GOVERNANCE STRUCTURES AND POLITICAL PROCESSES IN A PUBLIC SYSTEM: LESSONS FROM QUEBEC
GOVERNANCE STRUCTURES AND POLITICAL PROCESSES IN A PUBLIC SYSTEM: LESSONS FROM QUEBEC
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公共体系中的治理结构和政治进程：魁北克省的经验教训
DOI：
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
A. Valette
中科院分区：
文献类型：
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作者：
D. Contandriopoulos;J. Denis;A. Langley;A. Valette
一段时间以来，关于公共系统管理变革的形式和性质的争论一直以治理为主题。治理的所有定义都与确保不同行为者和组织之间的融合、在高度异质性的组织或社会领域中重新分配权力以及获得足够的合法性以集体名义行事的问题有关。本文重点关注公共系统中新的治理能力的出现所涉及的动态。更准确地说，我们研究医疗保健领域（以加拿大为例）的区域化政策的实施，被视为更新大型公共系统治理结构的一项重大尝试。
我们的研究借鉴了三个卫生区域的实证监管的比较分析，与区域化系统中三种理想类型的治理模型进行对比。第一个模型的灵感来自组织行为的经济方法，重点是授权、执行和控制。第二种模型基于对行为的政治解释，重点关注参与者之间的谈判过程。最后，第三种模式基于协商理论以及政策分析的制度学派，侧重于公众对公共事务的直接参与。本文的证据主要来自对主要知情人的采访和文献分析。
我们的分析表明，这三种模式本身都不足以赋予区域结构所需的权威和合法性，以在监管方面创造附加值，从而确保其生存。因此，区域委员会迫于环境限制，构思并实施这些模型的原始组合。区域行动的两种主要逻辑受到前两种模式的启发，尽管最后一种模式也有影响。总体而言，我们的研究还表明，由于对现有机构的依赖，公共系统中新的治理机构来源的实施相当脆弱。显然，改变特定体系中治理动态的尝试必须被视为一种政治活动，而不仅仅是一个由政策工具的合理调整组成的技术问题。
Debates about the form and nature of changes in the management of public systems have for some time now been articulated under the theme of governance. All definitions of governance are related to the problems of securing convergence among a diversity of actors and organizations, of redistributing power in an organizational or social field characterized by a high level of heterogeneity and of gaining sufficient legitimacy to act in the name of the collectivity. This paper concentrates on the dynamics involved in the emergence of new governing capabilities in public systems. More precisely we study the implementation of regionalization policies in the health care field (in this case of Canada) conceived as one major attempt to renew the governance structures in a large public system.
Our study draws on the comparative analysis of empirical regulation in three health regions as contrasted with three ideal type models of governance in regionalized systems. The first model is inspired by an economic approach to organizational behaviour and focuses on mandate-giving, execution and control. The second model is based on a political interpretation of behaviours and focuses on negotiation processes between actors. Finally, the third model is based on the theory of deliberation as well as the institutional school of policy analysis and focuses on direct public participation in public affairs. Evidence for this article is primarily derived from interviews with key informants and documentary analysis.
Our analysis shows that none of the three models is sufficient in itself to grant regional structures the authority and legitimacy they need to create added value in terms of regulation that could ensure their survival. Regional Boards are thus forced by environmental constraints to conceive and implement original mixes of these models. The two predominant logics in regional action are inspired by the first two models although the last one also has an influence. Overall, our study also suggests that the implementation of new sources of governing authorities in a public system is rather fragile because of dependence on existing institutions. Clearly, the attempt to modify the dynamics of governance in a given system must be conceived as a political exercise and not just as a technical problem consisting of the rational adjustment of policy instruments.