Mutual Learning About Health System Performance in Australia's Intergovernmental Health Committee System?

Since the early 1990s Australia, through the Australian Health Minister’s Advisory Council, began the process of developing a national health system performance framework. This includes service delivery measures for hospitals and has been used as a template for national data collections in mental health services. National performance frameworks have since become part of promoting greater integration of policy making and service delivery across Commonwealth and State jurisdictional health functions. The key focus of this paper is upon inter-governmental processes and routines to develop Australian national performance regimes in the realms of health and mental health care services. It presents initial findings from 26 elite interviews working across the inter-governmental interface, including some data about experiences of service managers. The report provides two contributions to the existing literature on Australia’s federal health system and more specifically health governance. Firstly, it presents a literature review of studies and theoretical concepts that have been deployed to examine cross jurisdictional processes of decision making. There is particular attention for the European literature on inter-governmental committee systems. Secondly, the paper presents initial findings from an explorative study of Australia’s inter-governmental machinery in the realms of health and mental health care services. This explorative study was based upon an initial 26 elite interviews from respondents working (or having worked in) Australia’s inter-governmental machinery, including some respondents from representatives of relevant Commonwealth semi-autonomous bodies. The researcher also observed two inter-governmental committee proceedings although reported data here draws only from interviews. These findings provide a first insight into the inner workings of Australia’s inter-governmental health machinery. It is argued that there has been evidence of mutual learning from Australia’s National Health Performance initiatives, and, exchanges and recommendations for future research to further investigate and pinpoint the causal processes through which mutual learning occurs are provided.This report was commisioned by Crawford School of Public Policy, The Australian National Universit

Translating Agency Reform: Rhetoric and culture in comparative perspective

The experience of the last two decades would suggest that a new international reform category has emerged, the agency. Although not always consistent with local titles, the agency label has been associated with public sector arrangements observed in countries as diverse as England (O’Toole and Jordan, 1995), Sweden (Fortin,1996; Gustafsson and Rhodes, 1989), Portugal, Japan (Oliver 2000), The Netherlands (Ter Bogt, 1999; Van der Knaap et al., 1997), Latvia (Pollitt et al., 2001; Pollitt, 2002), New Zealand (Boston et al., 1996), Canada (Aucoin, 1996), and Australia (Armstrong, 1998; Rowlands, 2002) - to name just a few examples. With endorsement from international organizations such as the OECD and World Bank, agencies have also been enforced upon developing countries such as Ghana and Tanzania as a condition for financial aid (Talbot and Caulfield, 2002; Minogue et al., 1999). Their spread has been the consequence of seeming universal agreement that they are a good thing. This has been reflected in OECD reports which have recognized the “greater use of agencies or their equivalents …(for) purposes that include better service, greater efficiency, a focus on results, as well as clearer accountability relationships between the institution and government” (OECD, 1997a:19). Agencies have not only been deemed appropriate reform accessories for all kinds of political administrative contexts, but they have apparently also been able to bring about a range of benefits in these different circumstances

Agentschappen: eenheid in verscheidenheid

In tegenstelling tot de definitieproblemen rond het begrip 'zelfstandig bestuursorgaan' (vgl. Van Thiel & Van Buuren, 2001) lijkt het begrip 'agentschap' redelijk duidelijk omlijnd (Smullen, Van Thiel & Pollitt, 2001). De criteria in de Comptabiliteitswet en de Instellingsprocedure Agentschappen omschrijven nauwkeurig onder welke omstandigheden een organisatie in aanmerking komt om agentschap te worden en wat een agentschap wel of niet mag doen. Wie inzoomt op de agentschappen die feitelijk zijn opgericht, ziet echter al snel dat we hier te maken hebben met zeer uiteenlopende organisaties, zowel qua historische achtergrond en politiek belang, als wat betreft hun omvang in geld en personeel, hun werkgebied, maar vooral in het takenpakket waar ze mee belast zijn. Alhoewel agentschappen in theorie allemaal belast zijn met de uitvoering van beleid, leidt dat in de praktijk tot behoorlijke verschillen

Calibrating Public Sector Governance: A survey of arm's-length agencies in the Australian Commonwealth Public Sector

This report presents the Australian findings from the Calibrating Public Sector Governance (CPSG) survey. The study is timely given the Government announcement of an independent review of the Australian Public Service. The CPSG survey is an international collaboration between leading researchers in the fields of public administration and accountability from different Western countries (Australia, Denmark, Norway, the Netherlands, Sweden, Switzerland and the United Kingdom). Australia's participation is led by Dr Amanda Smullen at the Crawford School of Public Policy, The Australian National University, and Associate Professor Paul Fawcett at the Institute for Governance and Policy Analysis, University of Canberra. The international project is led by Professor Thomas Schillemans at the School of Governance, Utrecht University, and has been funded by a NWO-VIDI grant (Dutch Research Council). The CPSG survey examines the public management, governance and accountability of public sector agencies in the Commonwealth Public Sector. For the purposes of this comparative research project, Australian public sector agencies are defined as distinct from portfolio departments, though they can also sometimes be located as separate organisational identities and units within departments. On this basis, we surveyed Corporate Commonwealth Entities (CCE) and Non-Corporate Commonwealth Entities (NCE) as defined by the Public Governance, Performance and Accountability Act 2013 (the PGPA Act). These agencies often have semi-autonomous status and operate at "arm's-length" both within or from portfolio departments. Public sector agencies typically vary in their degree and type of formal autonomy from financial autonomy through to distinct statutory responsibilities. Internationally, more than 1000 top-level managers of agencies responded to the CPSG survey.This report was commisioned by Crawford School of Public Policy, The Australian National Universit

Agentschappen en de verzelfstandigingsparadox

Verzelfstandiging van overheidsorganisaties leidt tot een paradox. Enerzijds krijgen de organisaties meer zelfstandi

Principals and Agents, or Principals and Stewards? Australian Arms Length Agencies’ Perceptions of Arm’s Length Government Instruments

After the large-scale creation of arm’s length agencies by governments around the globe, these governments now face the dilemma of how to manage, steer or control these arm’s length agencies. Different instruments have been developed, based on either of two theoretical models: principal-agent theory or stewardship theory. Both are based on economic models of man with a principal charging an agent or a steward with a task. Principal-agent theory is based on the principal distrusting the agent to perform as agreed, leading to a need for extra monitoring and control. Stewardship theory is based on trust, and requires very different instruments to manage at arm’s length. Using the perspective of arm’s length bodies at federal level in Australia, we will describe how they perceive the instruments that have been implemented by their portfolio depart

Conflictual accountability: behavioral responses to conflictual accountability of agencies

In contemporary public governance, leaders of public organizations are faced with multiple, and oftentimes conflictual, accountability claims. Drawing upon a survey of CEO’s of agencies in seven countries, we explore whether and how conflictual accountability regimes relate to strategic behaviors by agency-CEO’s and their political principals. The presence of conflictual accountability is experienced as a major challenge and is associated with important behavioral responses by those CEO’s. This article demonstrates empirically how conflictual accountability is related to (a) controlling behaviors by principals, (b) constituency building behaviors by agencies, and (c) a general pattern of intensified contacts and information processing by both parties

Pragmatic federalism and Australia's new national health agencies

This article examines the recent creation of Commonwealth semi-autonomous regulatory health agencies in the context of Australia�s pragmatic federal tradition. These (soft) regulatory agencies are novel to Australia�s historically fragmented federal health system, though they follow an apparent trend towards Commonwealth performance regulation of traditionally state/territory jurisdictional policies and functions. Following academic literature on the EU, the analysis here seeks to link notions of Australian pragmatic federalism with different types of multi-level governance. The Australian federal experience has long been plagued by the rival logics of Westminster and Federal institutions and it is argued that their amalgamation presents a continuum along which (pragmatic) intergovernmental arrangements can be characterized. This notion of a continuum is further conceptualized through the distinctions between performance regimes for (top down) accountability and performance regimes for learning. Key questions are how can Australia�s pragmatic federalism be characterized? And is there evidence of a deepening of Australia�s pragmatic federal traditions through the creation of these new regulatory agencies