Elected Mayors: Leading Locally?

The directly elected executive mayor was introduced to England a decade ago. Drawing inspiration from European and American experience, the elected mayor appealed to both New Labour and Conservative commentators in offering a solution to perceived problems of local leadership. There was a shared view that governance of local areas was failing and that elected mayors were the answer. The first local referendums were held in 2001. Most have continued to reject the idea of the elected mayor. During 2012, the coalition government initiated 10 further mayoral referendums in England's largest cities but only one, Bristol, opted for an elected mayor. Overall, there is no evidence of widespread public support, yet the prospect of more mayors - with enhanced powers - remains firmly on the policy agenda. Drawing from a decade of research, this paper considers reasons for the persistence of the mayoral experiment, the importance of local factors in the few areas where mayors hold office and the link to current policy debates. Using the authors' analytical leadership grid, this paper links the governmental, governance and allegiance roles of mayors to the problematic nature of local leadership. It then draws tentative conclusions about the strange case of the elected mayor in England

Local government: the past, the present and the future

Local government has faced critical issues since the 1970s. The case is made for local government as the government of local communities. Local government is presented as the government of difference, both responding to and creating differences between areas. The government of difference enhances the learning capacity of the system of government, a function not fully appreciated by central government. The role of local government has been weakened by the policies of successive governments. There has been a failure to recognise the need to strengthen local representative democracy. An almost continuous process of reorganisation has fragmented community government. These issues have arisen from a fundamentally defective relationship between local and central government. The government's approach fails to recognize that the main barriers to the development of localism lie in central government. Centralism remains dominant in the Localism Act and in Whitehall departments, even the Department for Communities and Local Government. The government has failed to provide a financing system for local government that sustains localism: local authorities continue to be dependent on government grants. The way ahead is to change the culture of central government through a code on central-local government relations coordinated across all departments by a unit in the Cabinet Office and monitored by a joint committee of parliament; a genuine Localism Act; and a financial system in which local authorities draw most of their revenue from their own voters with taxes whose rates they determine

Facing diversity under institutional constraints: challenging situations for community nurses when providing care to ethnic minority patients.

AIMS: To explore the challenges faced by community nurses when providing home health care to ethnic minority patients. BACKGROUND: Norway has a growing number of immigrants, including older immigrant patients. Community nurses who provide home care encounter considerable challenges when delivering services to an increasingly diverse patient population. DESIGN: A qualitative study based on a hermeneutics approach. METHODS: A qualitative study was conducted involving 19 nurses in Norwegian home health care districts, which had high proportions of minority patients. Data were collected in 2008. FINDINGS: We identified three critical aspects of the encounters between community nurses and minority patients. The first was intimate care. Nurses perceived the fear of mistakes and crossing boundaries related to the cultural and religious practices of minority patients as particularly stressful. The second was rehabilitation after stroke. The beliefs of nurses in the benefits of rapid rehabilitation conflicted with those of the minority patients and their relatives who favoured extended rest during recovery. Third, the commitment of community nurses to transparency in the care of dying patients was tested severely when they met relatives who believed in religious explanations for the destinies of patients and who wanted to conceal the true diagnosis from terminally ill patients. CONCLUSION: Community nurses encountered various challenges due to a lack of experience with highly diverse patient populations. This situation will continue to create difficulties for nurses and minority patients if management support and appropriate training measures are not provided