Affording Discretion in How Policy Objectives are Achieved: Lessons from Clinician Involvement in Managerial Decision-Making

McDermott, Aoife M.; Keating, Mary A.; Beynon, Malcolm James

doi:10.1057/9780230355026_5

Cited by 1 publication

(2 citation statements)

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“…For policy makers, it appears that contextualized change agency can enhance implementation by allowing local knowledge and insight to inform interventions (Matland, ; McDermott, Keating and Beynon, ). Introducing adaptive approaches to policy implementation may require a range of supporting structures.…”

Section: Discussionmentioning

confidence: 99%

“…However, even in contexts of ‘productive resistance’ the dichotomy between change agents and change recipients remains (Thomas, Sargent and Hardy, ). This dichotomy is particularly problematic in the context of policy implementation, because government mandate (Wallace et al ., ) and academic theory (Hjern, ; McDermott, Keating and Beynon, ; Schofield, ) suggest that effective policy implementation requires change recipients to ‘translate’ national agendas into local contexts. Translation refers to the adaptation of an external practice by an adopter, to enhance fit with the local context (cf.…”

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confidence: 99%

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Beyond Acceptance and Resistance: Entrepreneurial Change Agency Responses in Policy Implementation

McDermott

Fitzgerald

Buchanan

2013

British J of Management

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In this paper we explore how the implementation of public policy can differ from that mandated, and we argue that such departures are not necessarily a problem. Organizational change faces theoretical tension between considering non-acceptance behaviours as 'resistance' and requiring change recipients to tailor and adapt change agendas to fit local contexts. This tension is particularly salient in the public sector, due to the mandated nature of much public reform. We compare the implementation of policy change in four hospital case studies in two countries (Ireland and the UK). Based on interviews with 68 staff across the four cases, we identify how change recipients can react to, translate and contribute to policy change initiatives. Our findings challenge a straightforward distinction between change agents and change recipients, showing how 'first-order' recipients can act as 'second-order' change agents. Entrepreneurial second-order change agents use locally contextualized change agency to tailor and embellish policy mandates. We distinguish between 'adaptors', who make appropriate local adjustments, and 'extrapreneurs' who add extra dimensions to mandated change. This evidence suggests replacing the traditional 'acceptance-resistance' dichotomy with a continuum of responses to mandated policy, identifying how public sector actors can variously avoid, abstain, adopt, adapt or add to change agendas.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%