Chartered Institute of Public Finance and Accountancy



Public Money & Management

Volume 24, Number 2

April 2004

Contents

VIEWPOINTS

EDITORIAL
Changes to the Editorial Team
Andrew Gray

Academia and Practice in Public Management
Francis Terry

Evaluation and Accounting Standards
Robert Picciotto

CALL FOR PAPERS: 25TH ANNIVERSARY EDITIONS OF PUBLIC MONEY & MANAGEMENT

ARTICLES

Big Business: The Corporatization of Primary Care in the UK and the USA The corporatization of primary care in the USA and the UK over recent years has transformed the way that these services are managed and delivered. Traditional approaches have been largely overtaken by new models in which doctors, nurses and other primary care professionals work within much larger organizations. Judith Smith and Kieran Walshe explore the experience in the USA and the UK of seeking to organize primary care more corporately, and suggest that a tightly managed organizational model does not work well in primary care. Looser, network-based models are needed in which some of the benefits of corporatization can be achieved while the traditional smallorganization virtues of primary care can continue to thrive.

A '3RS' Strategy for Public Service Turnaround:
Retrenchment, Repositioning and Reorganization
Problems of public service 'failure' are high on the political agenda in the UK, and many national and local organizations are searching for effective turnaround strategies. Evidence from studies on turnaround strategies in the private sector suggests that organizations should pursue retrenchment, repositioning and reorganization. George A. Boyne's article will help managers to think more clearly about turnaround strategies that could work in their organizations.

Executive Agencies: Have they Improved Management in Government?
The UK's Next Steps programme has now been running for 15 years. It has been copied internationally, but has never been evaluated officially. Colin Talbot looks at whether Next Steps has achieved its immediate goals of structural and institutional change, and whether these have led to behavioural change and improved performance.

Reorganizing Two-Tier Local Government for Regional Assemblies
Referenda are to be held in three northern regions of England regarding the establishment of elected regional assemblies. If these are established, the areas with two-tier local government would be converted to unitary structures because the Government asserts that this would be necessary because the retention of the two tiers would be the retention of one tier too many. Following an analysis of the Audit Commission's Comprehensive Performance Assessment (CPA) ratings for the single tier and county councils, Michael Chisholm challenges this assertion. In addition, he explains why the electorate in the regions might not have a clear idea of the cost implications of restructuring local government.

The Politics of Evidence-Based Health Policy-Making
Israel's health-care system was substantially reformed following legislation in 1995. The main thrusts of the reform were to universalize health insurance coverage, increase freedom of choice, depoliticize the system, stabilize the system financially, and decrease service provision by the state by transferring some responsibilities to regulated 'sick funds'. Data were to play an important role in depoliticizing and making decision-making more rational. Robert Schwartz and Bruce Rosen explain why the Israeli experience gives some encouragement to proponents of evidence-based policymaking but show that, even where the intention is to use data, political motives are a strong force.