Browse
Health inequalities researchers have long advocated for governments to adopt policy instruments that address structural determinants of health rather than targeting individual behaviours. The assumption behind this position is that such instruments might challenge a core neoliberal principle of individualism embedded in the prevailing health policy paradigm. We critique this assumption by highlighting the discursive construction of policy instruments, and their discursive effects. Using the UK’s Tackling Obesity policy as a case study, we demonstrate how instruments designed to target structural determinants of health (such as food advertisement regulation) can actively sustain – rather than challenge, the dominant policy paradigm. We call this phenomenon ‘upstream individualism’, exploring how it relates to tensions in the research-policy relationship, and its relevance beyond health policy. We argue that instruments can shape policy change and continuity, including at a paradigm level, and that ‘upstream individualism’ provides a useful basis for theorising these power dynamics. This article contributes to the constructivist public policy literature by noting how policy instruments meant to challenge the discursive construction of individualism within public health can ultimately reinforce it.
Why and how do policymakers initially sceptical of policy innovations from abroad eventually transfer them to their own countries? Focusing on Chile’s reforms to combat business cartels in 2009 and 2016, this article answers that question. Policy diffusion and transfer literatures maintain that coercion, competition, learning or emulation could account for foreign inspirations in policymaking. However, these literatures overplay the role of coercion and emulation in policy transfer to countries in the global south, and have difficulty distinguishing between different mechanisms in empirical studies. To address these limitations, I suggest analysing three intermediate causal steps in policy transfer: first, policymakers’ motivations in initiating policy reforms, second, their reflections on how the foreign-inspired model responds to the policy problem at hand, and third, their reflections on the fit between the foreign model and domestic conditions. Through process-tracing of two anti-cartel reforms in Chile, I find that policymakers introduced foreign-inspired policy measures to combat business cartels through a process of learning from other countries and international organisations, rather than coercion or emulation. Learning was evident in three ways. First, in the initiation of the reform, as policymakers responded to a clearly identified policy problem; second, in policymakers’ careful reflection on how the foreign-inspired model responded to these problems; and third, in the adjustments made to fit the foreign model to domestic conditions. The analysis demonstrates the utility of analysing intermediate causal steps in policy transfer, and of paying more attention to local actors and political processes.
The role of charity in the provision of public services is of substantial academic and practitioner interest, and charitable initiative within the English and Welsh National Health Service (NHS) has recently received considerable attention. This study provides rich insights into the role that NHS-linked charities present themselves as playing within the NHS. The dataset analysed is a novel construction of 3,250 detailed expenditure lines from 676 sets of charity accounts. Qualitative content analysis of itemised descriptions of expenditure allows us to explore how these charities portray their activities. We distinguish between expenditures that can be framed as supplementary to government funding (such as amenities and comforts) and items that suggest charitable effort is substituting for government support (such as funding for clinical equipment). We also consider the claims being made through these representations, and suggest that the distinctiveness of the charity and NHS spheres are currently under question. We argue that, through their representational practices, charities are both shaping and blurring the expected roles of government and charity. Acceptance of the benefits that charitable initiative does provide, in terms of innovation, pluralism and participation, must be tempered with the realisation that charitable funds are playing a role in service provision that is not guided by clear policy, and that this has the potential to widen existing inequalities within a key public service.
It is often asserted that the representation of women in leadership positions within public service organisations is likely to result in improved outcomes for other women within those organisations. However, there has been little systematic research devoted to understanding whether this argument holds for the nonprofit organisations that now provide many public services. To cast light on this important issue, this article presents an analysis of the representation of women in leadership roles and the gender pay gap in Welsh housing associations – registered societies responsible for providing more than half of the social housing within Wales. The findings show that nonprofit service providers led by women in the most senior organisational positions may be more likely to have a lower gender pay gap, confirming arguments about the importance of actively representing female interests. At the same time, it seems that representation in the upper echelons in general is not likely to influence gender pay equality, which raises questions about whether a glass ceiling may be present, as has been observed in state-led public service provision. These findings suggest a need for more in-depth, multi-method research which systematically evaluates the way in which female leaders actively represent women’s interests in the myriad organisations that provide public services. This article has important implications given a renewed period of austerity in the public sector, which, as in the past, may threaten further progress on equality for those women who provide and receive public services.
This article provides an important international empirical application of the multiple-streams framework with some theoretical additions that make a novel contribution to the existing scholarship in this field. Using a modified multiple-streams approach (MSA) that extends Kingdon’s original agenda setting model to the decision-making stage, we analyse and explain an empirical puzzle in the context of the environmental regulation of coal-fired power plants, considered central to India’s economic development. The puzzle involves both the content – a stringency comparable to those in more developed economies – and the timing – within a year of a new national government coming to power with the promise of reviving economic growth. Our findings show how a top bureaucrat exploited the agenda window opening in the problem stream to couple the three streams, resulting in the notification of draft environmental standards. The political entrepreneurship of the same bureaucrat led to the adoption of final standards in the same form as the draft in the decision window created by developments during the period leading to the Paris climate summit. The operationalisation of the modified MSA to our empirical case generated new theoretical insights. First, we expand on the original formulation of decision stage dynamics and argue that the decision window could also open due to independent activity in any of the three streams. Second, we argue that transnational politics could act as an additional factor in the ripening of the political stream at the decision stage.
Over the past decade, there has been growing interest in the theory and practice of design in the public sector. Service design aims to improve the experience of public services through a human-centred, iterative and collaborative process of creativity and problem solving. However, there is a lack of empirical research on the application of design approaches in public service settings. This article aims to fill that gap, drawing on service research and empirical illustrations to explore what is being designed, how service design is practised, and the implications of service design. By applying ‘design of services’ and ‘designing for service’ perspectives, the focus of design is discussed, along with its implications for design practice and impact. While the analysis suggests an important shift in the practice of design with a focus on services, it proposes that applying design for service may further the potential of design and support deeper transformation. In this way, the article makes a significant contribution to scholarship on policy design, as well as public service delivery.
Articulating the research priorities of government is one mechanism for promoting the production of relevant research to inform policy. This study focuses on the Areas of Research Interest (ARIs) produced and published by government departments in the UK. Through a qualitative study consisting of interviews with 25 researchers, civil servants, intermediaries and research funders, the authors explored the role of ARIs. Using the concept of boundary objects, the paper considers the ways in which ARIs are used and how they are supported by boundary practices and boundary workers, including through engagement opportunities. The paper addresses the following questions: What boundaries do ARIs cross, intended and otherwise? What characteristics of ARIs enable or hinder this boundary-crossing? and What resources, skills, work or conditions are required for this boundary-crossing to work well? We see the ARIs being used as a boundary object across multiple boundaries, with implications for the ways in which the ARIs are crafted and shared. In the application of ARIs in the UK policy context, we see a constant interplay between boundary objects, practices and people all operating within the confines of existing systems and processes. For example, understanding what was meant by a particular ARI sometimes involved ‘decoding’ work as part of the academic-policy engagement process. While ARIs have an important role to play they are no magic bullet. Nor do they tell the whole story of governmental research interests. Optimizing the use of research in policy making requires the galvanisation of a range of mechanisms, including ARIs.
Alongside efforts to improve evidence use in policy, grassroots demands and governance-driven democratisation are informing an ever-increasing range of public engagement processes in UK policy. This article explores how these simultaneous efforts intersect within three policy organisations working at different levels of UK policy: local (Sheffield City Council), regional (Greater Manchester Combined Authority) and national (devolved) (Scottish Government). Employing documentary analysis and 51 interviews with individuals working in these organisations, we argue that there are organisational similarities in approaches to evidence and engagement, including: conceiving of both ‘data’ (statistics tracked by internal analysts) and ‘evidence’ (external analysis) in primarily quantified terms; and a tendency to limit the authority of publics to advising and consulting on predefined issues. Yet, we also find growing interest in more in-depth understandings of publics (for example, via ‘lived experiences’) but uncertainty about how to use these qualitative insights in settings that have institutionalised quantitative approaches to evidence. We identify four distinct responses: (1) prioritising public engagement; (2) strategically using public engagement and evidence to support policy proposals; (3) prioritising quantified evidence and data; and (4) attempting to integrate these distinct knowledge types. Surprisingly (given the organisational importance afforded to metrics), we categorised most interviewees in Cluster 4. Finally, we explore how interviewees described trying to do this kind of integration work, before reflecting on the promise and limitations of the various mechanisms that interviewees identified.
This article examines one of the causal concepts in the second advocacy coalition framework (ACF) policy change hypothesis: the notion that major policy change will not occur as long as the advocacy coalition that instated the policy status quo remains ‘in power’ in a jurisdiction. It examines the role of this causal concept in ACF theory. It then reviews existing scholarship on the causal concept, identifying relevant empirical evidence and critically examining how the concept has been operationalised. A standard operationalisation is proposed, defining status quo advocacy coalitions as ‘in power’ if they control a veto player in a jurisdiction’s policy process. Changes in Canadian firearms policy between 1976 and 2012 are used to illustrate the operationalisation and explore its potential.
This article analyses the preferred advocacy strategies of industry representatives and environmentalists in the conflict over oil and gas drilling in the state of Colorado. Environmental policy, social movement and nonprofit literatures describe the advocacy strategies of those seeking to influence policy. While early work assumed that actors with greater resources rely on inside tactics and those with fewer resources rely on outside tactics, more recent studies suggest that policy actors use an array of tactics. To build on recent research and improve our understanding of strategic decisions, this study examines the role that venues play in policy actors’ perceptions of the effectiveness of their advocacy tactics. Specifically, this research compares self-reported strategy effectiveness among members of the oil and gas industry with representatives of environmental groups, and asks whether effectiveness is moderated by perceptions of venue viability. Data derive from two waves of surveys of oil and gas policy actors in Colorado. Results hold implications for stakeholder engagement and suggest that venue perception is relevant to strategy effectiveness, but only within regulatory venues. In this way, the article makes a clear contribution to the interest group literature as well as the environmental policy subsystem literature.
