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The Governance Gap: Central–local steering & mental health reform in Britain and Sweden
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
2010 (English)Doctoral thesis, monograph (Other academic)
Abstract [en]

Why do governments choose certain types of governance strategies to steer the lower level agencies such as municipalities, health services and other welfare agencies? This is a problem facing many governments in the era of public management reforms, where policies are decided at national level while service responsibilities are decentralised and implemented by lower levels. Thus the main mechanism for governments to influence the implementation of these national reforms is through its choice of strategies and instruments to fill the governance gap between national policy-making and local government. The steering strategy selection is analysed in a comparative case study of the mental health reforms in Britain and Sweden. It is argued that despite the apparent similarities in the reforms, Britain chose hard governance and steering strategies, while Sweden chose soft. Thus the theoretical discourse of policy instrument choice is linked to the discourse of hard and soft governance.

A Triad of Influences are identified and investigated. Firstly, Administrative Traditions, is based on ideas that historical, institutional and constitutional legacies can form path dependencies. Secondly, Professions implementing welfare policies may influence government steering strategies, either through granted freedoms as trusted partners of the state, or utilised in order to achieve state objectives. Thirdly, Policy Framing may influence the way policy-makers construct a causal story relating to perceptions of the policy problem, which in turn creates preferences for certain types of steering based on norms and values of the policy-makers’ care ideology.

The study shows that administrative traditions are an important influence on steering choice for the mental health reforms. However, in contrast to earlier research, the study revealed that administrative and institutional explanations do not account for all choices made by the governments. In particular, the care ideology used by politicians to frame the need for policy action also influences steering choices and instruments. The perspective of professions gave mixed results at municipal level and may require more theoretical development, or the mixed results may be linked to municipal social work’s low status as a weak profession that resulted in limited influence.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2010. , 385 p.
Skrifter utgivna av Statsvetenskapliga föreningen i Uppsala, ISSN 0346-7538 ; 178
Keyword [en]
mental health, public management reform, governance, hard and soft governance, policy steering instruments, administrative traditions, institutional legacies, professions, social work, policy framing, municipal government, care ideology, medical model, disability, risk, welfare policy, Britain, Sweden.
National Category
Political Science (excluding Public Administration Studies and Globalization Studies)
Research subject
Political Science
URN: urn:nbn:se:uu:diva-134427ISBN: 978-91-554-7964-0OAI: oai:DiVA.org:uu-134427DiVA: diva2:372501
Public defence
2011-01-28, Brusewitzsalen, Gamla Torget 6., Uppsala, 13:15 (English)
Demokrati & deprofessionalisering/Democracy & de-professionalisation
Available from: 2010-12-17 Created: 2010-11-25 Last updated: 2011-10-04Bibliographically approved

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Maycraft Kall, Wendy Katherine
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