Blockchain Papers

Salvatore Furnari

No abstract is available for this record.

Thomas Elston, Germà Bel, Han Wang

Abstract Decentralized implementation of means‐tested social assistance programs requires significant organizational capacity among local governments. For other types of local public service, like refuse collection and utilities provision, inter‐municipal cooperation has proven capable of reducing the cost of subnational policy implementation, especially for smaller municipalities. But few impact evaluations test whether the same benefits can be achieved for less capital‐intensive and more co‐produced services, like social assistance. Moreover, most evaluations focus on production costs alone, despite the potential trade‐off with service quality. We analyze panel data describing both the cost and quality of housing allowance administration for 314 local authorities in England between 2009 and 2019, during which time 80 switched from autonomous services to inter‐municipal cooperation. Using coarsened exact matching and stacked difference‐in‐differences, we find no evidence of short‐term savings after cooperation, and only weak indications thereafter. We also observe declining processing speeds, increased maladministration, and signs of reduced payment accuracy, though mostly these are temporary effects. Altogether, these results suggest that, in this setting, inter‐municipal cooperation may be unsuited to labor‐intensive public services; that short‐ and long‐term effects can differ; and that, even in the absence of a profit motive, quality shading remains a risk in cooperation reforms.

Anna Bernhardt, Katrin Kaufmann-Kuchta

International research on adult education systems reaches certain limitations when explaining differences between and within countries. Often, research within the multilevel system of adult education examines issues located at the macro-level, meaning policy and legal frameworks, and at the micro-level, dealing with impacts on learners. This article focuses on the meso-level of adult education in two sample countries, referring to providers and their educational offers of publicly financed basic and community education. Guided by the theoretical approaches of educational governance and neo-institutionalism, we identify governance regimes and organizational fields and analyze the impacts of legal and financial regulation on providers and their provision. Based on document review and expert interviews, relations at the national and regional levels are analyzed. We find a decentralized system supporting the regional provision of basic adult education in Spain and a mixture of national and regional regulations leading to regional provision based on learners’ needs in England.

Sumaiyah Docrat, Crick Lund, Dan Chisholm

BACKGROUND: (MHPF) and the mechanisms by which these reforms can be structured and financed in the context of fiscal constraint. METHODS: A situational analysis guided by a newly developed analytical framework for sustainable mental health financing was conducted. The review was followed by qualitative, indepth interviews with a range of expert national stakeholders. RESULTS: Although the MHPF is said to be consistent with ongoing efforts toward the implementation of National Health Insurance (NHI), there is clear evidence of discordance between the MHPF and the NHI. The most promising strategies for sustainable mental health financing include: increased decentralization of resources to primary and community mental health services; active integration of mental health into ongoing NHI implementation including expanding the mandate of District hospitals and drawing on the private sector; submission of costed budget bids to support a mental health conditional grant and ensuring that explicit outcomes and deliverables are in place to monitor Provincial implementation. CONCLUSION: This paper has suggested several ways in which existing reforms may be leveraged to incorporate the objectives of the MHPF and achieve better mental health outcomes for South Africans, revealing critical opportunities for mental health service scale-up to be embedded in South Africa's future health delivery strategy. The realization of a conditional grant for mental health will require technical expertise to cost existing services towards the development of an investment case for mental health service scale-up nationally, projecting potential resource requirements and returns on investment of a strong service platform. In the longer-term, the NHI benefit package must be expanded to include comprehensive mental health services at all levels. Explicit results-based financing mechanisms within the NHI Fund must also be incorporated for mental health to incentivise quality of care. Private providers engaged by the NHI must commit to make use of evidence-based mental health interventions.

John Butcher

Abstract Externalised service provision is now an embedded feature of Australia's service delivery architecture. However, the lessons drawn from two decades of contracted service delivery suggest that “competition” is an imperfect platform for the delivery of public services, especially where issues of trust in government come into play. Could the concept of a “social license to operate” (SLO), which has been in use in the natural resources sector for over two decades, help to facilitate the conferral of greater trust, credibility and legitimacy upon governments, and externalised service providers in social policy spaces?

B.T.J. Hooghiemstra, Nienke Smulders, C. van Nieuwenhuizen

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Ciara Brennan, James Rice, Rannveig Traustadóttir, Peter Anderberg

Article 19 of the United Nations (UN) Convention on the Rights of Persons with Disabilities requires states to ensure that persons with disabilities have access to a range of support services, including personal assistance. The Convention is an agreement between state parties and the UN. However, in practice, disability services are often implemented at the local level. Drawing on the findings of qualitative research in Iceland, Norway and Sweden, this paper examines a paradox whereby states commit to ensure access to support services, but decentralize responsibility to autonomous and independent local governments. A multi-level governance framework is applied to analyse the findings of qualitative inquiry with policy-makers, local government officials and leaders of independent living organizations in all three Nordic countries. A multi-level analysis highlights the tensions and contradictions between decentralization and human rights commitments.

Ching Yuen Luk

Since the mid-1980s, both Shanghai and Hong Kong have implemented health insurance reform to contain healthcare costs. But the reform result in these two places represents polar extremes. While Shanghai witnessed a revolution in healthcare financing in 2000, Hong Kong remains status quo on healthcare financing. Using the theory of historical institutionalism, this study examines how the complex interplay of forces affects health insurance reform implementation in these two places. It finds that Shanghai succeeded in implementing health insurance reform because of contextual influences, ideological shift, policy feedback, the authoritative political institutions, the dominance of key bureaucratic stakeholders in health insurance reform process, the endorsement of new ideas, and the decentralization power given to local governments. On the other hand, it finds that Hong Kong failed to implement any health insurance reforms in 1993 because of a more democratic political system, policy feedback, the persistence of old ideas, and a robust economy. Besides, it finds that the government failed to implement healthcare financing reforms in 1999 and 2000 because of a disjointed political system, difficult economic circumstances, the new idea lacking public acceptance, policy feedback, and the institutionalization of old ideas.

Jon Glasby

With successive English governments extolling the virtues of greater choice and control within welfare services, there is growing debate about concepts such as direct payments and personal budgets (in the UK and in many developed countries). With the evidence base inevitably patchy and incomplete, there have been increasing criticisms of these approaches from the social care trade press and from academic policy commentators alike. Against this background, this paper reviews the concerns that are emerging and explores some of the limitations of current debates—many of which make an implicit appeal to ‘the evidence’ in order to justify increasingly polarised views. In particular, the paper argues that many current accounts are based on an imperfect understanding of the principles at stake; on a failure to apply the same burden of proof to the old system as well as the new; on prior attitudes to state services and to current social care; and on a potentially limited adherence to more traditional forms of evidence-based practice.

Josef T. Yap

Via regression analysis, this study is able to establish factors that impinge on per capita social sector expenditures. In addition, 32 out of the 62 provincial governments have allocated less on social sectors than what is needed to maintain their 1991 expenditure level in real terms. Inconsistencies regarding budget allocation of provincial governments on the social sectors and the objective indicators are detected.