17 research outputs found
Public Service Decentralisation : Governance Opportunities and Challenges
Background
This discussion paper identifies and analyses a number of
key governance issues that are relevant to âdecentralisationâ
as a concept in public sector reform. It explores,
particularly within the context of contemporary Irish
experience, some of the key opportunities and challenges
for effective leadership and collegiality in a geographically
decentralised Irish civil and public service: areas which may
have been comparatively neglected, in both research and
policy terms, in the past but which demand further
attention for effective implementation of current initiatives.
The research draws upon:
· an extensive review of the national and international
literature on civil/public service decentralisation, as
well as effective leadership and positive collegiality in
the commercial and non-commercial sectors;
· in-depth discussions with those engaged, at a senior
level, both in Ireland and elsewhere with developing and
implementing decentralisation programmes;
· in-depth discussions with the chief officers in a crosssection
of Irish public bodies directly affected by the
current programme, as well as senior trade union representatives
and senior private sector managers;
In this regard, it must be stressed that the geographical
decentralisation programme currently in hand for the Irish
public service will have a direct and/or indirect impact not
just on those specific bodies identified for decentralisation
under the current programme but will have an impact
across the public service as well as in other sectors. Indeed
the changes that are afoot are of a scale and character that
should lead to a fundamental recasting of the Irish system
of public administration.
EXECUTIVE SUMMARY
Policy context
Since 1994, the Irish public service has been engaged upon
a long-term programme of public service modernisation,
also known as the Strategic Management Initiative (SMI),
broadly along New Public Management (NPM) lines. While
Irelandâs efforts at geographical decentralisation long predate
the SMI and have not, until now, had significant,
explicit implications for the modernisation agenda, a
considerable sense of urgency has now been injected into
this gradually, self-modernising administrative system. For,
into a previously consensual and gradualist policy
environment, the Minister for Finance in December 2003
announced the Irish government\u27s commitment to the
voluntary decentralisation of over 10,300 posts in civil
service departments/offices and agencies to over fifty
locations across twenty-five counties throughout the
country. Of this total, over 3,000 of the posts earmarked for
relocation are in state agencies. Additionally, the
government decided that, save in exceptional
circumstances, any new agencies/bodies being established
in the future should be located in areas compatible with
this new programme. While decentralisation has not formed
an explicit plank of either current or past Irish public
service reform initiatives and while Ireland\u27s experience to
date has demonstrated little devolution of fiscal and other
high-level decision-making functions from central to local
levels, the spatial decentralisation of Dublin-based public
service employment and functions to non-metropolitan
locations has been a feature of Irish administrative reorganisation
at least since the 1960s.
Broadly speaking, there have been two previous phases
of geographical decentralisation in Ireland: (a) dispersal
during the period 1967 to 1987; followed by (b) a complex
period of dispersal, deconcentration and regionalisation
(1988-2003). Thus, even before the new programme is
implemented, previous national-level initiatives, together
with the adoption of regional strategies by some
departments/offices, have already resulted in a complex
spatial mosaic of public service locations. Together with
dispersed functional units, this complex mosaic includes
regionalised and/or county-based offices supported by
networks of branch, district and local offices. However,
there is little doubt that, although it builds upon these
earlier initiatives, the current decentralisation programme
will present unprecedented management and operational
challenges at the departmental/organisational and publicservice
wide levels. It will also be important to learn from
experiences in the past regarding leadership and collegiality
in a geographically complex civil service in order to help plot
the future.
The current proposals will not only mean that the
majority of civil service, as well as public service, posts will
be based outside Dublin but no fewer than eight
government departmental HQs will be located away from
the capital, while the government itself and many other
departments and stakeholder organisations will continue to
operate from the centre. As a consequence, an entirely new
approach to the governance of the service will be required
and, in particular, new models of leadership and collegiality
developed. This dramatic policy initiative, in the short-term,
has not only reverberated throughout the administrative
system, but, in the longer term, has the potential to present
hitherto un-thought of opportunities for radical reform and
improvements in the way the Irish public service operates.
Learning from others
A number of other countries have implemented decentralisation
initiatives in the past number of decades. For example, in the Netherlands and UK up to the end of the 1980s the decentralisation of public service employment
away from the capital had been used as part of a regional development strategy to relieve long-term unemployment in declining industrial areas. More recently, evidence from secondary sources indicates international experience of
relocation and decentralisation in a wide range of countries
and/or other public administrations; e.g. France, Germany,
Norway, Japan and Canada (British Colombia).
Internationally, the geographical decentralisation of the
civil and public service is seen as an opportunity to secure
improved efficiency on the back of business process reengineering
(BPR), new working practices and modernisation.
However, this research found that, although some
useful inferences can be drawn from a review of available
international evidence, it is difficult to identify in other
public administrations in OECD a direct comparator for the
current programme of Irish decentralisation. This lack of a
comparator relates to the scale of the current programme,
its scope, timing and, above all, its inclusion of proposals to
relocate entire organisations in locations away from the
capital city and centre of political life. For example, the UK
approach specifically excludes the movement of head offices
of government departments away from London.
Leadership and collegiality
Available research evidence suggests that both effective
leadership and positive collegiality are key features of good
governance and the significance of both these qualities is at
a premium within the context of a geographically complex,
decentralised civil and public service. Such qualities of good
governance as leadership, effectiveness, participation,
coherence, programme delivery and effective stakeholder
engagement are particularly relevant in the context of the
decentralisation programme given the continuing location
of the Oireachtas and a number of departments in central
Dublin and the particular challenges posed by the
geographical decentralisation of others. Indeed, it is
important to note that, as early as March 2004, the
Decentralisation Implementation Group was beginning to
acknowledge the importance of these qualities in forming
âa post-decentralised civil serviceâ: âThe geographic
relocation and dispersal of staff may help to reinforce
existing moves towards greater devolution of authority and
responsibility to, and within, organisations. There will be an
onus on management at organisational and suborganisational
level to exercise greater de facto
responsibility for HR, finance and other organisational
matters. A more geographically dispersed civil service needs
to be balanced by sufficiently strong common values and
culture to support effective system-wide co-operation and
decision-making. It will be necessary to reinforce, and
invest more heavily in corporate culture and ethosâ (First
Report of the Decentralisation Implementation Group to
Minister for Finance p.28). These opportunities and
challenges are explored in this research at
corporate/service-wide, interdepartmental and intradepartmental
levels
A review of the latest international literature and best
practice management frameworks clearly highlights that
not only is effective leadership the cornerstone upon which
organisational excellence is built, it also:
· gives strategic direction: it develops and communicates
vision, mission and values;
· achieves change and focuses efforts on customer
service;
· develops and implements a system for organisational
management and performance review;
· motivates and supports people, acting as a role model;
· manages the relationships with politicians and other
stakeholders, acting in a socially responsible manner.
These qualities hold true across the public and private
sectors. Effective and visible leadership is required to
promote an emphasis on co-operation, consensus,
persuasion and the like. A key quality of leadership is also
the capacity to operate in a collegial manner and to support
collegiality between and within organisations. Together with
positive collegiality, these qualities of effective leadership
apply at three levels: the corporate or service-wide; the
inter- and the intra-departmental. The key research
question for this study was to consider the extent to which
these qualities of leadership and collegiality could be
affected by the geographical dispersal of the public service
organisations concerned and, specifically, to identify and
discuss opportunities and challenges thus presented.
Opportunities and challenges
There is little doubt that the current decentralisation
programme will have a profound impact on structures,
communication frameworks, networking fora and the
relationship interface between the civil service, the political
and stakeholder systems. How this is managed is vital in
terms of the effects on customer service and the efficiency
of business processes during the transition phase and
beyond. As such, if effectively managed and implemented, it
could represent a unique opportunity to fundamentally
revisit and restructure the ways in which the civil and wider
public services conduct their business.
There is little doubt that the movement of public service
bodies away from Dublin will provide an unprecedented
xiii
opportunity for a fundamental overhaul of work done and
the way it is done, through the use of business process reengineering
and other techniques. Concerns from the past
regarding blocked career progression for those in dispersed
and regional civil service offices could be ameliorated by
adopting a regional approach to facilitate promotion across
public service bodies. Otherwise, a move away from Dublin
would very definitely become a one-way journey. Because of
the travel imperative for contact with the minister and
meetings with other public servants, while the burden of
travel will be greatly increased, especially when engaged in
EU and other international work, it is very likely that both
the frequency and management of meetings will become
subject to stricter discipline. The use of ICT will help
communication but it is expected to be only a limited
substitute for face-to-face collegiality.
The discussions that took place during this research
also suggest that it could be timely to re-explore the
potential benefits of a Senior Civil Service. Such an
incremental step could support the development of
leadership skills training and help sustain collegiality at the
service-wide level. Respondents frequently expressed
concern that local pressures could lead to a parochial mindset
developing. For instance one respondent said:
âLeadership has not historically been considered as a skill
that can be learned - it has been regarded rather as
Churchill described âgreatnessâ: you can be born with it,
achieve it or have it thrust upon you. Yet recent thinking in
both the private and public sectors sees the development of
the skills of leadership as essential to the effective delivery
of any programme of change - and that all efficient
organisations are in a state of ordered changeâ.
It was outside the scope of this research to suggest or
even less to prescribe firm recommendations for further
action. That needs to be on the national agenda for another
day. However, although no organisation is scheduled to
decentralise before the end of 2006, there is little doubt
that, if the current decentralisation programme is to rise
above the very considerable logistical issues (around
staffing/training and physical infrastructure) that have
understandably pre-occupied the implementation agenda to
date, then serious consideration of the governance
opportunities and challenges arising from this programme
need to rise up that agenda. Only two of these issues have
been initially reviewed and discussed in this paper: namely
effective leadership and positive collegiality. However, it is
clear from this research that, if Ireland is to retain its hard
won and justified reputation for first rate civil and public
services, as well as its international standing, positive
action is required across a wide front to turn leadership and
collegiality challenges into opportunities.
On the basis of this research evidence, such action
should include constructive, informed and positive support
being given to a wide range of issues, including:
· Giving urgent attention to the development of a servicewide
Knowledge Management initiative to minimise loss
and open up new opportunities for knowledge sharing
on a collegial basis, within, between and across those
public service bodies significantly affected by the decentralisation
programme. Allied to this is the need to map
more clearly, and understand better, current formal and
informal networks within the service. These will need to
be significantly recast. Resort to ICT and large amounts
of travel appear to only offer partial solutions.
· Implementing a coherent, service-wide change
management programme, which recognises and
empowers leadership within and across the civil and
wider public services. Again models appear to exist,
based upon international best practice, which could
inform this process, as could the more systematic indepth
analysis of private sector experiences. It would
appear also that the timing could be opportune for a
revisiting and reassertion of core public service values
that could help to maintain consistency in the
considerably more geographically complex and younger
service of the future. Allied and supportive of this
approach could be the further examination of the
implications for Ireland of the explicit development of a
senior civil and public service.
In summary, there is little doubt that the current
leaders of the Irish public service have had decentralisation
thrust upon them, even though it may be up to their
successors to fully operationalise the resultant changes
from new and diverse localities. While issues of staffing and
infrastructure are understandably pre-occupying minds
presently concerned with implementation, action will need
to be commenced soon to rearticulate, and sustain, the
values of the Irish public service and to cultivate the
leadership skills necessary for the next generation of
secretaries general and chief executives so that the
modernisation programme set in motion a decade ago is
sustained and re-invigorated. In a decade from now, a new
generation of leaders should be leading an entirely recast,
modernised civil and public service, in diverse places but
with shared values
The ExPeCT (Examining Exercise, Prostate Cancer and Circulating Tumour Cells) trial: study protocol for a randomised controlled trial
Background: Prostate cancer (PrCa) is the second most common cancer in Ireland. Many men present with locally advanced or metastatic cancer for whom curative surgery is inappropriate. Advanced cancer patients are encouraged to remain physically active and therefore there is a need to investigate how patients with metastatic disease tolerate physical activity programmes. Physical activity reduces levels of systemic inflammatory mediators and so an aerobic exercise intervention may represent an accessible and cost-effective means of ameliorating the pro-inflammatory effects of obesity and subsequently decrease poor cancer-specific outcomes in this patient population. This study will assess the feasibility and safety of introducing a structured aerobic exercise intervention to an advanced cancer population. This study will also examine if the evasion of immune editing by circulating tumour cells (CTCs) is an exercise-modifiable mechanism in obese men with prostate cancer. Methods: This international multicentre prospective study will recruit men with metastatic prostate cancer. Participants will be recruited from centres in Dublin (Ireland) and London (UK). Participants will be divided into exposed and non-exposed groups based on body mass index (BMI) â„ 25 kg/m2 and randomised to intervention and control groups. The exercise group will undertake a regular supervised aerobic exercise programme, whereas the control group will not. Exercise intensity will be prescribed based on a target heart rate monitored by a polar heart rate monitor. Blood samples will be taken at recruitment and at 3 and 6 months to examine the primary endpoint of platelet cloaking of CTCs. Participants will complete a detailed questionnaire to assess quality of life (QoL) and other parameters at each visit. Discussion The overall aim of the ExPeCT trial is to examine the relationship between PrCa, exercise, obesity, and systemic inflammation, and to improve the overall QoL in men with advanced disease. Results will inform future work in this area examining biological markers of prognosis in advanced prostate cancer. Trial registration Clinicaltrials.gov NLM identifier: NCT02453139. Registered on 12 May 2015. This document contains excerpts from the ExPeCT trial protocol Version 1.5, 28 July 2016
Recommended from our members
Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study
Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9â27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6â16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2â1.8), stage II (OR 1.6; 95% CI 1.4â1.9), and stage III or worse (OR 2.8; 95% CI 2.3â3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat
Recommended from our members
Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study
The original version of this article unfortunately contained a mistake
Circulating Tumour Cell Numbers Correlate with Platelet Count and Circulating Lymphocyte Subsets in Men with Advanced Prostate Cancer: Data from the ExPeCT Clinical Trial (CTRIAL-IE 15-21)
Interactions between circulating tumour cells (CTCs) and platelets are thought to inhibit natural killer(NK)-cell-induced lysis. We attempted to correlate CTC numbers in men with advanced prostate cancer with platelet counts and circulating lymphocyte numbers. Sixty-one ExPeCT trial participants, divided into overweight/obese and normal weight groups on the basis of a BMI â„ 25 or n = 29). CTC count positively correlated with absolute total lymphocyte count (r2 = 0.1709, p = 0.0258) and NK-cell count (r2 = 0.49, p 2 = 0.094, p = 0.0001). Correlation was also demonstrated within the overweight/obese group (n = 123, p n = 79, p = 0.001) and blood draw samples lacking platelet cloaking (n = 128, p n = 15) had a higher proportion of CD3+ T-lymphocytes (p = 0.0003) and lower proportions of B-lymphocytes (p = 0.0264) and NK-cells (p = 0.015) than the non-exercise group (n = 14). These findings suggest that CTCs engage in complex interactions with the coagulation cascade and innate immune system during intravascular transit, and they present an attractive target for directed therapy at a vulnerable stage in metastasis