Governance & Strategy
Literature summary
Article of Rhodes: Network governance
(Network) governance refers to governing with and through networks. Policy networks are
(in)formal interdependent institutional linkages between government and other actors.
Policies emerge from bargaining between network members. Everything is influenced by
social interactions. Macro-level perspective.
There are four characteristics of network governance:
1. Interdependence between organizations. Any organization is dependent upon other
organizations for resources. Governance is broader than government, covering
non-state actors. Changing the boundaries of the state meant the boundaries
between public, private and voluntary sectors. Rooted in trust.
2. Self-organized continuing interactions between network members, caused by the
need to exchange resources and negotiate shared purposes.
3. Game-like interactions, rooted in trust and regulated by rules of the game
negotiated and agreed by network participants. Game-like interactions are the rules
that are being set by the network.
4. A significant degree of autonomy from the state. Networks are not accountable to
the state; they are self-organizing (through interactions). Although the state does not
occupy a privileged, sovereign position, it can indirectly and imperfectly steer
networks.
The term network governance has two faces:
- It describes public sector change whether it is the increased fragmentation caused
by the reforms of the 1980s or the joined-up governance of the 1990s, which sought
to improve coordination between government departments and the multifarious other
organizations.
- It interprets the British government; it says the hierarchic Westminster model of
responsible government is no longer acceptable. We have to tell a different story of
the shift from government with its narrative of the strong executive to governance
through networks. The term always refers to the changing role of the state after the
varied public sector reforms of the 1980s and 1990s.
By defining the core executive in functional terms, the key question becomes: ‘Who does
what? and Who has what resources?
The ‘hollowing out of the state’ means simply that the growth of governance reduced the
ability of the core executive to act effectively, making it less reliant on a command operating
code and more reliant on diplomacy. In what ways has the capacity of the British core
executive been eroded? The state has been hollowed out from above (for example, by
international interdependence); from below (by marketization and networks); and sideways
(by agencies and the several species of parastatal bodies).
The network members are steered by the state. The state is not the only interaction member,
but the state does have the power/autonomy to change the rules. States can steer by setting
rules and boundaries through laws, etc. Less top-down. Also touches upon ethnography.
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Article of Riley & Manias: Governmentality
Governmentality is the nurses using their knowledge (that surgeons don’t have, but need to
have to work) to govern the surgeons and to steer them in a way of working. Nurses have
capacities that give them a sense of autonomy. Micro-level perspective.
Nurses steer the surgeons and each other. 3 ways how:
1. Technical knowledge of surgeons’ needs for surgery → preferred instruments, nurses
compete by selectively withholding information
2. Inscribing bodies in time → habits of time, change order of surgeries accordingly
3. Deep knowledge of surgeons (approachability of surgeons during surgery, how they
will react).
4. Prudence as a technology of governance → Nurses engaged in the discursive
practice of ‘‘prudent silence’’ to govern communication in the operating room. By
prudent silence we mean silence exercised through judicial wisdom. In an excerpt
from field notes, a nurse coordinator had walked into an operating room to enquire
about an estimated finishing time for surgery.
Knowledge of the nurses and surgeons. Governmentality of Foucault with the dome-like
prison. There is hierarchy, nurses have limited power, but they have their own ways of
governing their time and space and the surgeons. Nurses use their knowledge by modifying
their behavior in practice, and steer in daily practices. Behavior can be communication of
location of certain instruments in the operating room. Everyone has power. In this article the
government doesn’t have a role.
Article of Scholten: Dual governance
Hospital governance is defined as a set of processes and tools related to decision making in
steering the totality of institutional activity, influencing most major aspects of organizational
behavior, and recognizing the complex relationships between multiple stakeholders. Duality
between hospital managers and doctors. Governance is needed to define a new strategy.
Meso-level perspective. There is a shared power. The government is just one of the actors
that influences hospital governance. Internal and external. Organizational structure.
Hospital governance is a complex problem because of two intermingling dynamics: The first
dynamic is internal and the second external. Internal dynamics are rooted in the character of
hospital organization as a professional organization—consisting of several interdependent
but relatively autonomous groups—meeting the challenge to create workable and viable
relations. The external dynamics of hospital governance result from governments and
stakeholders' pressure to change hospital governance. Hospital governance is a matter not
only of consulting and negotiating managers and doctors but also of the power of actors who
act on different societal levels.
Dual hospital governance, the coexistence of managerial and professional lines of
authority, can be understood as a characteristic feature of hospital governance. In hospitals,
decision making is not rooted in a single “governance chain,” the unified decision making
and reporting structure we recognize in corporate governance. Particularly, traditional
decision making in hospitals depends on consensus management by permanent
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consultations and negotiations between fundamentally different governance systems, each
with its specific “institutional logic.” Decision making by management is built on hierarchy
whereas doctors furnish some of their colleagues with responsibility by giving them a
mandate. Their governance systems differ fundamentally as managers practice top‐down
decision making whereas doctors typically take decisions bottom‐up. The challenge of
hospital governance is rooted in the “peaceful coexistence” of the two governance structures
and, eventually, the integration of decision‐making processes in the hospital.
Two layers of steering:
- Executive board
- Management for units and medical management within units.
Need a clear board of directors. Stop duality. There are still shadows of hierarchy. Constant
consensus management by permanent consultations and negotiations. It may be more
efficient to have hierarchy. Also talks about decoupling.
Article of Peters: Multi-level governance
Negotiated, non-hierarchical exchanges between institutions at the transnational, national,
regional and local levels, and to a vertical ‘layering’ of governance processes at these
different levels. Moving from a model of the state in a liberal-democratic perspective towards
a state model characterized by complex patterns of contingencies and dependencies on
external actors. Political power and institutional capability are less and less derived from
formal constitutional powers accorded the state but more from a capacity to wield and
coordinate resources from public and private actors and interests. The state is no longer a
proactively governing society but is more concerned with defining objectives and mustering
resources from a wide variety of sources to pursue those goals.
The state is an ‘enabling state’, where the state is not proactively governing society but is
more concerned with defining objectives and mustering resources from a wide variety of
sources to pursue those goals. The state's current main objectives are to increase efficiency
in public service delivery and delivering more customer-attuned services. State model is
characterized by complex patterns of contingencies and dependencies on external actors.
State provides resources to external actors. Institutions and intergovernmental relationships
on different layers. The overall nature of the political project pursued by contemporary
Western states has changed significantly over the past 10–15 years. Previously, the
emphasis was on expanding the political sphere in society; the current main objectives are to
increase efficiency in public service delivery and delivering more customer-attuned services.
Macro-level perspective, shift in steering, from hierarchical to non-hierarchical and bypassing
the state level. Political power and institutional capability are less and less derived from
formal constitutional powers accorded the state but more from a capacity to wield and
coordinate resources from public and private actors and interests. More Macro even than
Rhodes for the EU perspective. A baseline definition of multi-level governance is that it
refers to negotiated, non-hierarchical ex- changes between institutions at the transnational,
national, regional and local levels. Thus, multi-level governance refers not just to negotiated
relationships between institutions at different institutional levels but to a vertical ‘layering’ of
governance processes at these different levels.
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