ALBERT

Notes: Draws upon detailed empirical work undertaken with elected members and senior officers from a sample of 30 UK local authorities. Its focus is on the ways in which authorities have responded to rapid changes in the economic, social and political contexts and the profound challenges which these present to traditional modes of policy making and public management. Suggests that existing theoretical frameworks give insufficient attention to implications of changing local governance for the roles of elected members and that, in practice, most councillors feel ill-equipped to respond to these changes. Local authorities need therefore to develop training and support for local politicians in fulfilling their rapidly changing and increasingly demanding roles. In particular they should look at ways of supporting elected members in working with external agencies so that they bring the "added value" of locally accountable political leadership to the work of partnerships involving public, private and voluntary sectors agencies. This will require them to embrace new forms of communication and methods of learning which are likely to be one of the key ingredients in attempts to revitalize local democracy.

Notes: Of many managerialist panaceas, the most prevalent one today is the assertion that private sector practices will solve the public sector's "self-evident" inadequate performance. This managerialist view assumes hegemonic proportions in Anglo-Saxon public sectors and largely goes unchallenged, notwithstanding serious reservations about the superiority of private managerial prerogatives one would draw from organization theory or, even, mainstream liberal economics, which is largely silent about the role of management and control in economic behaviour. It is a particular brand of economics that underscores the linking of public agency efficiency to managerial ability and performance. In neo-institutional economics, "rent-seeking" behaviour is attributed to civil servants, rather than corporate entrepreneurs, and from that ideological perspective of bureaucratic pathology flows a whole series of untested propositions culminating in the commercializing, corporatizing and privatizing rationales, now uncritically accepted by most bureaucrats themselves to be axiomatically true. The economistic underpinning of managerialism and its "New Functionalism" in organizational design hardly addresses the significant structural, cultural and behavioural changes necessary to bring about the rhetorical benefits said to flow from the application of managerialist solutions. Managerialism expects public managers to improve efficiency, reduce burdensome costs and enhance organizational performance in a competitive stakeholding situation. Managerialism largely ignores the administrative-political environment which rewards risk-averse behaviour which, in turn, militates against the very behavioural and organizational reforms managerialists putatively seek for the public sector.

Notes: Over the past decade, there has been growing international interest in utilising private contractors to improve efficiency and reduce costs of road maintenance. In developing countries the existing private contracting sector is often too weak to take on this work. Accordingly projects to foster private sector involvement have been designed and implemented through international technical assistance, with a varying emphasis on financial, training and other support in order to achieve a workable market. This paper discusses case studies from five different countries which vary widely, in terms of social, cultural, contractual and organizational practices. While there are many different aspects to a construction development programme the paper discusses the issues of international assistance, training programmes, equipment provision, contracts and payments, programme objectives, contractor selection. Lessons are drawn from previous project experience in order to propose guidelines for future contractor development projects.

Notes: This article examines contracting-out in practice in public health and water services in Ghana. Drawing on in-depth interviews and discussions with knowledgeable officials, complemented by documentary analysis and secondary sources, the article provides insights into some of the institutional constraints and capacity issues that policy-makers and implementers need to be aware of in seeking to introduce and implement contracting-out policies in a developing country context. Though contracting-out in Ghana's health and water sectors has so far been used in the provision of support services, attempts to broaden its application to include the direct provision of core services raise a number of capacity questions related to regulatory frameworks, enforcement and monitoring mechanisms, development of management information systems and skills for contract management. The capacity and willingness of the private sector to take on direct provision of public services are also crucial.

Notes: The focus of the paper is on the relationship between General Practitioners (GPs) and central government. This relationship dates from the introduction of national health insurance in the UK. From the outset it had an impact on GPs' medical role, their professional status and income. The structure created in 1911 meant that GPs operated as franchisees and, notwithstanding Labour's policy objective of creating a salaried service, this role continued, effectively unchanged, after the creation of the National Health Service (NHS) in 1948. General Practice was also the poor relation in contrast to hospital medicine, a feature intensified by the priorities of the NHS. These forces meant that GPs had a dual role: that of clinician and gatekeeper to specialist hospital services, a role in which they exercised substantial clinical freedom: and running a small business, a feature which was exaggerated by the absence of grant aid to improve premises prior to the Family Doctor Charter of 1965. This structural relationship has been progressively transformed by changes in the 1980s and 1990s. On the one hand the emphasis on cost control has seen central government attempting to combine a financial with a clinical gatekeeping role. The crucial change in this respect is the creation of GP fundholding which, in turn, could be seen to have implications for the subordinate status of GPs within the medical profession. However, this has been combined with trends to greater measures of control over GPs. Of central importance in this respect were the changes introduced by the 1990 GP contract. The contract involved an attempt to substantially reduce clinical autonomy by building in much more detailed contractual duties with respect for example, to health promotion activities. This was combined with the use of financial incentives to reach, for example, immunization targets. Control over clinical autonomy has also involved constraints over prescribing and the shift from Family Practitioner Committees to Family Health Service Authorities. The rationale for this shift is the move from an administrative to a managerial body, acting as the agent of central government in enforcing the contract and imposing financial norms. GPs are thus to be made managerially accountable. The paper analyses the place of general practitioners in central government's approach to health strategy and examines the tensions generated by the combination of conferring new powers on GPs and increasing controls over them. These tensions are related to current disputes over out-of-hours working and attempts by GPs to redefine a "core of service" approach to their job. The ambiguities of reliance on professionals combined with the desire to exert greater controls is traced in the recent policy statement by the Secretary of State Primary Care: The Future (1996). The paper thus aims to contribute to the critical discussion of the impact of central government managerialist initiative on key professional groups in the welfare state.

Notes: Describes the reorganization of social services in Munich, Germany, from 1992 to 1996. A model of co-operation between different providers of public services was introduced. Its use was confirmed in 1997.

Notes: In the UK the Benefits Agency is seeking to process its business more efficiently, and commissioned research to investigate the number and nature of the contacts customers have with the Agency. The paper draws on this research and outlines the case for adopting a longitudinal perspective to elucidate and analyse customers' contacts with a welfare provider. No research design is unproblematic, and the lessons learned in mapping the customers' contacts will be discussed. In particular, the difficulties encountered and the solutions adopted in drawing a sample representative of pieces of business, in designing a contact grid, and in operationalising the notion of a contact will be elaborated. Some key findings from the research are used to illustrate the advantages of a longitudinal study.

Notes: The paper describes the application of a group decision support system (GDSS) to the work of a panel of public sector workers assessing the needs of clients for various forms of social support and benefit. In particular, the paper focuses on the development of consistency of approach to judgement when the workers come from a variety of professional backgrounds. The application is concerned with the introduction within Norway of an approach to the production of judgemental information relating to clients, and for its subsequent utilisation in a national system. The framework, known as GERIX, is intended to ensure that assistance and support is provided on a fair and equitable basis across the nation. The approach is centred on a set of criteria designed to enable a comprehensive review of a client situation to be undertaken. Data for a client, utilising the criteria, are based on judgemental assessments by professionals. It is, therefore, critical for all involved in these assessments to understand and apply the model in a consistent way. Results strongly suggest that the approach to group process support enhances individual learning of professionals who are required to utilise the GERIX framework.

Notes: Outlines the urban redevelopment of Hong Kong from the early 1900s to the present day. Obstacles such as: absentee ownership, compensation to owners, resettlement of tenants, financial difficulties, piece-meal efforts and the lack of a centralized co-ordination body are discussed. The development of the Land Development Corporation has provided opportunity to address these problems, forming as it does a public/private development partnership.

Notes: The research on which this article is based has been carried out over a period of five years (1992-1997). It focuses on the management of change in the National Health Service (NHS) since the reforms introduced in the 1990 NHS Act. The research comprises four case studies: two NHS Trusts providing mental health services and two colleges of nursing and midwifery. All four bodies have experienced major changes brought about, in the main, by the creation of the NHS internal market. The article attempts to map the process of managing change in these four organizations. It outlines the difficulties encountered by managers in designing and implementing effective strategies for their organizations. In particular, the article: highlights major discrepancies in linking strategic plans with the reality of managing public services and the complexities of planning for large-scale changes in the 1990s; shows that although leadership is important, it must be appropriate to an organization's situation; argues that organizations can make false assumptions about the immutability of the environment in which they operate and the degree of choice available. The article concludes by presenting a model of change which incorporates environmental conditions, internal cohesion, management styles and approaches to change.