita on local services and exhibit different spending priorities. They spend propor-tionately more on redistributive services, eg. health, hospitals, welfare and housing. They also spend more per capita on police, fire and education. On the revenue side, older cities depend more on commercial property taxes, while newer cities rely more on residential property taxes. The most significant difference on the revenue side, however, concerns the greater reliance of younger cities on locally generated non-tax sources (eg. user fees), whereas older cities remain more dependent on intergovernmental aid.

José Saramago: An Introduction

Born into a farming community in Azinhaga in the Ribatejo region of Portugal on 16 November 1922, Saramago received his secondary education in Lisbon, but was forced to abandon his studies because of financial difficulties. He worked first as a mechanic, then became a technical designer employed in public administration and social services. Subsequently he found employment as a translator, became literary editor of a publishing house, turned to journalism and was appointed director of the Diario de Noticias in 1975. Determined to become a writer, he published several books of poetry and essays in the 1960s and early 1970s, and by the late 1970s he was drafting plays and his early novels. His golden decade, as it were, came in the 1980s with the publication of four major novels which were to bring him fame.

PUBLIC MANAGEMENT OR PUBLIC ADMINISTRATION?

Abstract: The debate over managerialism has been the most controversial issue in Australian public administration journals in recent years. Although most articles have been critical, there have been responses in favour of the changes by senior public servants. One unfortunate consequence of this debate has been the appearance of a gap between academic public administration and public service practice.This paper argues that, from several angles, the work now carried out by public services is management rather than administration. It argues that managerialism is a long‐overdue reform to a model which has outlived its usefulness. The traditional model of public administration was an irrelevance for many years; it was never efficient or effective and deserved to be replaced. However, public management does not necessarily mean the widespread and uncritical adoption of practices from the private sector. What it should mean is that a distinctive public management needs to be developed. This should take account of the differences between the sectors, but still recognise that the work being done by public servants is now managerial rather than administrative.

Unemployment and Fiscal Activism in a Small Open Economy

SECTION 1 : INTRODUCTIONAn endemically high rate of unemployment has always been one of the most pressing problems facing policy makers in Ireland. Since 1980 the unemployment rate has risen inexorably, as illustrated in Figure 1. Furthermore, on the basis of the most recent medium-term projections to 1990 (Bacon (1986)), the unemployment rate is set to continue to rise, albeit at a much slower rate, to over 18 per cent of the labour force. This more recent rise in unemployment is, of course, a phenomenon not confined to Ireland, but shared, in one form or another, by many other European economies.All political groups in Ireland place great emphasis on their policies to alleviate unemployment. The extent of direct state intervention in the Irish labour market can be seen clearly from Figure 2. Employment in the sheltered marketed services sector grew over the period 1973-83 by 18.4 percent (56900), while employment in the non-market sector (public administration and other non-marketed services) grew by 40.2 percent (68700). While industrial employment remained relatively stagnant, displaying cyclical highs in 1974 and 1980, agricultural employment declined steadily. Over the same period, the labour force grew by 17.7 percent (196900) and migration abroad, having declined from a net outflow of about 60000 per annum in 1959 to a zero net flow by 1970, became a net inflow during the years of 1973-78, but has returned to a net outflow since 1983 (Figure 3).

The Virtuous Citizen, the Honorable Bureaucrat, and "Public" Administration

WORTHLEY: My first comment is in reference to Dwight's example from health care. Public servants have a lot to learn from what has happened in health care. Health systems agencies frequently have a citizen participation structure, and in some instances there is a requirement for 50 percent consumer participation in planning processes and administrative decisions. I am aware of some terrible difficulties administrators and doctors have had in dealing with consumers who may not have had a high school education but who know something about going to a hospital. Your comment, Lou, about good government not being an acceptable substitute for self-government is something administrators and doctors have had to face head on. Is good medicine a proper substitute for participatory medicine? Some planners I have dealt with are beginning to believe that good medicine requires participatory medicine. The second thing I want to comment on is your profound point, Lou, that public service administration should be interesting. That is the key to promoting citizenship. When occasionally I have the thrill of teaching an undergraduate public administration course, I require my students to attend public hearings and interview public administrators. Inevitably they come back and tell me how boring the public hearings and the administrators were. The message I get from all around is that if we as professors, administrators, and consultants are not interesting, we cannot promote citizenship. Finally, in thinking about the role of universities, there are few public administration programs which actually market their courses to ordinary citizens. We ought to educate people, and help people educate themselves, about how administration works. We have neglected citizens.

Ageing, Development and Social Service Delivery Systems in Latin America: Problems and Perspectives

ABSTRACTEconomic development in Latin America has facilitated the broadening and improvement of governmental services in public health, social security and public administration. These improvements, particularly in public health, have precipitated changes in rates of morbidity and mortality. Many countries have also experienced a fall in birth rates during this period. The result of people living longer and having fewer children is a progressive ageing of Latin American societies. This article explores some critical questions posed by the ageing of populations in these societies. Within the context of varying patterns of national development, special emphasis is placed on the systemic potential for politico-administrative response in the area of social and health services.

Herb Waite's Assignment: Africa

OpFlow Editorial Advisory Committee member Herb Waite is working for two years as a treatment plant specialist with Public Administration Service in Addis Ababa, Ethiopia. The former water treatment instructor at the Community College of Denver (Colorado) is concerned mainly with operator training during the project.

Special report: community mental health in China.

In late Fall 1979, I joined 24 people on a two week tour of the People's Republic of China to study the alcohol, drug abuse and mental health problems of that country. The group was organized by the Rutgers University School of Alcohol Studies and included psychiatrists; psychologists; physicians; an educator; professionals in substance abuse, family planning and domestic violence; a member of the Swedish Parliament; a spouse of one group member and a 22 month-old child. Our group visited four major cities in the People's Republic of China: Kwangchou (Canton), Peking, Shanghai and Changsha. We met with psychiatrists from medical colleges who also staff psychiatric units in the university-based hospitals, psychiatrists from non-university affiliated psychiatric hospitals, members of the public health service (representing prevention and treatment, medical operations and health education), psychologists and hospital administrators. In addition, we visited hospitals, psychiatric facilities, factories, communes, workers' homes and schools in the four cities. Arrangements for the tour in China were made through the Chinese International Travel Service which also provided one interpreter-guide to accompany us throughout the trip plus additional interpreter-guides in each city. Although the guides were helpful, it seemed that some questions and answers lost a great deal in translation. There were times when our guide would offer a short interpretation of what had been a long response from the people answering our questions, and we sometimes suspected that information deliberately was not being conveyed. However, we were forced to rely on these verbal reports from the Chinese professionals, and on our own observations, since there is a scarcity of data and statistics. Community mental health in China must first be placed in the perspective of some very basic Chinese social systems (the family and the group) and a political system (production, information dissemination, group conformity) which differ significantly from our social and political systems. The Chinese place a very high value on the family unit and the functional aspects of the family. This is reflected in low divorce rates and in the extended family which typically has grandparents, parents and children living in close proximity.

THE DEPARTMENT OF THE PRIME MINISTER AND CABINET IN PERSPECTIVE

As much as any department, the Department of the Prime Minister and Cabinet comes in for its share of public comment, both as to functions and purpose, on its alleged struggle for supremacy in the economic or welfare or foreign policy field or somewhere else. Inside the Department we tend to give this sort of allegation a tired smile; and because it is wide of the mark, a first reaction is to be critical of the commentators. The second reaction, probably the proper one, is realization that there needs to be greater understanding of the role of the Department and its objectives, which can only be achieved by wider discussion and public debate. The proper reticence of senior officers about entering public debate on policy issues tends sometimes to flow over to a reticence on questions of public service administration. That is a pity, because public administration is our business: better administration is our objective. It is not something to be achieved within the confines of the public service; or more precisely it is to be achieved in fuller measure by debate and analysis inside and outside the Service.

Devon and the General Strike, 1926

Rural areas have generally been ignored in recent studies of the General Strike of 3–12 May 1926 on the implicit assumption that its impact in such areas would be negligible. To see if this assumption is correct this article examines the course of the strike in Devon and reaction to it. The likelihood of militant action in Devon in part depended upon the structure of the occupied population. In 1921 16 per cent of the occupied population of Devon County and the County Boroughs was in agriculture, and this rises to 25 per cent if we take the administrative county alone. In Exeter 49 per cent of the occupied population was in commerce, the professions, public administration, defence and personal service; in Plymouth the percentage for this group was 52 per cent. Consequently even the industrial areas were likely to be relatively weakly organised. Once out of the County Boroughs the industrial population, apart from a concentration of railwaymen at Newton Abbot, was so scattered as to make organisation and co-ordination difficult. There was no tradition of militancy in the county.