A health service fit for the 21st century : The Welsh ‘Health and Social Care 2010’ project

‘Health and Social Care 2010’, a project of the Welsh Health Planning Forum, has been designed to link the overall strategy of the National Health Service in Wales with the planning of local health-care strategies. During the first phase of the project, forces that may impact on health and social services in the future have been identified, and consideration has been given to how the services could adapt to the expected changes. The result has been a vision of a new kind of health care based on clusters of services. Testable indicators of the vision's fulfilment have also been identified in the form of nine assumptions regarding specific future developments in the health and social services. Groups at several pilot sites have analysed these assumptions in terms of their achievability and desirability, thus illuminating potential roadblocks in reaching the desired future, as well as creative ways around these problems.     

Revisiting the ‘Court of Generations’ Amendment : A conversation

In 1991, futurist Bruce E. Tonn proposed a ‘Court of Generations’ Amendment to the US Constitution. His proposed ‘Court of Generations’ lacked punitive powers but, hopefully, would have sufficient legitimacy to counteract extreme present-minded thinking evident in US political processes and institutions. Although Tonn's ‘Court of Generations’ Amendment has been well received in the futures community, who else has heard of it? Otherwise, has it made any difference? How can the cumbersome and nonfuturistic amendment procedure in the US Constitution generate a futures-oriented ‘Court of Generations’? And for those who sincerely look forward to a ‘Court of Generations,’ precisely what kind of tactically savvy visionary leadership will give the ‘Court of Generations’ any chance of being approved? During 1997, Vincent Kelly Pollard engaged Dr. Tonn in an Internet conversation aimed at clarifying these issues.     

A Consulting Giant; a Disgruntled Client: A ‘Failed’ Attempt to Change Management Controls in a Public Sector Organisation

There has been very little research into management consulting interventions in public sector organisations, especially in emerging economies. This paper aims to fill this void by narrating the empirics of a consulting assignment carried out by a large international consulting firm in a Pakistani public sector organisation. The study found that consultants’ recommendations of ‘businesslike’ management controls, such as a modern performance measurement system and a ‘state‐of‐the‐art’ information system, were rejected outright by the client management. Employing a critical realist perspective that focuses on the structural conditions facing both the client and the consultants, and on the strategies adopted by both parties, the study aims to explain the empirics of the case. Through structural and strategic analysis, this paper aims to enhance our understanding of the dynamics of management consulting in public sector organisations, especially in emerging economies.     

Loan officers and loan ‘delinquency’ in Microfinance: A Zambian case

The paper seeks to promote greater understanding of the importance of loan officers in group-based microfinance by explaining their actual roles, dilemmas and tensions when working with poor clients. Few existing studies have used data outside Bangladesh and most focus upon relatively well-performing institutions. Using data from Zambia this study focuses on the recent crisis of Christian Enterprise Trust of Zambia (CETZAM) and the effects of its practices for accounting for and dealing with defaulters. The findings firstly show that loan officers faced powerful hierarchical accountability pressures and pursued inappropriate methods to compel further repayments to resolve this crisis. Its approach to borrower default was found to be stressful for loan officers and potentially detrimental for CETZAM's own short and long-term survival by reducing client loyalty and trust.     

Institutional sustainability: ‘community’ and waste management in Zimbabwe

This article addresses sustainability as a social process. In doing so it extends beyond the Brundtland notion of present and ‘future generations’ to grapple with the divergent social worlds in which the term is constructed by different actors. It is thus concerned with how learning can take place within development interventions to enable actors to build new norms and behaviours which cut across social divides. A framework has been developed to (i) explore and make explicit the assumptions held by stakeholders; (ii) develop an awareness of the nature and practices of accountability; (iii) build an understanding of cause and effect (attribution) in relation to action. It is suggested that structured participation in these processes can help to build inter-organizational and inter-associational learning which can provide the basis for new norms and behaviours stretching beyond the formal life of any intervention (institutional sustainability). The article draws on research from Zimbabwe, however it is suggested that the framework can have applicability in many situations.     

Telework remains ‘made to measure’ The large-scale introduction of telework in the Netherlands

About 25% of all jobs in the Netherlands can be done in telework. We cannot give a quantitative overview of the costs and benefits of telework, partly due to the ‘made to measure’ quality of telework projects, but a qualitative overview shows that overall telework will be beneficial both on the micro and macro level, provided its introduction is voluntarily for all involved. The main barrier to the introduction is that organizations do not know enough about the implementation process. Considering the differences between organizations, a large-scale introduction of telework can be stimulated by creating a large variety of telework examples. Telework will have to remain ‘made to measure’.