Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-22T19:34:53.292Z Has data issue: false hasContentIssue false
  • English
  • Français

Events, Public Discourses and Responsive Government: Quality Assurance in Health Care in England, Sweden and Japan

Published online by Cambridge University Press:  04 November 2010

NAONORI KODATE
NAONORI KODATE
Affiliation:
Research Associate – Risk Programme, King's College London/NIHR King's Patient Safety & Service Quality Research Centre, Strand Bridge House, 138-142 Strand, London WC2R 1HH, e-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

One would expect the common agenda of improving the quality of care in hospital sectors across nations to bring about a convergence of their quality assurance systems. However, one finds great variations in the ways in which such schemes are constructed and communicated to the general public in different countries. This paper examines three universal health care systems (England, Sweden and Japan) and explores the degree to which political institutions and public opinions affect the processes of quality assurance system building within them. It argues that the inputs from governments in response to public concerns are the key to understanding the changes in this seemingly profession-dominated policy domain; therefore policy changes are significantly affected by dynamic interactions between events, public discourses and governance structures within these countries. The findings also demonstrate that public access to information has begun to have a large impact on policy debates in all three countries.

Type
Research Article
Information
Journal of Public Policy , Volume 30 , Issue 3 , December 2010 , pp. 263 - 289
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References

Alink, F., Boin, A. and 't Hart, P. (2001) ‘Institutional Crises and Reforms in Policy Sectors: The Case of Asylum Policy in Europe’, Journal of European Public Policy, 8:2, 286–306.CrossRefGoogle Scholar
Anderson, P. (1999) England Publishes First Tables of Hospital Performance. British Medical Journal 318 (26 June 1999), 1715.CrossRefGoogle ScholarPubMed
Appleby, J. and Alvarez-Rosete, A. (2003) ‘The NHS: Keeping Up with Public Expectations?’, in Park, A. et al. (eds.) British Social Attitudes (20th Report): Continuity and Change over Two Decades. London: Sage.Google Scholar
Asahi Shimbun. September 3, 1997; May 5, 1998; December 16, 1999; March 21, 2002; December 15, 2004; October 30, 2005; October 17, 2009.Google Scholar
Bevan, G. and Hood, C. (2006) ‘What's Measured is What Matters: Targets and Gaming in the English Public Health Care System’, Public Administration, 84:3, 517–538.CrossRefGoogle Scholar
Bird, S. M., Cox, D., Farewell, V. T., Goldstein, H., Bolt, T. and Smith, P. C. (2005) ‘Performance Indicators: Good, Bad and Ugly’, Journal of the Royal Statistical Society Series A, 168:1, 1–27.CrossRefGoogle Scholar
Blomqvist, P. (2004) ‘The Choice Revolution: Privatization of Swedish Welfare Services in the 1990s’, Social Policy & Administration, 38:2, 139–155.CrossRefGoogle Scholar
Breyer, S. (1993) Breaking the Vicious Cycle: Toward Effective Risk Regulation. Cambridge, MA: Harvard University Press.Google Scholar
British Medical Journal (2000) ‘Hospital League Tables Are Misleading’, BMJ 320 (18 March 2000), 808.CrossRefGoogle Scholar
Campbell, J. C. and Ikegami, N. (1998) The Art of Balance in Health Policy: Maintaining Japan's Low-Cost Egalitarian System. Cambridge: CUP.CrossRefGoogle Scholar
Currie, G., Waring, J. and Finn, R. (2008) ‘The Limits of Knowledge Management for UK Public Services Modernization: The Case of Patient Safety and Service Quality’, Public Administration, 86:2, 363–385.CrossRefGoogle Scholar
Dagens Nyheter. November 24, 1995; June 18, 1996; September 25, 2000; October 27, 2000; February 19, 2001; January 11, 2002; November 18, 2002; November 26, 2004; April 21, 2005; October 14, 2005; November 14, 2005.Google Scholar
Davies, M. (2008) ‘Jönköping County Council – Småland, Sweden’, in Baker, G. Ross et al. (eds.), High Performing Healthcare Systems: Delivering Quality by Design. Tronto: Longwoods Publishing, 121–144.Google Scholar
Day, P. and Klein, R. (1987) Accountabilities: Five Public Services. London: Tavistock.Google Scholar
Department of Health (1997) The New NHS. Modern and Dependable. London: The Stationery Office.Google Scholar
Department of Health (1998a) A First Class Service: Quality in the New NHS. London: The Stationery Office.Google Scholar
Department of Health (1998b) Our Healthier Nation, Cm 3852: London: The Stationery Office.Google Scholar
Department of Health (2000a) An Organization with a Memory. London: The Stationery Office.Google Scholar
Department of Health (2000b) The NHS Plan, Cm 4818-I. London: The Stationery Office.Google Scholar
Department of Health (2002) NHS Performance Indicators. Acute NHS Hospital Trusts: London: The Stationery Office.Google Scholar
Döhler, M. (1995) ‘The State as Architect of Political Order: Policy Dynamics in German Health Care’, Governance, 8:3, 380–404.CrossRefGoogle Scholar
Dunleavy, P. and Hood, C. (1994) ‘From Old Public Administration to New Public Management’, Public Money and Management, 14:3, 9–16.CrossRefGoogle Scholar
Eckstein, H. (1975) ‘Case Studies and Theory in Political Science’, in Greenstein, F. and Polsby, N. (eds.), Handbook of Political Science Vol. 7. Reading, MA: Addison-Wesley, 79–138.Google Scholar
Expressen. March 16, 17, 2004.Google Scholar
Fredriksson, M. and Winblad, U. (2008) ‘Consequences of a Decentralized Healthcare Governance Model: Measuring Regional Authority Support for Patient Choice in Sweden’, Social Science & Medicine, 67:2, 271–279.CrossRefGoogle ScholarPubMed
Freeman, R. (2000) The Politics of Health in Europe. Manchester: Manchester University Press.Google Scholar
Garpenby, P. (1989) The State and the Medical Profession: A Cross-National Comparison of the Health Policy Arena in the United Kingdom and Sweden 1945–1985. Linköping: University of Linköping.Google Scholar
Garpenby, P. (1997) ‘Implementing Quality Programmes in Three Swedish County Councils: The Views of Politicians, Manager and Doctors’, Health Policy, 39:3, 195–206.CrossRefGoogle ScholarPubMed
Garpenby, P. (1999) ‘Resource Dependency, Doctors and the State: Quality Control in Sweden’, Social Science & Medicine, 49:3, 405–424.CrossRefGoogle ScholarPubMed
Gouldson, A. (2004) ‘Risk, Regulation and the Right to Know: Exploring the Impacts of Access to Information on the Governance of Environmental Risk’, Sustainable Development, 12:3, 136–149.CrossRefGoogle Scholar
Hacker, J. S. (1998) ‘The Historical Logic of National Health Insurance: Structure and Sequence in the Development of British, Canadian, and US Medical Policy’, Studies in American Political Development 12:1, 57–130.CrossRefGoogle Scholar
Hallandsposten. November 12, 2004.CrossRefGoogle Scholar
Ham, C. (2004) Health Policy in Britain: the Politics and Organisation of the National Health Service. 5th ed.Basingstoke: Palgrave Macmillan.Google Scholar
Harrison, S., Hunter, D. J. and Pollitt, C. (1990) The Dynamics of British Health Policy. London: Unwin Hyman.Google Scholar
Hobolt, S. B. and Klemmemsen, R. (2005) ‘Responsive Government? Public Opinion and Policy Preferences in Britain and Denmark’, Political Studies, 53, 379–402.CrossRefGoogle Scholar
Hollingsworth, J. R. and Hanneman, R. (1984) Centralization and Power in Social Service Delivery Systems: the Cases of England, Wales and the United States. Boston, Mass.; Lancaster: Kluwer-Nijhoff.CrossRefGoogle Scholar
Immergut, E. M. (1992) Health Politics: Interests and Institutions in Western Europe. Cambridge: CUP.Google Scholar
Ito, H., Iwasaki, S., Nakano, Y., Imanaka, Y., Kawakita, H. and Gunji, A. (1998) ‘Direction of Quality Improvement Activities of Health Care Organizations in Japan’, International Journal for Quality in Health Care 10:4, 361–363.CrossRefGoogle ScholarPubMed
Jennings, W. (2009) ‘The Public Thermostat, Political Responsiveness and Error-Correction: Border Control and Asylum in Britain, 1994–2007’, British Journal of Political Science 39: 4, 847–870.CrossRefGoogle Scholar
Jones, B. D. and Baumgartner, F. R. (2005) The Politics of Attention: How Government Prioritizes Problems. Chicago, Ill.; London: University of Chicago Press.Google Scholar
Jost, T. S. (1992) ‘Recent Developments in Medical Quality Assurance and Audit: An International Comparative Study’, in Dingwall, R. and Fenn, P. (eds.), Quality and Regulation in Health Care. International Experiences. London: Routledge.Google Scholar
Kato, J. and Rothstein, B. (2006) ‘Government Partisanship and Managing the Economy: Japan and Sweden in Comparative Perspective’, Governance, 19:1, 75–97.CrossRefGoogle Scholar
Klazinga, N., Stronks, K. Delnolj D. and Verhoeff, A. (2001) ‘Indicators without a Cause. Reflections on the Development and Use of Indicators in Health Care from a Public Health Perspective’, International Journal for Quality in Health Care 13:6, 433–438.CrossRefGoogle ScholarPubMed
Klein, R. (1996) ‘Self-inventing Institutions: Institutional Design and the UK Welfare State’, in Goodin, R. E. (ed.), The Theory of Institutional Design. New York: CUP, 240–255.CrossRefGoogle Scholar
Klein, R. (2001) The New Politics of the NHS. 4th ed.Oxford: Radcliffe.Google Scholar
Kondo, J. (2005) ‘The Iron Triangle of Japan's Health Care: The Japan Medical Association is Losing its Grip on Healthcare Policy’, British Medical Journal 330 (8 January 2005), 55–56.CrossRefGoogle Scholar
Lægreid, P., Opedal, S. and Stigen, I. M. (2005) ‘The Norwegian Hospital Reform: Balancing Political Control and Enterprise Autonomy’, Journal of Health Politics, Policy and Law, 30:6, 1027–1064.CrossRefGoogle ScholarPubMed
Levay, C. and Waks, C. (2005) ‘Professions and the Pursuit of Transparency: Two Cases of Professional Response’, Paper read at the 21st European Group of Organizational Studies Colloquium. Berlin.Google Scholar
Lindgren, A. and Söderqvist, M. (2004) Behövs ranking av de svenska sjukhusen? (Need of a Ranking of the Swedish Hospitals?)Stockholm: Svenskt Näringsliv och Vårdföretagarna.Google Scholar
Lodge, M. and Hood, C. (2002) ‘Pavlovian Policy Responses to Media Feeding Frenzies? Dangerous Dogs Regulation in Comparative Perspective’, Journal of Contingencies and Crisis Management, 10:1, 1–13.CrossRefGoogle Scholar
Ministry of Health, Labour and Welfare (2001) Iryōhō, Ishihō, Shikaishihō Kaisei no Yōten (The Gist of the amended Medical Service Law, Physicians Law, and Dental Practitioners Law). Tokyo: Kokuritsu Insatsu Kyoku.Google Scholar
Moran, M. and Wood, B. (1993) States, Regulation and the Medical Profession. Buckingham: Open University Press.Google Scholar
Moran, M. (1999) Governing the Health Care State: A Comparative Study of the United Kingdom, the United States, and Germany. Manchester: Manchester University Press.Google Scholar
National Board of Health and Welfare (1993) Kvalitetssäkring i hälso och sjukvården inklusive tandvård (Quality Assurance in Health and Hospital including Dental Care) (SOSFS 1993: 9). Stockholm: Socialstyrelsen.Google Scholar
National Board of Health and Welfare (1996) Kvalitetssystem i hälso-och sjukvården (Quality Assurance System in Health and Hospital Care) (SOSFS 1996: 24). Stockholm: Socialstyrelsen.Google Scholar
NHS Executive (2000) Quality and Performance in the NHS: NHS Performance Indicators: NHS Executive.Google Scholar
OECD (1993) OECD Health Systems: Facts and Trends 1960–1991. vols. 1/2. Paris: OECD.Google Scholar
OECD (1994) Performance Management in Government: Performance Measurement and Results-oriented Management, Public Management Occasional Paper no. 3: Paris: OECD.Google Scholar
Øvretveit, J. (1994) ‘A Comparison of Approaches to Health Service Quality in the UK, USA & Sweden and of the Use of Organizational Audit Frameworks’, European Journal of Public Health, 4: 46–54.CrossRefGoogle Scholar
Pollitt, C. (1987) ‘Capturing Quality? The Quality Issue in British and American Health Policies’, Journal of Public Policy, 7:1, 71–92.CrossRefGoogle Scholar
Pollitt, C. and Bouckaert, G. (2004) Public Management Reform: A Comparative Analysis. 2nd ed.Oxford: OUP.CrossRefGoogle Scholar
Pollitt, C., Harrison, S., Dowswell, G., Jerak-Zuiderent, S. and Bal, R. (2010) ‘Performance Regimes in Health Care: Institutions, Critical Junctures and the Logic of Escalation in England and the Netherlands’, Evaluation, 16:1, 13–29.CrossRefGoogle Scholar
Salter, B. (1999) ‘Change in the Governance of Medicine: The Politics of Self-regulation’, Policy & Politics, 27:2, 143–158.CrossRefGoogle Scholar
Saltman, R. B. and Bergman, S.-E. (2005) ‘Renovating the Commons: Swedish Health Care Reforms in Perspective’, Journal of Health Politics, Policy and Law, 30:1/2, 253–275.CrossRefGoogle Scholar
Schumaker, P. D. (1975) ‘Policy Responsiveness to Protest-Group Demands’, The Journal of Politics, 37:2, 488–521.CrossRefGoogle Scholar
Scrivens, E. (1995) Accreditation: Protecting the Professional or the Consumer? Buckingham: Open University Press.Google Scholar
Selck, T. J. (2006) ‘The Effects of Issue Salience on Political Decision-making’, Constitutional Political Economy, 17:1, 5–13.CrossRefGoogle Scholar
Steslicke, W. E. (1973) Doctors in Politics: the Political Life of the Japan Medical Association. New York: Praeger.Google Scholar
Stimson, J. A. (2004) Tides of Consent: How Public Opinion Shapes American Politics. Cambridge: CUP.CrossRefGoogle Scholar
Svenska Dagbladet. November 8, 1996; May 27, 1997; April 29, 1999.Google Scholar
Swedish Association of Local Authorities and Regions (2005) National Healthcare Quality Registries in Sweden. Stockholm: Sveriges Kommuner och Landsting.Google Scholar
The Guardian. June 21, 23, 1994; January 21, 1998; April 14, 1998; June 17, 1999; September 25, 2002; January 9, 2003; April 19, 24, 2003; December 19, 2003; January 8, 2004; July 21, 2004; November 29, 2004.Google Scholar
Tuohy, C. J. (1999) Accidental Logics: The Dynamics of Change in the Health Care Arena in the United States, Britain, and Canada. Oxford: OUP.CrossRefGoogle Scholar
van den Heuvel, J., Koning, L., Bogers, A., Berg, M. and van Dijen, M. E. (2005) ‘An ISO9001 Quality Management System in a Hospital: Bureaucracy or Just Benefits?’, International Journal of Health Care Quality Assurance, 18:5, 361–369.CrossRefGoogle ScholarPubMed
Wilsford, D. (1994) ‘Path Dependency, or Why History Makes It Difficult But Not Impossible to Reform Health Care Systems in a Big Way’, Journal of Public Policy, 14:3, 251–283.CrossRefGoogle Scholar
Wlezien, C. (2005) ‘On the Salience of Political Issues: The Problem with “Most Important Problem”’, Electoral Studies, 24:4, 555–579.CrossRefGoogle Scholar
WHO (2000) Health Systems: Improving Performance, The World Health Report, 1020–3311. Geneva: WHO.Google Scholar
Wood, B. D. (1991) ‘Federalism and Policy Responsiveness: The Clean Air Case’, The Journal of Politics, 53:3, 851–859.CrossRefGoogle Scholar
Yin, R. K. (1989) Case Study Research: Design and Methods (Applied Social Research Methods). Newbury Park; London: Sage.Google Scholar
Yomiuri Shimbun. December 16, 1999.Google Scholar

Websites

http://www.chi.nhs.uk/ratings/ (accessed on 10 January 2010)Google Scholar
http://www.drfosterintelligence.co.uk/ (accessed on 12 March 2010)Google Scholar
http://www.performance.doh.gov.uk/performanceratings/index.htm (accessed on 20 April 2010)Google Scholar

Interviews

EN-1 – health policy researcher (December 14 2005, the author, Birmingham/the UK).Google Scholar
EN-2 – health policy researcher (May 16 2007, the author, London/the UK).Google Scholar
JP-1 – doctor/civil servant (March 11 2007, the author, Tokyo/Japan).Google Scholar
JP-2 – doctor/academic (March 12 2007, the author, Tokyo/Japan).Google Scholar
SW-1 – doctor/academic (June 19 2006, the author, Stockholm/Sweden).Google Scholar
SW-2 – senior civil servant (May 23 2006, the author, Stockholm/Sweden).Google Scholar