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Article
Publication date: 1 January 2006

Brian Dollery, David Murray and Lin Crase

To invoke Julian Le Grand's conceptual model of the interaction between human motivation and policy formulation in order to explain how motivational endogeneity in the university…

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Abstract

Purpose

To invoke Julian Le Grand's conceptual model of the interaction between human motivation and policy formulation in order to explain how motivational endogeneity in the university environment has distorted policy outcomes in the Australian higher education reform program.

Design/methodology/approach

Le Grand contends that changes in the perception of policy makers of both motivation and agency in the public sector have transformed public sector reform programs in the past two decades. However, because producers and consumers of public services react vigorously to different policy presumptions of their behaviour, a problem of endogeneity arises that may distort the intended outcomes of reform processes. This conceptual framework is applied to higher education reform in Australia from the so‐called Dawkins reform program in the late 1980s onwards.

Findings

Argues that the Le Grand model can shed light on the changes in Australian higher education that have occurred as a consequence of the ongoing reform process and account for at least some of the unintended negative consequences of the reforms.

Originality/value

The paper represents the first application of the Le Grand model to higher education reform.

Details

Journal of Educational Administration, vol. 44 no. 1
Type: Research Article
ISSN: 0957-8234

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Article
Publication date: 1 July 1995

Hugh V. McLachlan

Le Grand gives an illustration of an employment situation which would generally be considered racist ‐ (Amanda and Catherine are equally talented and hard‐working employees. The…

53

Abstract

Le Grand gives an illustration of an employment situation which would generally be considered racist ‐ (Amanda and Catherine are equally talented and hard‐working employees. The former is white and better paid than her black colleague) ‐ and gives an analysis of the ethics of the situation in terms of his theory of equity. I shall discuss his analysis and his theory of equity. Is the situation inequitable? If it is, is it ‘inequitable’ for the reason that Le Grand puts forward as constituting the essence of ‘inequity’?

Details

International Journal of Sociology and Social Policy, vol. 15 no. 7
Type: Research Article
ISSN: 0144-333X

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Article
Publication date: 23 May 2008

Kate Baxter, Marjorie Weiss and Julian Le Grand

The purpose of the paper is to investigate the inter‐ and intra‐organisational relationships in the commissioning of secondary care by primary care trusts in England, using a…

966

Abstract

Purpose

The purpose of the paper is to investigate the inter‐ and intra‐organisational relationships in the commissioning of secondary care by primary care trusts in England, using a principal‐agent framework.

Design/methodology/approach

The methodology is a qualitative study of three case studies. A total of 13 commissioning‐related meetings were observed. In total, 21 managers and six consultant surgeons were interviewed.

Findings

There are a number of different levels at which contractual and managerial control take place. Different strengths of control at one level can affect willingness to comply with agreements at other levels. Agreements at one level do not necessarily result in appropriate or expected action at another.

Research limitations/implications

The system for commissioning in the National Health Service (NHS) has changed with the introduction of payment by results and practice‐based commissioning. However, the dynamics of the inter‐ and intra‐organisational relationships studied remain.

Practical implications

Incentives within organisations are as important as those between organisations. Within a chain of principal‐agent relations, it is important that a strong link in the chain does not result in the exploitation of weaknesses in other links. If government targets and frameworks are to be met through commissioning, it may be advantageous to concentrate efforts on developing incentives that align clinician with NHS trust objectives as well as NHS trust with primary care trust (PCT) and government objectives.

Originality/value

This paper is based on original empirical work. It uses a principal‐agent framework to understand the relationships between PCTs and NHS trusts and highlights the importance of internal NHS trust governance systems in the fulfilment of commissioning agreements.

Details

Journal of Health Organization and Management, vol. 22 no. 2
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 17 August 2015

Karsten Vrangbaek

The purpose of this paper is to investigate different types of patient involvement in Denmark, and to discuss the potential implications of pursuing several strategies for patient…

1629

Abstract

Purpose

The purpose of this paper is to investigate different types of patient involvement in Denmark, and to discuss the potential implications of pursuing several strategies for patient involvement simultaneously.

Design/methodology/approach

The paper presents a preliminary framework for analysis of patient involvement in health care. This framework is used to analyze key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care.

Findings

Patient involvement is important in Denmark at the rhetorical level, and many policies and initiatives have been introduced. All three governance forms (voice, choice and co-production) are used. However, there are important barriers and limitations in translating the rhetoric into practice, and potential synergy and negative synergy effects can be identified when pursuing the strategies at the same time.

Research limitations/implications

Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed framework further.

Practical implications

The paper includes implications for the development of patient involvement in health care.

Originality/value

This paper fulfills a need to study different types of patient involvement and to develop a theoretical framework for characterizing and analyzing such involvement strategies.

Details

Journal of Health Organization and Management, vol. 29 no. 5
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 21 December 2015

Ray Jones

Whilst the government makes progress on opening up children’s social work, including child protection, to the market place and to private and commercial businesses, there has been…

814

Abstract

Purpose

Whilst the government makes progress on opening up children’s social work, including child protection, to the market place and to private and commercial businesses, there has been little comment on the strengths and weaknesses, and the opportunities and threats, of the political policy direction being pursued. In particular, what are the implications for the integration and consolidation of services, which had been the “joined-up” services policy ambition of previous governments and, for health and social care services, remain the declared ambition of the current government? The paper aims to discuss these issues.

Design/methodology/approach

This paper considers the potential impact on children’s social work services and child protection from the government’s policy and regulatory changes which open up all children’s social work to the market place.

Findings

Particular concerns are noted that the changes now being allowed and promoted will lead to greater fragmentation rather than integration.

Originality/value

This is the first paper to reflect on the government’s push and preference for the unregulated market place it created in 2014 for children’s social work, including child protection.

Details

Journal of Integrated Care, vol. 23 no. 6
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 1 May 1987

R.G. Brooks

Health economics is now a well‐established topic within the discipline of economics. A 5,500‐item bibliography covering material up to 1982 is available (Blades et al, 1986)…

209

Abstract

Health economics is now a well‐established topic within the discipline of economics. A 5,500‐item bibliography covering material up to 1982 is available (Blades et al, 1986). Health economists write on such diverse matters as (to select at random) demand for acute care in hospitals, the costs of illness, the economics of alcoholism, cost‐benefit analysis in magnetic resonance imaging, and the pros and cons of any number of ways of financing the delivery of health services. Here in the UK the Health Economists' Study Group boasts around 150 members. Meanwhile, hardly a day goes by without the newspapers containing items concerning topics which could form the basis for health economists' involvement in analysis, evaluation and, in some cases, policy advice. The jargon of economics and evaluation is becoming familiar to a wider audience: thus articles on cost‐effectiveness and cost‐benefit analysis appear regularly in medical journals and the quality‐adjusted life‐year (QALY) has featured on TV. Thus a review of some of the recently published books in this area would appear appropriate at this juncture.

Details

Journal of Economic Studies, vol. 14 no. 5
Type: Research Article
ISSN: 0144-3585

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Article
Publication date: 1 July 2001

Colin Talbot

Examines the way the public sector and public management evolved in the UK over the last two decades of the twentieth century. Concentrates on the period between 1979 to 1997 when…

3636

Abstract

Examines the way the public sector and public management evolved in the UK over the last two decades of the twentieth century. Concentrates on the period between 1979 to 1997 when the UK had a succession of Conservative governments, when there was a kind of “arms race” of escalating rhetoric between the right and the left. Attempts to present a balanced account of what actually happened to the UK’s public sector in general. Concludes that public services are still a very large proportion of national life, and that they have not qualitatively altered the share of national resources they consume, the numbers of people they employ or the range of services they offer.

Details

International Journal of Public Sector Management, vol. 14 no. 4
Type: Research Article
ISSN: 0951-3558

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Article
Publication date: 1 March 1993

Uri Yanay

In many western, industrialised countries, the shrinking role of governments in providing direct services is manifested by the transfer of traditional government services to…

142

Abstract

In many western, industrialised countries, the shrinking role of governments in providing direct services is manifested by the transfer of traditional government services to voluntary, non‐ profit organisations. An additional stage is marked by a significant reduction in government contributions to these non‐ profit organisations.

Details

International Journal of Sociology and Social Policy, vol. 13 no. 3/4
Type: Research Article
ISSN: 0144-333X

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Article
Publication date: 7 June 2013

Patricia Dearnaley

Changes in the social care sector over the past 20 years have effected a fundamental shift in commissioning and delivery relationships, creating new markets for social housing…

185

Abstract

Purpose

Changes in the social care sector over the past 20 years have effected a fundamental shift in commissioning and delivery relationships, creating new markets for social housing services. This paper aims to examine how far existing theories around competitive advantage in markets are compatible with the new public management (NPM) approach to the market, or whether there is a need for a new approach to business planning for agencies that addresses the particular characteristics of this specific quasi‐market.

Design/methodology/approach

This paper draws upon original research developed through a single holistic case study of a UK social housing service, using qualitative research methods including document analysis, interviews, secondary data, observations and facilitated meetings.

Findings

Existing business theory and models around competitive advantage do not suit this “contrived” NPM market. A new framework or model will be needed for analysis and business planning in this new environment.

Originality/value

This paper adds to existing knowledge by critiquing current business models, and positing a potential development to existing contingency theory: the external drivers model. The study has resulted in a number of outputs including an outline of a toolkit to assist in using the model. The model requires further research to establish its generalisability to other organisations and other sectors.

Details

Housing, Care and Support, vol. 16 no. 2
Type: Research Article
ISSN: 1460-8790

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Article
Publication date: 1 March 1992

John Conway O'Brien

A collection of essays by a social economist seeking to balanceeconomics as a science of means with the values deemed necessary toman′s finding the good life and society enduring…

1243

Abstract

A collection of essays by a social economist seeking to balance economics as a science of means with the values deemed necessary to man′s finding the good life and society enduring as a civilized instrumentality. Looks for authority to great men of the past and to today′s moral philosopher: man is an ethical animal. The 13 essays are: 1. Evolutionary Economics: The End of It All? which challenges the view that Darwinism destroyed belief in a universe of purpose and design; 2. Schmoller′s Political Economy: Its Psychic, Moral and Legal Foundations, which centres on the belief that time‐honoured ethical values prevail in an economy formed by ties of common sentiment, ideas, customs and laws; 3. Adam Smith by Gustav von Schmoller – Schmoller rejects Smith′s natural law and sees him as simply spreading the message of Calvinism; 4. Pierre‐Joseph Proudhon, Socialist – Karl Marx, Communist: A Comparison; 5. Marxism and the Instauration of Man, which raises the question for Marx: is the flowering of the new man in Communist society the ultimate end to the dialectical movement of history?; 6. Ethical Progress and Economic Growth in Western Civilization; 7. Ethical Principles in American Society: An Appraisal; 8. The Ugent Need for a Consensus on Moral Values, which focuses on the real dangers inherent in there being no consensus on moral values; 9. Human Resources and the Good Society – man is not to be treated as an economic resource; man′s moral and material wellbeing is the goal; 10. The Social Economist on the Modern Dilemma: Ethical Dwarfs and Nuclear Giants, which argues that it is imperative to distinguish good from evil and to act accordingly: existentialism, situation ethics and evolutionary ethics savour of nihilism; 11. Ethical Principles: The Economist′s Quandary, which is the difficulty of balancing the claims of disinterested science and of the urge to better the human condition; 12. The Role of Government in the Advancement of Cultural Values, which discusses censorship and the funding of art against the background of the US Helms Amendment; 13. Man at the Crossroads draws earlier themes together; the author makes the case for rejecting determinism and the “operant conditioning” of the Skinner school in favour of the moral progress of autonomous man through adherence to traditional ethical values.

Details

International Journal of Social Economics, vol. 19 no. 3/4/5
Type: Research Article
ISSN: 0306-8293

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