DOCTORS AS MANAGERS - New Public Management in a New Zealand hospital

In a corporatized New Zealand public hospital, senior management introduced a strategy of ‘clinical leadership’ intended to incorporate clinicians more fully within some system of organizational control, and to make them accountable for the resources consumed as a consequence of their treatment decisions. An organizational restructuring created semiautonomous business units based around clinical specialities and headed by clinician managers. Clinician managers played a boundary role between their professional colleagues and management. In the short term, a number of senior clinicians adapted to this role and there was some evidence for their acculturation into managerial identifications. However, the majority of clinician managers acted to absorb change rather than actively champion change. For many clinical units, clinical practice continued more or less unchanged. The concept of loosely coupled systems is used to explain this separation of internal operations from organizational form.     

The problem with pay flexibility: changing pay practices in the UK health sector

This paper critically assesses models and policies of pay flexibility as applied to the public sector. Examination of the arguments for greater pay flexibility across three dimensions - external labour market flexibility, organizational flexibility, and macroeconomic flexibility - reveals a number of weaknesses, rooted in a failure to problematize the conflicting motives for greater pay flexibility in the context of pressures internal and external to the organization. An alternative 'model' of changing pay systems is developed and applied to the case of the UK health sector where there have been attempts to introduce various forms of flexible local pay arrangements. Drawing on interviews conducted during the mid-1990s with personnel and HRM managers at fifteen NHS Trusts, a number of issues are examined, such as: the impact of differential external labour market conditions of workers on the development of strategies designed to tie local pay to improved performance; the introduction of performance-related pay as a means to institutionalize wider earnings differentials within the organization; and the potential conflict between pressures to link local pay structures with local labour market conditions, on the one hand, and customary employee-held norms that link pay to occupational skills and professional status, on the other.     

Pathology Services as a Pilot for the Market-led Control of Health Resources in New Zealand

This article examines the management of New Zealand's publicly funded pathology services throughout the 1990s in the context of the 'more market' radical reshaping of health services that occurred over that time. Because of the extreme market discipline to which they were subjected, pathology services are interpreted in the analysis presented here as a managerial 'pilot experiment' conducted by a health administration pursuing a long-term agenda of full privatization in health care services. Arguing from extensive archive and interview data collected over the last decade, the authors conclude that compromises involved in maintaining market-led resource control, together with unforeseen repercussions, made the strategy untenable in the New Zealand health care environment.     

空间资源紧缺下的城市密度演变与政策价值取向——以深圳市为例(2000年至2006年)

本文在2000年深圳市密度特征的基础上,分析了至2006年的全市密度总体演变趋势和结构(特区内外和用地类型)演变趋势.并进一步分析了在空间资源极度短缺的深圳市.城市密度政策受到多重价值取向的叠加影响,其表现出的实际结果往往更具政策参考价值.     

Seeing Like a City‐State: Behavioural Planning and Governance in Egypt's First Affordable Gated Community

Haram City is Egypt's first ‘affordable’ gated community, hosting both aspirational middle‐class homeowners and resettled poor urban residents. Amidst legal ambiguity during Egypt's 2011–2013 revolutionary period, the management team of this public–private partnership was tasked with creating a ‘fully self‐sufficient’ city. While Haram City is the product of top‐down ‘seeing like a state’ master planning (Scott, 1998 ), the day‐to‐day resolution of class vulnerabilities and disputes over ‘reasonableness’ in city life requires forms of interpersonal adjudication otherwise addressed through local urban law—‘seeing like a city’ (Valverde, 2011 ). This article uses ethnography of management techniques aiming to ‘upgrade behaviour’ to theorize that a private entity, in a strategically indeterminate relationship with the state, reconciles future‐oriented planning and storied prejudices by merging two visions of governance. Imitating the repertoire of urban law, managers plan the very realm of bottom‐up decision making. They then adapt top‐down urban planning to bottom‐up dispute resolution to spatially consolidate the ‘consensual’ outcomes of a rigged game. Evoking both colonial Egyptian vagrancy laws and neoliberal paternalist welfare, ‘seeing like a city‐state’ governance amounts to authoritarianism that conceals itself within custom, appearing neutral so as to plan streets, codes and inner lives at once.