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These are the answers to the questions of workgroup 2. Governance and Strategy.
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Workgroup 2Governance and Strategy
Questions:
1. In their article 'Conceptualizing decentralization in European health systems: a
functional perspective', Saltman and Bankauskaite (2006) distinguish between three
forms of decentralization: political, administrative and fiscal. Give a description of
these three forms of decentralization and then explain which of these three forms of
decentralization play a role in the example of 'the Greater Manchester project'.
2. Saltman and Bankauskaite (2006), just like Lowndes and Sullivan (2008) in their
article 'How low can you go? Rationales and challenges for neighborhood
governance’, identify various dilemmas and trade-offs as a result of decentralization.
Describe three possible dilemmas / trade-offs in the 'Greater Manchester project'
and explain how those involved in the Greater Manchester Region could deal with
this.
3. How can you use a micro, meso and macro perspective of governance (as discussed
in week 1) to reflect on the Greater Manchester project? What would these different
theoretical lenses make visible? Explain how you would use these perspectives to
evaluate the project.
4. Informal carers play an important role in the provision of health and social care in
the Greater Manchester region. Use the lecture from Prof Kim Putters and the article
of Singleton (2005) to reflect on ethical and practical dilemmas of involving informal
care givers for health and social care.
5. Involving informal care givers also has consequences for healthcare professionals.
Use the article of Bochove et al. (2016) and specifically the concept of boundary
work to reflect on these consequences.
Saltman (2006)
Political:
- Moving authorities to lower levels of authority
- National regional or regional national
- Lack of uniformity; can be positive or negative
- County
Administrative:
- Lower level workers get more authority for decision-making
- Mid and lower level public sector administrators active managers
- GP
Fiscal:
- Fundraiser and expenditure activities of government performed by lower levels
instead of centrally (regional municipal)
- Budget
there are three types of decentralization like mentioned above, but they are often
interrelated and dependent on one another.
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