Southern European Governments and Public Bureaucracies in the Context of Economic Crisis

Sotiropoulos, Dimitri A.

doi:10.1177/138826271501700205

Cited by 28 publications

(18 citation statements)

References 29 publications

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“…"Agreements" or "Pacts" deliberated by the State-Regions Conference and translated into law by the Parliament (Carpani, 2006;Fargion, 2006). These dynamics did not occur only in Italy but were common to all the European countries most affected by the financial crisis and sovereign debt, namely those of Southern Europe (Portugal, Spain and Greece) and, in a partially different form, Ireland (Pavolini and Guillén, 2013;Asensio and Popic, 2019;Léon et al, 2015;Sotiropoulos, 2015). All the last mentioned countries were forced to adopt In the Italian case, these trends seemed particularly evident in some reforms like those of pensions in late 2011 and the adoption of austerity packages on public expenditure and staff (Bordogna and Neri, 2014).…”

Section: The Re-assertion Of the Role Of The Statementioning

confidence: 99%

The Italian National Health Service after the Economic Crisis: From Decentralization to Differentiated Federalism

Neri¹

2019

eces

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This essay analyses the evolution of the National Health Service (NHS) in Italy after the beginning of the financial crisis of 2008, focusing on some trajectories of change underway in the NHS governance. It starts with a reconstruction of the economic and financial framework of the NHS in the last 10 years, briefly describing the austerity policies implemented in the health sector. It then outlines the NHS institutional framework as it emerged from 1990s reforms, which is based on intergovernmental relations and joint policy-making between the State and the Regions. In the third part, it shows how the response to the economic crisis has had a significant effect on these relations, triggering a transformation in the NHS governance. This change, which is far from being concluded, could seriously undermine the universalistic nature of the Italian NHS and its ability to pursue the values of equity and solidarity, especially at a territorial level.

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Section: The Re-assertion Of the Role Of The Statementioning

confidence: 99%

The Italian National Health Service after the Economic Crisis: From Decentralization to Differentiated Federalism

Neri¹

2019

eces

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“…This is important because the specific historical, cultural and politico-administrative context had prohibited a decisive break with the well-established Napoleonic tradition of Southern European countries and "the country had not closely followed the New Public Management trend" (Spanou, 2008, p.153). New Public Management reforms may have been temporally adopted by law before 2010 (Spanou, 2008, pp.168-169), but these were given low priority from central and local political leaders and were met with indifference by civil servants (Sotiropoulos, 2015). The Greek "Kallikratis" Reform Programme…”

Section: The Greek Local Government Transformation In the Period 2010mentioning

confidence: 99%

Contextualising public entrepreneurship in Greek local government austerity

Melissanidou

Johnston

2019

IJEBR

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Purpose Public entrepreneurs are an under-researched group in local government. The purpose of this paper is to explore the contextual complexities of public entrepreneurs who pursue more creative ways of “doing more with less” to cope with dynamic financial and societal anxieties of Greek local government fiscal austerity policy reforms. Precisely, this study aims to the understanding of how specific contextual influences impact, first, on the nature of public entrepreneurship and, second, on manifested outcomes. A systematic approach marks the authors attempt to assess the broader impact pointing out the implications for research, policy and practice. Design/methodology/approach A case study of Greek local government draws on 26 in-depth semi-structured interviews with public entrepreneurs across top, middle and front-line levels of management, field notes, documentary and archival evidence. Findings The findings demonstrate unique Greek contextual complexities such as contradictory tensions between triggered decentralisation of control and responsibilities of the local government and attempts of external reinvention rather than internal renewal. These complexities influence public entrepreneurs’ systemic entrepreneurship behaviours in Greek local government since the implementation of fiscal austerity policy reforms in 2010. Their representation is manifest in policy, administrative and technological outcomes with public value consequences. Originality/value This research contributes to a deeper understanding of public entrepreneurship in context. Greek local government public entrepreneurs bring original insights on the contextual influences of their systemic enactment and manifested outcomes, with implications for research, policy and practice.

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“…The minimisation of room for discussion and negotiation was motivated by the lack of time and alternatives in the face of the commitments made with the EU and the need to reassure the markets. These dynamics did not occur only in Italy but were common to all the European countries most affected by the financial crisis and sovereign debt, namely, those of Southern Europe and, in a partially different form, Ireland [23][24][25][26].…”

Section: The Evolution Of the Governance Of The Nhs Between The Reassmentioning

confidence: 99%

Economic Crisis, Decentralisation and Health Inequalities: The Case of Italy

Neri¹

2019

Universal Health Coverage [Working Title]

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The chapter describes the recent evolution of the Italian National Health Service (NHS), highlighting the potential and effective consequences of the economic and financial crisis on social and territorial inequalities, especially in terms of service access and quality. First, it analyses the cost-containment and austerity policies in the NHS, which brought to a relevant underfunding of the public healthcare system, comparing public expenditure trends in Italy with those of other Western European countries. Then, it stresses the increasing role played by private expenditure, emphasizing the risks in terms of health inequalities connected to the high level of out-of-pocket payments and to the spread of the occupational funds. Finally, a reconstruction and analysis of the current changes in the NHS governance is carried out, explaining in details how the reassertion of the role of the Central State in health policy entails different consequences for different areas of Italy, widening the territorial inequalities and increasing the North-South divide. So far, these changes have taken place without any structural reform, in an imperceptible but progressive way, which does not help to develop an appropriate and necessary debate on the future of the healthcare system. 2As a result, the NHS is structured on three levels: a national level, constituted mainly by the Ministry of Health; an intermediate level represented by the Regions and their Regional Ministers and health departments and a local operational level, directly accountable to the Regional one, made up of about 70-75 Aziende sanitarie ospedaliere (hospital trusts, henceforth HTs) and about 135-140 Aziende sanitarie locali (local health authorities, henceforth LHAs).Since 2001, no major reforms have been introduced into the NHS. However, important changes have almost imperceptibly taken place, connected the economic and financial crisis, which are weakening the universalist nature of the NHS.This chapter will analyse the evolution of the NHS in Italy during the last decade, hence in the years of the crisis, focusing on some trajectories of change underway, mainly in the health expenditure and in the NHS institutional framework governance. These trends might have important consequences in terms of service access and quality, increasing the traditional social and territorial inequalities and hence weakening the universalistic nature of the NHS.

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Southern European Governments and Public Bureaucracies in the Context of Economic Crisis

Cited by 28 publications

References 29 publications

The Italian National Health Service after the Economic Crisis: From Decentralization to Differentiated Federalism

The Italian National Health Service after the Economic Crisis: From Decentralization to Differentiated Federalism

Contextualising public entrepreneurship in Greek local government austerity

Economic Crisis, Decentralisation and Health Inequalities: The Case of Italy

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