An analysis of ophthalmology services in Finland - has the time come for a Public-Private Partnership?

Tynkkynen, Liina‐Kaisa; Lehto, Juhani

doi:10.1186/1478-4505-7-24

Cited by 9 publications

(5 citation statements)

References 23 publications

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“…Previous studies identified the lack of problem definition and the absence of concrete proposals as barriers to the policy window [44, 45]. However, in this study, there was consensus on what should be done and how to do it but the political climate was unfavourable.…”

Section: Discussionmentioning

confidence: 72%

“…The Multiple Streams Theory of the policy process was developed in the United States in 1990s, yet it remains a popular choice for understanding the health policy process in Europe [ 42 – 44 ]. Previous studies identified the lack of problem definition and the absence of concrete proposals as barriers to the policy window [ 44 , 45 ]. However, in this study, there was consensus on what should be done and how to do it but the political climate was unfavourable.…”

Section: Discussionmentioning

confidence: 99%

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Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis

Hugh

Perry

Bradley

et al. 2014

Health Res Policy Sys

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BackgroundIn 2006, the Health Service Executive (HSE) in Ireland established an Expert Advisory Group (EAG) for Diabetes, to act as its main source of operational policy and strategic advice for this chronic condition. The process was heralded as the starting point for the development of formal chronic disease management programmes. Although recommendations were published in 2008, implementation did not proceed as expected. Our aim was to examine the development of recommendations by the EAG as an instrumental case study of the policy formulation process, in the context of a health system undergoing organisational and financial upheaval.MethodsThis study uses Kingdon’s Multiple Streams Theory to examine the evolution of the EAG recommendations. Semi-structured interviews were conducted with a purposive sample of 15 stakeholders from the advisory group. Interview data were supplemented with documentary analysis of published and unpublished documents. Thematic analysis was guided by the propositions of the Kingdon model.ResultsIn the problem stream, the prioritisation of diabetes within the policy arena was a gradual process resulting from an accumulation of evidence, international comparison, and experience. The policy stream was bolstered by group consensus rather than complete agreement on the best way to manage the condition. The EAG assumed the politics stream was also on course to converge with the other streams, as the group was established by the HSE, which had the remit for policy implementation. However, the politics stream did not converge due to waning support from health service management and changes to the organisational structure and financial capacity of the health system. These changes trumped the EAG process and the policy window remained closed, stalling implementation.ConclusionsOur results reflect the dynamic nature of the policy process and the importance of timing. The results highlight the limits of rational policy making in the face of organisational and fiscal upheaval. Diabetes care is coming on to the agenda again in Ireland under the National Clinical Care Programme. This may represent the opening of a new policy window for diabetes services, the challenge will be maintaining momentum and interest in the absence of dedicated resources.Electronic supplementary materialThe online version of this article (doi:10.1186/1478-4505-12-53) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis

Hugh

Perry

Bradley

et al. 2014

Health Res Policy Sys

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“…We chose the process-oriented MSF because it takes into account the multicausal relationships of the complex and real-world context of our single case. In the PPP context, there are only a few papers using the MSF addressing different PPP policies and regulations in Denmark and Ireland (Petersen, 2010), prerequisites of the Finnish health care system for PPPs in the field of ophthalmology (Tynkkynen & Lehto, 2009) and more generally, why PPPs appeared in public policy-making worldwide (Greve, 2006). We are using the MSF, that was originally focusing on agenda setting and its further development, to analyze the policy formulation occurring in the establishment of a PPP for innovation (Ackrill et al, 2013;Herweg, 2013;Kingdon, 2014).…”

Section: Multiple Streams As An Adequate Framework For the Study Of T...mentioning

confidence: 99%

One for the money, two for the show: What are the actor‐based incentives for public‐private partnerships for innovation?

Ilgenstein

2021

European Policy Analysis

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This paper aims to identify the processes that lead to the establishment of public-private partnerships (PPPs) with a focus on the financial and policy incentives of the actors involved. To this end, it applies the Multiple Streams Framework to a qualitative case study to answer the following research question: are actors of PPPs for innovation motivated due to financial incentives or can they be policy driven? Although the fiscal context plays an important role in our case, the study shows that policy goals, such as providing infrastructure or public services and promoting innovation can be the main drivers for establishing a PPP.These findings offer a theoretical and practical contribution to analyze PPPs as a phenomenon. First, we establish a theoretical framework of possible incentives for actors in PPPs and, secondly, provide new insights into the PPP discussion in the public administration literature. K E Y W O R D Sinnovation, public-private partnership | INTRODUCTIONThis paper aims to identify the processes that lead to the establishment of public-private partnerships (PPP) with a focus on the preferences of the involved actors. More specifically, we analyze financial

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“…Previous efforts to utilise MSA in Nordic health care include Guldbrandsson and Fossum (2009) and Tynkkynen and Lehto (2009). 6.…”

Section: Supplemental Datamentioning

confidence: 99%

Still ‘skiing their own race’ on New Public Management implementation? Patient choice and policy change in the Finnish and Swedish health-care systems

Smith

Rauhut

2019

International Review of Administrative Sciences

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This article applies an agenda-setting approach to the impact of New Public Management on health-care reform in Sweden and Finland (1993–2016). A system-level view of agenda setting and New Public Management implementation is used to order the historical data derived from literature reviews of each health reform process. New Public Management is viewed as a hybrid concept rooted in the search for efficiency gains and cost containment but, here, generating system preservation and system change strategies, characterised as ‘public competition’ and ‘choice and marketisation’. Sweden and Finland are viewed as ‘pragmatic modernisers’ in the public management literature. Health-care system reform in each country was based on similar problems and similar policy ‘solutions’, and was promoted by similar actors, while the implementation of choice and marketisation again saw windows of opportunity open in a similar manner in each. Policy divergence nevertheless occurred. We identify three key reasons for this, relating to the site and pervasiveness of conflict, the impact of party systems, and administrative openness to outside ideas. Sweden’s conflictual politics produced stalemate while consensual Finland produced radical policy change. Point for practitioners • Finland and Sweden wanted to modernise rather than overturn the traditional welfare settlement with New Public Management implementation. • Similar policy problems emerged and similar solutions were forwarded, often by similar actors and for similar reasons. • In both countries, powerful centre-right government correlates with the promotion of fundamental ‘choice and marketisation’ policies. • National differences in New Public Management implementation remain.

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An analysis of ophthalmology services in Finland - has the time come for a Public-Private Partnership?

Cited by 9 publications

References 23 publications

Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis

Developing recommendations to improve the quality of diabetes care in Ireland: a policy analysis

One for the money, two for the show: What are the actor‐based incentives for public‐private partnerships for innovation?

Still ‘skiing their own race’ on New Public Management implementation? Patient choice and policy change in the Finnish and Swedish health-care systems

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