A Simple Matter of Control? NHS Hospital Nurses and New Management*

ABSTRACT Over the past two decades the National Health Hospital Service has been subjected to considerable changes in is organization. ‘New’ public sector management (NPM) has been given the task of changing hospital culture and making service provision more efficient. Nurses, as the largest occupational group within the National Health Service (NHS), have attracted considerable management attention and there are two distinct accounts concerning how NPM has supposedly gained control of the nursing labour process. Firstly, it is proposed that the physical division of labour of health care professionals is now firmly in the hands of hospital management through the use of Tayloristic techniques. Secondly, alternative accounts suggest that public sector organization cultures have been successfully orientated toward a customer service ethos, and that the convincing discourse of ‘quality’ is achieving some success as a normative control device. This paper investigates the responses of nurses to NPM, whichever form this may take, and presents data collected as part of a longitudinal study carried out in an NHS Trust hospital. It charts the changes which have occurred in the nursing labour process over a six year period, but especially draws upon more recent data to show how nurses, over a period of time, develop their own ways of reinterpreting management's desires. It argues that management is more likely to continue to rely on nurses’ traditional autonomy in the delivery of health care in recognition that nurses may resist some but accommodate many of the demands made of them.     

Service Guarantee Strength: The key to service quality

While most authors describe a service guarantee as a “zero-one variable” indicating the presence or absence of an explicit written service guarantee, this paper develops a construct called “Service Guarantee Strength” (SGS) that is a continuous variable. This construct measures the degree to which a firm sets clear service quality standards for itself on dimensions that customers care about, and has an formal policy for quickly giving meaningful compensation to customers when these standards are not met.The paper builds upon established micro-level behavioral theory to develop the “Service Guarantee Strength Framework”. This framework posits that high Service Guarantee Strength leads to improved service quality, customer satisfaction, and loyalty through three intervening variables—marketing communications impact, employee motivation and vision, and learning through service failure.An empirical investigation was conducted to test the SGS Framework using both employee and customer data from three pairs of firms, with each pair in a different industry. None of these firms had an explicit service guarantee. Unlike many behavioral research studies, this study measured both employee and customer perceptual data and compared the two. The research finds that Service Guarantee Strength is positively related to customer perceptions of service quality, customer satisfaction, and loyalty.     

The new public management and the UK Police Service

This article explores the impact of the introduction of the New Public Management (NPM) within the UK Police Service since the mid-1990s. A specific focus upon individual performance management (one of the central features of NPM) is examined from the perspective of the police sergeant who has primary responsibility for managing performance and ultimately the delivery of policing services within one of the UK's ‘essential’ public services. After a discussion of the literature on individual performance management within the context of the NPM, the article identifies four major research questions relating to: the job role demands of performance management; access to valid and reliable performance management information; the capacity to provide follow-up development and support; and the wider integration of performance management with organization strategy and service objectives. After reporting on interview data collected from role sets in which the sergeant is a focal member, the article concludes with a discussion of the constraints upon effective performance management within the NPM.     

Public Management In North America

Although recent public management reforms in Canada. Mexico and the USA are characterized by similar themes and vocabularies - privatization, customer service, devolution - the nature and extent of actual change reflects the national politics and administrative histories of the three countries. In brief, Canadian public management has been heavily influenced by the need for fiscal retrenchment at both, national and provincial levels, Mexican public management has been influenced by the transition from oligarchic to democratic governance at federal, state and local levels, and USA public management has been preocuppied at the federal level with implementation of the Government Performance and Results Act and with the miscellaneous initiatives organized under the ‘Reinventing Government’ theme as it has been popularized by the Clinton administration.     

Accounting for Administrative Change in Three Asia-Pacific States

The New Public Management (NPM) appears to be of universal applicability. However, if examined on a country-by-country basis we can observe considerable variations. This article surveys public management change in three Asia-Pacific countries and contends that even in countries that share similar characteristics, in this case, British post-colonial bureaucracies, there is little uniformity. We might assume that administrative change is the result of the attraction of NPM to élites who shop around the international market for ideas, but this is a gross oversimplification. However, the apparent internation alization of NPM appears to be driven by policy transfer activity. The survey of public management in these countries reveals that although the policy transfer approach is difficult to apply empirically, it is worth pursuing as it strips away the appeal of NPM. Although in each of these countries, it is difficult to argue with any conviction that policy has been transferred from another country, a number of adaptations and ideas have been utilized by bureaucratic élites. Policy transfer is a more subtle process, and more ‘context sensitive’ than we might first assume. Even where a policy developed elsewhere can be demonstrated to be successful, its transfer to another country is less than, straightforward and often it is the rhetoric, rather than the substance, that is adopted.     

上海世博会公共服务与“中国服务”的提升

上海世博会是迄今为止中国举办的最大的一次盛会,集中体现了中国服务的新水准.世博会既是中国服务的见证,也是中国服务的一个新起点,推动着中国服务向更高水平发展.本文概括阐述了上海世博会公共服务的概念和主要类型;尝试构建了世博会公共服务流程和管理体系,从服务准备、服务实施和服务质量控制三方面分析了世博会公共服务的运营与传递;在此基础上,从六个方面说明世博会见证了中国服务的提升.     

Decentralization,the New Public Management,and The Changing Role of The Public Sector In Africa

The role of the public sector in most countries around the world is changing both with respect to public service delivery and the stimulation of economic progress. That change, which was occasioned by the need for policy reform, has resulted in what is now termed ‘the new public management’, reflecting a movement away from the old values and norms of public sector administration. This article examines and analyses the concept of decentralization and its relevance to the changing role of the public sector, within the context of ‘the new public management’. and with special reference to Africa. The perspective of the article assumes that the new public management provides an appropriate framework for responding to the efficient delivery of public services in Africa.     

Theorizing the organization and management of non-governmental development organizations

This article uses a case study of public recruitment in Nepal as the vehicle for a discussion of the value of three current public management models: an anticorruption model, a psychometric selection model and the new public management (NPM) model. The political context of Nepal and the role and functions of the Public Service Commission (PSC) are described. The article argues that, in contrast to current NPM doctrine, preserving the current remit of the PSC as a central agency responsible for recruitment is necessary to preserve the integrity of recruitment, which is an important element in an anticorruption strategy. The article also reviews the case for selective introduction of psychometric methods of selection. The article implies an increased importance for public recruitment in development thinking, and argues for the vital role of Service Commissions in limiting corruption. While recognizing the reality of the problems which the NPM model was developed to tackle, the article provides evidence for rejecting its claim to universality.     

NPM Can Work: An optimistic review of the impact of New Public Management reforms in central and eastern Europe

Abstract

This article reviews the New Public Management (NPM) literature in central and eastern Europe (CEE) with the aim of assessing whether reforms have ‘worked’. Increasingly, academics have tended to argue against the suitability of NPM instruments in this region. To understand the impact of this much-debated policy, we first propose a classification of the impacts of NPM geared to the realities of central and eastern European states. Then, we use this classification to carefully review empirical studies across the region over the past 10 years. Unlike much of the recent academic literature, we suggest that NPM can work. NPM policy has not always been successful to the extent expected and promoted, but there is enough evidence to show that some of the central ideas in NPM have led to improvements in public service organization or provision across different organizational settings. An adequate degree of administrative capacity, sustained reform over time and a ‘fitting context’ are the main factors that can tip the scale for the success of these management instruments. The article provides a fresh and transparent assessment of a major administrative development in a growing region with implications for other parts of the world that experience similar challenges and opportunities.     

Value Co-Creation through Patient Engagement in Health Care: A micro-level approach and research agenda

Abstract

Patient engagement has gained increasing prominence within academic literatures and policy discourse. With limited developments in practice, most extant academic contributions are conceptual, with initiatives in the National Health Service (NHS) concentrating at macro- rather than at micro-level. This may be one reason why the issue of ‘value co-creation’ has received limited attention within academic discussions of patient engagement or policy pronouncements. Drawing on emerging ideas in the services marketing and public management literatures, this article offers the first elucidation of the importance of studying ‘value co-creation’ as a basis for further empirical analysis of patient engagement in micro-level encounters.     

服务质量管理模型的研究

服务质量是当前企业所面临的关键问题，服务质量的控制管理对企业效益具有重要意义。本文从服务质量管理的角度，构造了客户反馈条件下的服务质量管理模型，并通过建模分析提出了不同服务质量管理策略的最优选择方法，为企业提高服务质量管理效果提供参考。     

Citizens’ Entrepreneurial Role in Public Service Provision

Abstract

In public service provision, citizens are conventionally reactive, portrayed as ‘users’, ‘customers’, ‘co-producers’, or ‘participators.’ Occasionally, following dissatisfaction, citizens themselves proactively create alternative services, namely, entrepreneurial exit (EE). Laymen then become providers of previously governmental professional services. Drawing upon six EE manifestations, findings suggest that if the newly-introduced service gains social acceptance, existing provision may change in one of the three modes: (a) First-order incremental change, legitimization of EE as an alternative service provision; (b) Second-order participative change, increased public participation in service provision fostered by EE; and (c) Third-order reformative change, existing service provision is reformed to satisfy citizens’ demands.     

1992 and Beyond: Market Freedom or Collectivist Regulation?

Is the ‘social dimension’ of the European Community the ‘socialist dimension’? Dr Martin Holmes, of Oxford University, argues that there is a real danger to Britain's prosperity from the Common External tariff and the CAP, in addition to the collectivism of the ‘Social Charter’.     

Constructive Pressures And Incentives To Reform: Globalization and its impact on public sector performance and governance in developing countries

Contrary to widespread pessimism regarding the effects of globalization on nation states and the quality of governance in developing countries, this contribution stresses that several of its features can be made instrumental, and be beneficial, in terms of public policy making and state capability. Four ‘constructive pressures’ stemming from globalization could be seized constructively by citizens and governments in the developing world: First, better informed and better connected citizens, and an emerging global civil society, demand improvements in service delivery, transparency, and participation. Second, subnational governments, often backed by local NGOs and businesses, and keen to attract foreign investment, increasingly exert pressure vis-à-vis central governments. Third, global investment strategies by private businesses increase the demand for appropriate institutional arrangements within developing countries as well as credible government policies. Although with mixed results, forth, International Organizations, in particular IFIs, have been addressing public sector modernization in developing countries, also sponsoring global public policy networks in critical areas. Moreover, policy coordination and cooperation among states increases significantly, constraining arbitrary action by governments. Globalization, thus, advances the discussion about, and the demand for, new institutional arrangements, clearly with new opportunities for improvements in state capability and governance.     

基于服务补救的快递企业服务质量提升研究

快递服务的投诉主要集中在快件延迟、邮件丢失、邮件损坏等服务失误方面。服务失误的频繁发生会让顾客产生不满情绪,严重时会影响企业的竞争力。服务补救则为企业提供了提高顾客感知服务质量和重塑企业服务品牌和企业形象的第二次机会。对于我国快递企业而言,通过服务补救改善服务质量需要坚持责任、及时、主动、沟通等基本原则,并通过逐步建立完善的服务补救机制、给一线快递人员授权、重视一切顾客问题策略等达到提升服务质量的目标。     

Customer Orientation and Management Control in the Public Sector: A Garbage Can Analysis

Recent public sector reforms have increasingly tended to re-cast citizens as ‘customers’. This paper explores the implications of such customer orientation efforts for management control based on a field study in a Swedish central government agency. We extend prior research on this topic, informed by critical and institutional theories, with insights from the garbage can literature and focus on a key decision-making process involved in making extant management control practices more customer-focused. Our analysis nuances the predictions of critical scholars, suggesting that customer orientation initiatives will commodify public services and narrow the interests served by public sector organizations. In doing so, we draw attention to how conflicting institutional arrangements fostered a garbage can situation hampering radical change in management control practices. Our garbage can analysis provides a bridge between critical and institutional perspectives by re-instating a focus on decision-making. We show how the intricacies of decision-making may moderate the power embedded in novel management control practices and foster inertia and unintended outcomes. Our analysis also raises important policy implications pertaining to the possibilities of combining customer orientation efforts with rationing of public services.     

Stepping into the kitchen: lay clients as co-producers of a professional service

This study examines the implications for service organizations and their staff of clients’ involvement as co-producers of a professional service. Two female infertility clinics were analysed, one using micro-surgery (MS) and the other in-vitro fertilization (IVF) techniques. These differed on the dimension of patients’ involvement in the delivery of treatment. In the MS clinic patients were ‘passive’ recipients of treatment, whereas in the IVF clinic patients were required to partake as co-producers in the delivery of the medical service. Thus, reflected here are two different forms of client–provider interface, which the results show to have different implications. Bringing the clients, as co-producers, ‘into the kitchen’ where service is prepared (IVF) was found to involve issues associated with the lay client–professional provider work interactions, like perceptions of performance, functional work behaviour (conflicts, poor co-ordination, etc.), lower work/service satisfaction of staff and clients, and coping with service uncertainty. These and other implications for front-line service are examined and discussed.     

Co-Production and the Co-Creation of Value in Public Services: A suitable case for treatment?

Co-production is currently one of cornerstones of public policy reform across the globe. Inter alia, it is articulated as a valuable route to public service reform and to the planning and delivery of effective public services, a response to the democratic deficit and a route to active citizenship and active communities, and as a means by which to lever in additional resources to public service delivery. Despite these varied roles, co-production is actually poorly formulated and has become one of a series of ‘woolly-words’ in public policy. This paper presents a conceptualization of co-production that is theoretically rooted in both public management and service management theory. It argues that this is a robust starting point for the evolution of new research and knowledge about co-production and for the development of evidence-based public policymaking and implementation.     

Notes on contributors

This article establishes a basic framework for a comparative analysis of public management reform around the world in recent times. It focuses on politicians and administrators as ‘drivers’ and/or ‘supporters’ of reform, as influenced by their policy roles and contributions, along with electoral politics and government-legislature alignments. Three models are outlined on the basis of the reform experience of selected countries. The models are then related to various reform initiatives by way of eight propositions. The underlying aim is to provide some guidance for research and understanding of reform in different contexts.     

Reforming local public services

Abstract

The following article is aimed at analysing reforms in public service delivery and management at the local level of government in Germany and France from a cross-countries comparative perspective. Particular attention is paid to the results and effects these reform initiatives have caused with regard to the administrative organization, steering capacities, and output performance. Two major approaches of reform will be addressed: privatization, contracting-out, and ‘corporatization’ of local services on the one hand and public management reforms on the other. Proceeding from the distinct ‘starting conditions’ of reforms in the two local government systems, the question will be pursued, as to whether there has been an increasingly convergent or divergent development in French and German local service provision, and how these evolutions can be explained.