Implementation Flashcards
What is policy implementation?
What happens between policy expectations and (perceived) policy results’
(Deleon, 1999, cited in Hill and Hupe, 2002: 2)
The know-do ‘gap’
‘Effective interventions exist for many priority health problems in low income countries; prices are falling
and funds are increasing. However, progress towards agreed health goals remains slow. There is increasing consensus that stronger health systems are key to achieving improved health outcomes. There is much less agreement on how to strengthen them.’
(Travis et al, 2004 Lancet 364: 900-906)
Other important related phenomen
• Unintended consequences
– i.e. things rarely work out entirely as planned
• ‘Second order’ consequences – i.e. dynamic effects of policies
• ‘Diffuse benefits, concentrated costs’ – i.e. resistance can be expected
The ‘top-down’ approach
• Aim is to produce an outcome that conforms to the original intention of policy formulators
• Implementation is seen to be:
– part of a linear and rational, ‘stages’ model
of the policy process
– managerial, administrative, technical, but not essentially political
• Policy implementation is seen to be what takes places after policy making is completed
• Policy is communicated hierarchically and usually belongs to policy makers at the ‘top’
• success is seen as dependent on the control of the policy makers over the implementers
• Goal is to reduce ‘gaps’ and ‘clearance points’ in the process by
– making goals clear & consistent
– minimising the number of actors needed
– limiting the extent of change necessary
– placing implementation responsibility in an agency sympathetic to the policy’s goals
Criticisms of ‘top-down’ model
Fails to consider the significance of earlier stages of the policy process
Depoliticises implementation
Primary focus is on the ‘centre’/’top’
only considers power and influence of ‘policy makers’ ignores actors outside the ‘core’ governmental policy making arena
Cannot take account of policy change during implementation
Depends on many assumptions/pre-conditions in its pure form
‘Pre-conditions for ‘perfect implementation’ I
- External circumstances do not constrain implementation
- Adequate resources (including time) are available
- Resources are available at the right stage in the implementation
- Policy is based on a valid theory of cause and effect - i.e. it is an appropriate response to the problem
- Relationship between cause and effect is direct with few intervening links
- Dependency relationships are minimal
- Objectives are understood and agreed upon
- Tasks are specified in the correct sequence
- Perfect communication and co-ordination
- Those in authority can demand and obtain perfect compliance
(Hogwood and Gunn, 1984)
The ‘bottom-up’ approach
• Shifts analytical and practical concern from the centre to the periphery
• Argues that local actors have fuller knowledge of the problems and their solutions
• Recognises the ‘agency’ of implementers – highlights role of ‘street level bureaucrats’ – who can be particularly influential in health
• Recognises that implementers play a major role in formulating policy
– Policies evolve as they are implemented
‘The decisions of street level bureaucrats, the routines they establish, and the devices they invent to cope with uncertainties and work pressures, effectively become the public policies they carry out’
(Lipsky, 1980: xii; cited in Hill and Hupe 2002: 52) • Has considerable empirical support
– central planners can only indirectly influence local settings so there is often wide variation in how a policy is implemented
• Goal of implementation is to:
– design policies that are flexible enough to allow local implementers the freedom to adapt them to local conditions
– recognise the importance of understanding the goals, strategies and activities of local actors
– take account of local contexts
– ‘backward mapping’ used to design policies that are likely to be acceptable to actors charged with implementation
Criticisms of the ‘bottom-up’ approach
- Emphasises feasibility/acceptability at the expense of what is important
- Poses problems for democracy and accountability
- because street-level bureaucrats have great discretion is no reason to design policy around them
- who should have the legitimate right to exercise authority on behalf of the people?
- risks romantic siding with the ‘under-dog’ (who may be a high status, self-interested professional!) - Under-estimating the power of the centre and its importance in assuring valued outcomes
- e.g. to ensure consistency and equity
The ambiguity-conflict model of implementation (Matland, 1995)
• Based on insight that not all implementation processes are difficult, but some are, due to:
• Policyconflict
– where actors are inter-dependent, their objectives are
incompatible and they perceive a zero-sum game
• Policyambiguity – of goals
– of means
• Goal conflict and ambiguity are often negatively correlated
Synthesis approaches: policy implementation as ‘network management’
- Bring together ‘top-downers’ and ‘bottom- uppers’
- Focus on agency and power of central actors, and of implementers
- Try to find ways to use local actors to deliver policy rather than let them entirely shape policy
- Increasing interest in understanding and working with and through the networks at and between different levels in a policy area
When to use a broadly ‘top-down’ versus ‘bottom-up’ approach?
• ‘Top-down’ when:
– change is incremental
– technology is certain
– goal conflict is low
– institutional setting is tightly coupled
• However, ‘bottom-up’ is not necessarily appropriate in the opposite circumstances
– there may be policies where central steering is preferred to ensure implementation consistent with goals
– in practice, some combination may be necessary
Applying learning from analyses of processes to practice
• Anticipate resistance & perverse effects
– political aspects are as important as the technical
• Assess macro-conditions & adjust implementation plans, as far as possible – some ambiguity can be useful
• Make policy values explicit & build shared understanding, trust & support if needed
• Develop necessary financial, technical & managerial resources
• Do stakeholder analysis & build strategic implementation process
(Walt, 1998)
