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Public value, politics and public management
- Reginald Stanley
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1 Public value, politics and public management A literature review Ricardo Blaug Louise Horner Rohit Lekhi
2 Contents Aims of The Work Foundation project 4 Executive summary 6 1. Conceptions of politics and public management Explanatory approaches Conflicting imperatives? Bureaucracy and democracy Respective processes of accountability The shift to political management Authorising public value Constructors of public value Conceptions of public value Processes of democratic legitimation Methods of consultation and feedback Processes of democratic accountability The political calculus of public value Political involvement in Best Value Creating public value Justifying resource allocation Public value as a strategic goal Public value as a management tool Managing citizen expectations Measuring public value Why and what to measure Clarifying intentions Measurement that destroys public value Measurement that creates public value Public accountability 57 Conclusion 59 Bibliography 62 2
3 List of Boxes, Tables and Figures Box 1: Consultation methods 32 Box 2: Accountability and good governance 38 Box 3: Intervening to create public value an example from the Netherlands 44 Box 4: The sources of public service innovation in the USA 49 Box 5: Ways of measuring service performance 52 Box 6: CPA a lighter touch? 55 Box 7: Examples of public involvement in the evaluation of public services 57 Box 8: Measuring the performance of public sector broadcasting 58 Table 1: Comparing perspectives old public administration, new public management and new public service 12 Table 2: Models of governance 13 Table 3: Public value in traditional public administration, new public management and public value management 23 Table 4: Reasons for policymakers to seek citizen participation 29 Table 5: Participatory methods used by local authorities in England 30 Figure 1: The interaction between politicians and public managers 15 Figure 2: Moore s public value scorecard 46 3
4 Aims of The Work Foundation project Building on existing academic and policy work around public value, The Work Foundation s project aims to help policymakers, public managers and institutions understand the concept of public value and see how it can be applied in practice. Public value addresses many of the contemporary concerns facing public managers. These include problems of securing legitimacy for decision making, resource allocation and measuring service outcomes. This research project draws together different strands of the current debate around public value, clarifies its elements and seeks to further understanding of this topical and important conceptual innovation in public service delivery. The project s objectives are to: provide a clear definition of public value provide public managers with a set of guiding principles that orient institutions to the creation of public value use sector and case studies to illustrate how organisations might understand where gaps occur in achieving public value clarify the components and processes of public value in order to facilitate its future capture and measurement. Sponsors The project is sponsored by the following organisations: BBC The Capita Group plc Department for Culture, Media and Sport Home Office London Borough of Lewisham Metropolitan Police OfCOM Quality and Improvement Agency (formerly the Learning and Skills Development Agency) Royal Opera House. The NHS Institute for Innovation and Improvement (formerly the NHS Modernisation Agency) About this paper This paper is one of several background reports being prepared for the public value sponsor group. The research outputs include: Public Value, Citizen Expectations and User Commitment: A literature review Public Value and Local Communities: A literature review Sector papers, seminars and presentations on how public value applies to different sectors like local government, policing, skills, broadcasting, arts and culture, and health 4
5 Case studies examining how public value applies to different institutions, ranging from Lancashire Constabulary to the V&A Museum, and as a way of understanding particular local policy issues, such as recycling in Lewisham Papers on measurement exploring how social scientists have operationalised the concept of public value and applied it in a variety of diverse settings. These also examine how public managers are currently measuring public value, the gaps in information, difficulties around decision making, and how a public value framework can resolve these issues. Please note that the views expressed in this report represent those of the authors and may not necessarily represent those of the project s sponsors. 5
6 Executive summary This paper summarises the findings of the literature review on politics and public management and sets out the theoretical background that underpins the concept of public value. It explores its potential as a theory of public management, which aims to guide the actions of public managers delivering services to the public funded through taxation. Section 1: Public value a theory of public management? Theories of public management attempt to grapple with the fundamental tension between democracy and bureaucracy. These depend on different perceptions of the role of politicians and public servants, their respective influence on governance structures, the extent of administrative discretion and concepts of the public interest. There are three main theories: Principal-agent: This argues that politicians make policy that public managers implement. New public management (NPM): This approach has characterised much public policymaking in the UK in recent years and has aggressively pushed forward technical efficiency as the goal of public bodies at the expense of democratic processes and social values. This has often resulted in the loss of organisational responsiveness and legitimacy. NPM encourages public managers to pursue targets rather than to orient them towards the changing nature of political legitimacy, or to seek public authorisation for activities or initiatives. Public value: Welling from new public service theory, public value argues for a renewed emphasis on the important role public managers can play in maintaining an organisation s legitimacy in the eyes of the public. Far from advocating a return to inefficient public services, public value embraces notions of valued public services and efficiency. It calls for more rounded accountability whereby organisations face their citizens as well as their political masters, rather than static, top-down models that focus public managers on meeting centrally driven targets and performance management. In this way, it attempts to recast the tension between bureaucracy and democracy. This report points to the weakness of the citizen s voice in most public policy decisions in recent years, with citizens only having an opportunity to express their preferences via the ballot box intermittently. But public value does not argue for increased participation by the public in decision making for its own sake. Public value as an approach requires us to take seriously the capacity of public managers at all levels to engage with citizens. Expert in administrative structures and often more sensitive to local conditions, public managers are, therefore, being increasingly drawn into what is most accurately described as a political role. 6
7 Public value thus turns on public authorisation for an organisation s activities. If organisations are to create public value in their practices and use evaluative standards to measure their performance, then those values and evaluative standards must be authorised by the public. This report therefore puts forward the idea of public value as a dynamic process between authorisation, creation and measurement. Section 2: Authorisation Authorisation for what is provided by the public sector, ie what is publicly valuable, results from what is seen as valuable by elected politicians, senior public managers, the media, social scientists and public intellectuals. The question posed by our public value approach is whether the views of those who receive services and those who deliver them are adequately taken into account in the construction and conception of public value. Understanding citizens preferences is key here. Failure to engage with the public about what they want and need may result in services not providing public value, but a value determined and recognised solely by politicians, public managers or even private organisations delivering on behalf of government. Discerning public preferences is notoriously difficult and there are dangers in relying on what an uninformed public states about what it wants provided. There is a clear role for both managers and politicians in shaping those preferences and taking tough decisions about what the public needs, even if the public does not state any preference for this. The example of the MMR vaccine is a good example of justified policy resistance on the basis of medical evidence to calls for the vaccine to be replaced. The provision of better information, and therefore transparency, about the decisions taken by public bodies on behalf of the public are therefore as essential as innovative ways to engage, consult and deliberate with the public. The report finds a great deal of evidence of processes by which citizens are engaged, such as citizens juries, particularly in local government. It also finds that the government s interest in these more participatory approaches is waning, in part due to the difficulties in making them meaningful. The public value approach would seek to overcome this by adding such participatory methods to established accountability processes and making accountability a democratic process in itself. Section 3: Creation Public value is clarified and authorised by the public, but it is made, increased and created by public service organisations through their decisions about what services to provide. It is for these organisations that politicians and public managers must justify the allocation of resources and develop management practices that are consistent with the generation of public value. 7
8 In relation to the allocation of resources, public value emphasises the importance of understanding the values or qualities of public services, for example fairness, when public organisations consider what to do and whom services should target. The BBC is using a public value framework to help decide which new services will best support one of five core values they have identified as key to the organisation s strategic mission as a public broadcaster. Their framework also highlights the potential use of public value as a strategic goal of being a public service broadcaster. The BBC s approach embraces individuals as both consumers of their services who derive personal enjoyment and education, and as citizens who value the cultural, democratic or educational benefits of BBC services to society as a whole. Section 4: Measurement If public value is to be an effective driver of public service reform, then it requires a measurement framework that enables public managers to recognise when and the extent to which such value is being created. It is assumed that public services should be underpinned by performance measures that enable evaluations of effectiveness and guide improvement. What is unique about the public value approach is that it does not cast existing performance management frameworks into the dustbin, but suggests instead that the act of measurement can either fail to capture adequately what value is created or lead to the destruction of public value. The report finds evidence of both cases. For example, performance measurement that focuses on what is common between public bodies and then ranks them according to how well they achieve these common standards, such as Comprehensive Performance Assessment in local government, fails to capture what is different between local authorities. Public managers may also meet targets by whatever means to the detriment of social outcomes; for example, the case of an eye hospital meeting targets for outpatient waiting times by cancelling follow-up appointments led the hospital s clinical director to estimate that 25 patients had lost their vision as a consequence of the delays in follow-up appointments. Alternative approaches to the use of performance management and measurement are thus required if they are to demonstrate public value and help create value in and of themselves. The report argues that such regimes should reflect better how an organisation is meeting national standards, but also that organisations be given the freedom to set their own targets that reflect their unique circumstances. Furthermore, both of these sets of measures should be publicly authorised that is, agreed and pursued with the public. 8
9 Conclusion The report concludes that there is a need to re-conceptualise the goal for public managers and institutions aiming to produce public value as one that seeks to improve institutional responsiveness to the refined preferences of the public. This is about the capacity of a public body to listen to and engage with the public and shape and inform the public s preferences, rather than just give the public what it wants at a particular point in time. 9
10 1. Conceptions of politics and public management 1.1 Explanatory approaches The interaction between elected politicians and senior public managers has been extensively studied, and now offers a variety of explanatory approaches. It is useful to place these approaches on a spectrum, one that ranges from those that stress a fairly straightforward relationship of top-down influence between politician and public manager to those suggesting a much greater degree of reciprocity and complexity in this relationship. We identified in the literature three broad and indicative approaches to the interaction between politicians and senior public managers. The first, that of principal-agent theory, regards governance structures as simultaneously enabling and constraining the actions of public managers. 1 Politicians create static and bureaucratic governance structures in a top-down fashion and hold managers accountable for mandated results. Politicians, as principals and primary drivers of change, ultimately control public managers as agents through constitutional powers such as oversight, appointment, budgeting and legislation. Democracy here takes the form of governance structures that ensure public managers actions reflect the mandates of elected officials. The second approach, that of new public management (NPM), draws heavily on public choice theory and assumes the need for a more entrepreneurial approach to governance. Here, public sector organisations are encouraged to emulate the responsiveness of their private sector counterparts. 2 This approach thus highlights the need for efficient and effective performance, although this can also encompass concerns for equity, responsiveness and accountability. 3 Governance structures are the product of ongoing competition and compromise and the public interest is more than an aggregation of individual self-interests. 4 It is thus a mistake to suggest, as do traditional approaches to public administration, that public management is mandated in any simple way by elected officials. Rather, senior public managers are best understood as being constrained, vetoed or supported by elected officials through a complex process of negotiation. However, this gain in complexity also has its costs. While market-like flexibility may be a desirable end in itself, it can often come into conflict with popular preferences 1 See for example McCubbins M and Schwartz T, Congressional Oversight Overlooked: Police patrols versus fire alarms, American Journal of Political Science, Vol 28 No 1, pp , 1984; Feldman M and Khademian A, To Manage is to Govern, Public Administration Review, Vol 62 No 5, pp , See for example Osborne D and Gaebler T, Reinventing Government: How the entrepreneurial spirit is transforming the public sector, Wokingham, Addison-Wesley, 1992; Denhardt R B and Denhardt J V, The New Public Service: Serving rather than steering, Public Administration Review, Vol 60 No 6, pp , Kettl D and Milward B (eds), The State of Public Management, Baltimore, MD, Johns Hopkins University Press, See Knott J and Miller G, Reforming Bureaucracy: The politics of institutional choice, New York, Prentice Hall, 1987; Moe R, The Emerging Federal Quasi Government: Issues of management and accountability, Public Administration Review, Vol 61 No 3, pp ,
11 about the provision of services. Here, then, NPM has struggled with the rapidly changing demands for accountability in a modern liberal democracy. 5 A third approach to analysing the interaction between politicians and senior public managers is that of new public service theory. 6 Drawing on theories of democratic citizenship, community and civil society, this focuses on a governance system with citizens at the centre. The role of public managers is to help build a collective, shared notion of the public interest, not merely to aggregate individual preferences. Policies and programmes that effectively meet public needs are achieved through collective and collaborative processes that emphasise the importance of citizens over customers and people over productivity. In this view, accountability requires that public managers attend to a much wider set of demands than those of the market. They must also respond to statutory and constitutional law, community values, political norms, professional standards and citizen interests. 7 These very different perspectives emerge as a result of deep-seated philosophical differences. As suggested in Table 1 on the next page, they are premised (often unwittingly) on divergent views of rationality and human behaviour. On this theoretical basis, each then constructs its own notion of the public interest, assigns a role for government and another for public servants. Of the approaches presented here, that of new public service theory would appear to offer the most appropriate framework in which to advance the idea of public value. However, rapid changes in the authorisation environments of modern democracy suggest that a still-more dynamic understanding of the interaction between politicians and senior public managers is required. Neither can we assume that the nature of such a dynamic interaction is the same across an increasingly heterogeneous public sector. In the relationships interaction/dynamics model, public managers are themselves seen as an important source of governance structures (see Table 2 on page 13). 8 They achieve this through the networks and relationships they create and support. Feldman and Khademian use the example of the US Security and Exchange Commission to show that managers not only receive, but also exert, influence over politicians. 9 They do so by managing their professional relationships so as to achieve desired policy outcomes. Here, the relationship between politicians and 5 See Feldman M and Khademian A, To Manage is to Govern, Public Administration Review, Vol 62 No 5, pp , 2002; Peters G and Savoie D, Managing Incoherence: The coordination and empowerment conundrum, Public Administration Review, Vol 56 No 3, pp , Denhardt R B and Denhardt J V, The New Public Service: Serving rather than steering, Public Administration Review, Vol 60 No 6, pp , See Feldman M and Khademian A, To Manage is to Govern, Public Administration Review, Vol 62 No 5, pp , 2002; Selden S C, Brewer G and Brudney J, The Role of City Managers: Are they principals, agents or both?, American Review of Public Administration, Vol 29 No 2, pp , Feldman M and Khademian A, 11
12 public managers is conceived of as one of reciprocal influence and offers a marked contrast to traditional approaches (such as principal-agent theory), which suggest that this relationship is static and top-down. Table 1: Comparing perspectives old public administration, new public management and new public service Old public administration New public management New public service Primary theoretical and epistemological foundations Political theory, social and political commentary augmented by naïve social science Economic theory, more sophisticated dialogue based on positivist social science Democratic theory, varied approaches to knowledge including positive, interpretive, critical and postmodern Prevailing rationality and models of human behaviour Synoptic rationality, administrative man Technical and economic rationality, economic man or the self-interested decision maker Strategic rationality, multiple tests of rationality (political, economic, organisational) Conception of the public interest Politically defined and expressed in law Represents the aggregation of individual interests Result of a dialogue about shared values To whom are public servants responsive? Clients and constituents Customers Citizens Role of government Rowing (designing and implementing politics focusing on a single, politically defined objective) Steering (acting as a catalyst to unleash market forces) Serving (negotiating and brokering interests among citizens and community groups, creating shared values) Mechanisms for achieving policy objectives Administering programmes through existing government agencies Create mechanisms and incentive structures to meet policy objectives through private and non-profit agencies Building coalitions of public, non-profit and private agencies to meet mutually agreed needs Approach to accountability Hierarchical administrators are responsible to democratically elected political leaders Market-driven the accumulation of self-interest will result in outcomes desired by broad groups of citizens (or customers) Multi-faceted public servants must attend to law, community values, political norms, professional standards and citizen interests Administrative discretion Administrative officials allowed limited discretion Wide latitude to meeting entrepreneurial goals Discretion needed, but constrained and accountable Assumed organisational structure Bureaucratic organisations marked by top-down authority in agencies and control or regulation of clients Decentralised public organisations with primary control remaining with the agency Collaborative structures with leadership shared internally and externally Motivational basis of public servants and administrators Pay and benefits, civilservice protection Entrepreneurial spirit, ideological desire to reduce size of government Public service, desire to contribute to society Source: Denhardt and Denhardt,
13 Table 2: Models of governance Governance structures Static Dynamic Sources of influence on governance structures Direction of influence on governance structures and public management actions Potential for change in governance structures What governance structures create accountability for How is democracy achieved? Single politicians create governance structures Linear, hierarchical, top-down politicians constrain the actions of public managers through governance structures Relatively static change comes through the direct action of principals Results how well public managers achieve results is mandated by politicians Through politicians as responsive to electorate and in control of public manager activities Multiple governance structures created through interactions of people in many different roles Reciprocal public managers influence the structure of relationships that constitute governance structures, and constrain and enable their actions Relatively dynamic opportunities for different actions are created in each interaction Results and democratic process do policy results have public value? Do decision making and implementation efforts build democratic capacity? By making visible and continuously evaluating the appropriateness of the nature and quality of the relationships through which policy is enacted Source: adapted from Feldman and Khademian, 2002 Each of the above approaches highlights different elements in the interaction between politicians and public managers. These range from top-down initiatives, where politicians set the ends and public managers merely implement them, to complex networks of reciprocal negotiations. Taken together, they exhibit a discernable increase in the attention paid to contemporary changes, not only in the relationship between politicians and public managers, but also in the relationships of each to the citizenry at large. In regard to the former, research tends to examine the different imperatives to which politicians and public managers are subject. As we shall see, these often conflicting imperatives recall the age-old tension between democracy and bureaucracy and draw the attention of researchers towards their respective forms of accountability. Finally, we will consider work on the nature of leadership in a rapidly evolving and increasingly democratic authorisation environment for public policy. 1.2 Conflicting imperatives? As we have seen, in traditional approaches to public administration the interaction between politicians and public managers was conceived of in terms of a simple opposition, one that occurred because their respective roles meant they were subject to different imperatives. This notion of separation here between politics and administration dates back at least to Weber s account of bureaucracy and perhaps also to Woodrow Wilson s conceptual separation of these two spheres Svara J H, Complementarity of Politics and Administration as a Legitimate Alternative to the Dichotomy Model, Administration and Society, Vol 30 No 6,
14 Miller describes this separation as a useful myth because it obscures the influence of administrators and prevents politicians implementing policies that merely channel benefits toward themselves. 11 More recent approaches to this relationship have advanced the notion of complementarity. Thus, Mountjoy and Watson acknowledge the tensions between the aims of politicians who are elected, and public managers seeking to retain professional integrity and to serve the public. What mitigates this tension and allows for collaboration, they suggest, is reciprocal restraint. Thus: while elected officials could dominate administrative practice they are constrained by a respect for administrative competence and commitment. [Similarly] administrators could use their considerable resources to become self-directed, but they are restrained by a commitment to accountability in the complementary relationship. Attention to the constraining effect of reciprocating values produces an array of models for describing [the] political-administrative relationship. 12 Peters and Pierre provide additional analytic detail on the various types of relationships that constitute the interaction between politics and public management. 13 Placing them on a continuum, they see one end as a formal and Weberian separation of functions between the two sets of actors (see Figure 1 overleaf). At this extreme, politicians are firmly in charge and bureaucrats act in a confined and pre-determined solution space. At the other pole is bureaucratic government, in which administrative know-how and command of technical information always trumps that of politicians. Once again, Peters and Pierre note real conflicts between political and administrative officials. They describe a strongly politicised relationship in which politicians and bureaucrats are, in essence, vying for control over public policy. 1.3 Bureaucracy and democracy Governance thus faces again the age-old question of how we are to reconcile the imperatives of bureaucracy and democracy. In static and dichotomous approaches, politicians were seen as making policy on behalf of their constituents, while public managers merely implemented pre-given goals. Against this, more dynamic approaches view public managers as democratic facilitators, and as engaged in mending democratic processes that appear broken and unable to articulate and produce essential public policy Miller G, Above Politics: Credible commitment and efficiency in the design of public agencies, Journal of Public Administration Research and Theory, Vol 10 No 2, pp , Mountjoy R S and Watson D J, A Case for Reinterpreted Dichotomy of Politics and Administration as a Professional Standard in Council-Manager Government, Public Administration Review, Vol 55 No 3, pp , Peters G and Pierre J (eds), Politicians, Bureaucrats and Administrative Reform, London, Routledge, Stoker G, Public Value Management (PVM): A new resolution of the democracy/efficiency tradeoff, unpublished paper, Institute for Political and Economic Governance (IPEG), University of Manchester,
15 Figure 1: The interaction between politicians and public managers Bureaucratic autonomy Administrators are committed to accountability and responsiveness Complementarity Politicians respect administrative competence and commitment Statement or laissez-faire Political dominance Source: Adapted from Peters and Pierre, 2001 In traditional approaches to public administration, democracy gave the goals and bureaucracy delivered the technical efficiency required for their implementation. However, in NPM the democratic system was carefully limited to providing only a very broad direction for policy. Politicians were expected to allocate resources efficiently and assess performance. Thereafter, they were to refrain from hampering the technical and organisational activities of public managers. NPM thus sought managers who were entrepreneurial, empowered and directive. In addition, a central aspect of their activity was to seek out, clarify and assist in the expression of customer needs. 15
16 When policy emerges from a highly complex interaction and negotiation between politicians and public managers, it is the result of a series of trade-offs. These often take the form of trade-offs between democratic values and the imperatives of practice. NPM has been heavily criticised for its tendency to play down the former, to reduce the scope of the political sphere and thereby to allow the tradeoff between democracy and bureaucracy to tip fatally towards the latter. This has often resulted in the loss of organisational responsiveness and legitimacy. NPM thus has a tendency to send public managers off to pursue their own targets, rather than to orient them towards the changing nature of political legitimacy. Politicians then confront a policy environment that is far harder for them to control. 15 Here, citizens are also reduced to mere consumers of services and inadequately consulted about policy objectives. These dangers arise directly from the NPM conception of the trade-off between democracy and bureaucracy, which claims technical efficiency as the ultimate organisational goal. Public value stands astride the fault that runs between politicians and public managers. It offers a new perspective on the trade-off between democracy and bureaucracy. Yet the importance it attaches to authorisation, democracy and dialogue cannot negotiate away this trade-off by simply dismissing efficiency. The public value approach must somehow locate and express public notions of value, and be viable and effective. An orientation to public value recognises both the need for efficiency and for democracy. While locating and expressing public notions of value is no easy task, doing so when the very nature of accountability is changing is more difficult still. Stoker argues that there is now a lack of clarity about where responsibility lies and consequently a major accountability deficit. 16 He points out that this development now runs alongside claims that civil society is itself in decline and that the cultural resources to build bottom-up networks of governance may no longer be available. 17 In this scenario: It would appear that there is a structural limitation in governance by networks from a democratic viewpoint. 18 In the current authorisation environment, as Rhodes suggests, we must replace private government with public accountability and we must do so throughout the interstices of the webs of institutions which make up governance Kettl D F, Sharing Power: Public governance and private markets, Washington DC, The Brookings Institution, Stoker G, Public Value Management (PVM): A new resolution of the democracy/efficiency tradeoff, unpublished paper, Institute for Political and Economic Governance (IPEG), University of Manchester, Putnam R D, Bowling Alone: The collapse and revival of American community, New York, Simon & Schuster, Stoker G, Public Value Management (PVM): A new resolution of the democracy/efficiency tradeoff, unpublished paper, Institute for Political and Economic Governance (IPEG), University of Manchester, Rhodes R, Governance and Public Administration in Pierre J (ed), Debating Governance, Oxford, Oxford University Press,
17 1.4 Respective processes of accountability The public value approach raises questions for traditional assumptions about public administration and accountability. 20 Public value encourages managers to conceive of goals that go beyond organisational survival and the mere meeting of targets. One such goal is the need to maintain legitimacy in the organisation s authorisation environment. Without legitimacy an organisation is unable to command resources, commitment or co-operation. Kelly et al are concerned that static forms of accountability that lock public organisations into fulfilling carefully-specified functions can result in a debilitating loss of responsiveness to their authorisation environment and a corresponding loss of legitimacy. 21 At the same time, it is clear to them that politicians are unable to stipulate how a local agency can best provide a service, let alone how that service can increase user satisfaction, achieve legitimacy and ensure effective outcomes. However: [This] does not mean that in every instance public value should be equated with greater managerial discretion and looser accountability. 22 Indeed, they suggest it is often beneficial to require that service providers adhere to some kind of service template to ensure the reliability and efficiency of that service. They see this kind of approach working well in the disbursement of housing benefit and in the use of clinical protocols in the NHS. Here, public value is created by ensuring that all service providers adhere to recognised best practice. 23 For Kelly et al, best practice involves the use of structures of accountability that are shaped to support the creation of public value. This is precisely not what happens with static, function-based and performance-related accountability. The excessive use of inspections, auditing and efficiency measures are here seen as detrimental to the creation of public value. As they suggest: [A] more rounded accountability that faces outwards towards users and citizens, as much as upwards towards departments and inspectorates, is likely to work better. 24 They then identify five key relationships to which this more rounded accountability will need to attend. These include relationships with democratically elected leaders, with taxpayers, with service users, staff and management colleagues. Importantly, they do not accord primacy to the upward-facing accountability relationship that senior managers have with politicians. Indeed: In any clash between political accountability and adherence to the law, the latter will always take precedence and some countries have legislation on policies in the public service which deal with this Kelly G, Mulgan G and Muers S, Creating Public Value: An analytical framework for public service reform, London, Prime Minister s Strategy Unit, Cabinet Office,
18 This last point again highlights the increasing heterogeneity of the public sector, and the very different accountability requirements and statutory responsibilities to which different actors are subject. Structures of accountability must not only be shaped to support the creation of public value, but also take into account the great variety of public service roles (social care, enforcement, regulation etc) as well as its different levels of management. 1.5 The shift to political management Historically, social democracy has not left much room for citizen voice and has been capable of only a very weak relationship between civil society (the public) and the state. Popular participation in government was limited to voting in elections and to involvement in political parties. Citizens could influence policy only by selecting the political actor that best represented their political views. With politics restricted to the institutions of state, and democracy to the periodic selection of autonomous representatives 26, public managers were expected to somehow achieve what politicians had not: an understanding of constantly evolving public preferences. Corrigan and Joyce argue that a weak interaction between state and civil society results in the public not conceiving of public services as their own. 27 It is this that explains why, when subjected to severe budgetary cuts, the public was so quick to accept the alleged inefficiency of public services. Again, when services were portrayed in the media as being out of touch, most agreed wholeheartedly. 28 This loss of ownership arose from the inability to engage the public. The proffered solution, however, failed to address the democratic deficit. Instead, new forms of public management emerged around the interaction between marketisation and managerialism. This could be seen as the result of, at least in the UK, a twintrack state strategy of replacing the public sector where possible, and reforming what could not be replaced. 29 The weakening relationship between state and civil society has thus been accompanied by changing conceptions of the public sector; by the arrival of private providers of public services and by concern over the responsiveness of centralised and target-driven reform. Even in 1993, Pollitt rejected the strategy of replacement by private providers and sought instead to deliberately extend the range of actors involved in the running of public services. 30 This, he argued, would significantly change the authorisation environment in which the interaction between politicians and public managers takes place. Indeed, it would force politicians to reckon with a new, informed and highly legitimate source of opinion on what should be done This would not, 26 Schumpeter, Corrigan P and Joyce P, Reconstructing Public Management: A new responsibility for the public and a case study of local government, International Journal of Public Sector Management, Vol 10 No 6, pp , Pollitt C, Managerialism and the Public Services, Oxford, Blackwell,
19 Pollitt pointed out, be the consumerism of the New Right, but the active participation of users and taxpayers in the running of everyday services a real cultural shift. 31 Public value requires that we bring the public back in. Citizens should participate directly in a vibrant representative democracy. Management that creates public value facilitates such participation and acts as a community enabler. It devolves powers and emphasises the representative role of elected members. In this way it gains strength from the active involvement of the community instead of being based on the fact of election alone. 32 Certainly, any serious increase in participation by the public would quickly generate new pressures on both politicians and public managers. Yet Corrigan and Joyce suggest that a period of conflict might be regarded as functional, particularly in cases where elected representatives [are] purely advocates of the bureaucracy. 33 Increased participation turns on citizens having the time and energy to put into the political system. As Corrigan and Joyce remark: If this is over-optimistic then, as a strategy, it falls at the first fence. 34 Yet the public value approach requires us to take seriously the superior capacity of public managers at all levels to engage with citizens. Expert in administrative structures and often more sensitive to local conditions, public managers are, therefore, being increasingly drawn into what is most accurately described as a political role Leach S, Stewart J and Walsh K, The Changing Organisation and Management of Local Government, Basingstoke, Macmillan, Corrigan P and Joyce P, Reconstructing Public Management: A new responsibility for the public and a case study of local government, International Journal of Public Sector Management, Vol 10 No 6, pp ,
20 2. Authorising public value In a democracy, the values that guide public organisations are the product of public debate and negotiations between institutions. How we conceive and legitimate public values thus turns on their public authorisation. If organisations are to create public value in their practices and use evaluative standards to measure their performance, then those values and evaluative standards must be authorised by the public. This is no more than to reassert the fundamental dynamic at the heart of the public value approach and the democratic nature of our current authorising environment. This section explores this environment and the processes by which it operates. It begins by reviewing research on the construction and conception of public value, then examines practical methods by which organisations seek democratic authorisation for their activities. 2.1 Constructors of public value What the public perceives as valuable is notoriously hard to establish. As a way of measuring public preferences by aggregating individual preferences, the electoral system is itself an attempt to address this question. The careful separation of powers, the institutionalisation of conflict and accountability, freedom of the press and the expansion of the franchise are all intended to deliver governments that express the will of the people. The public value approach requires public organisations to seek out, listen to and guide public conceptions of value. As such, it is profoundly democratic. Yet the practical viability of more democracy, of more public participation in the design, delivery and evaluation of services requires policy actors to imagine a different authorisation environment. In 1680, a certain Lord Sidney was outraged by John Locke s suggestion that the franchise be extended. What next?, he scoffed. Would you have us poll the whole nation? Similarly, today we seek new ways for the public to express its will, and to have its values inform and legitimate the goals of public organisations. Since Lord Sidney s failure of political imagination, public administration has not only accommodated a vastly expanded franchise, but has also (re)discovered society. Whether in the form of social capital, democratic culture, civil society or associational life, we now gaze on a complex and rapidly changing authorisation environment. Yet it is in this heterogeneous environment that public value is constructed. Social scientific research has shown both the strengths and weaknesses of social capital theory and there is a growing consensus that the concept of civil society offers little more than the opportunity for academics to argue over how it is to be defined. For this reason it is more fruitful to use Jürgen Habermas s notion of the public sphere. 35 The public sphere is here seen as something that opens each time 35 Habermas J (translated by Burger T), The Structural Transformation of the Public Sphere: An inquiry into a category of bourgeois society, Cambridge, MA, MIT Press, 1981; see also Keane J, Democracy and Civil Society, London, Verso,
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Arclinea Design Week 8/12 April 2014
As part of Eurocucina / Design Week 2014, Arclinea will be present both at Corso Monforte 28, in its own Flagship Store, and at Corso Monforte 23, in the Galleria Visconti.
Arclinea Flagship Store Corso Monforte 28: ARTUSI GOURMET, OUTDOOR COLLECTION, accessories, finishes, innovative materials – designed by Antonio Citterio.
Arclinea@Galleria Visconti: GAMMA78, KITCHEN & VANITY - styling by RobertoPamio+
ARTUSI GOURMET, OUTDOOR COLLECTION, ACCESSORIES, FINISHES AND MATERIALS designed by Antonio Citterio
As part of the 2014 Salone del Mobile (Furniture Exhibition), Arclinea will present one of its historic products to the general public, ARTUSI (designed by Antonio Citterio in 1997), which provides a concrete expression of his original concept of "uniqueness":
Inside the Arclinea showroom, guests can also discover the countless new products in the Collection:
- PRODUCTS AND ACCESSORIES such as the new line of "Winery" products, created through the development of Project Division Arclinea, which comprises wine shops, enopockets, tasting stands, pre-selected and presented in spaces characterised by true excellence. Even more new products in indoor and outdoor chair collection, new accessory solutions and customisable backrests…
- MATERIALS, FINISHES AND INNOVATIVE PROCESSES, such as the new stainless steel treatment or the 'Armour' laminate, obtained with the help of nanotechnologies, new finishes and shades for woods…
In the inner courtyard, Arclinea will be presenting its Arclinea OUTDOOR COLLECTION: a comprehensive line covering the whole Collection, with island and wall kitchens, hot tables and chairs.
styling by RobertoPamio&Partners
The GAMMA project reclaims the key concepts of Gamma30, a kitchen produced by Arclinea in the 1970s, with updated contents and finishes. It proposes a solution characterised by a clean, elegant style, with a look that can be at once neutral and extremely sophisticated, and which will never go out of fashion. In terms of its finishes and transversal elements, Gamma mirrors the Arclinea Collection, while its adaptability makes it particularly suited to the creation of dedicated contract projects, for a "total Arclinea look". A host of customisable products ranging from the kitchen, the focal room of the home, to other areas. As part of the Eurocucina | Design Week, Arclinea is presenting GAMMA78, styled by RobertoPamio&partners, at Galleria Visconti, with a wide range of innovative solutions for both the kitchen and the vanity room.
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Big Sur Bakery & Restaurant Map
Pacific Coast Hwy. (Rte. 1, 30 miles S. of Carmel)
831-667-0520 | Make Restaurant Reservations | Menu
Use this map to Big Sur Bakery & Restaurant to get there and back safely. If the "Get directions" pop-up does not appear, click the green arrow to get driving directions to and from this restaurant.
Find out which restaurants and chefs top the list of GAYOT's 2016 Annual Restaurant Awards.


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- Home
- Academics
- Health & Nursing Programs
- Our Programs
Programs that lead to careers
The Nursing & Health Sciences Institute operates districtwide, offering course work
on the Cocoa, Melbourne, Palm Bay and Titusville campuses. We're also home to a regional
training center for the American Heart Association.
EFSC provides state-of-the-art classrooms and clinical laboratory facilities where students learn to apply their specialized skills. Human Patient Simulation Technology is utilized throughout the curriculum so students can practice their newly learned skill and see the consequences of their actions before they work on a live patient.
Course work can lead to a variety of degrees and certificates — all of which will fast-track you into your desired career field. Check the menu in this section for the full list of programs. Continuing education courses are also offered on a wide array of health-related topics. Many emergency first aid and CPR classes are available through the American Heart Association.
Applicants for our programs must be 18 years of age prior to the start of their intended program's clinical courses. For more information about program requirements, please view the program links and/or contact our specialized Admission and Advising office.
Nursing & Health Sciences Programs
- Computed Tomography (CT) A.T.C.
- Dental Assisting A.T.D. (Cocoa)
- Dental Assisting Technology & Management A.S. (Cocoa)
- Dental Hygiene A.S. (Cocoa)
- Diagnostic Medical Sonography A.S.(Melbourne)
- Magnetic Resonance Imaging (MRI) A.T.C.
- Medical Assistant C.C.C and A.S. (Cocoa, Palm Bay)
- Medical Information Coder/Biller C.C.C. (Cocoa)
- Medical Laboratory Technology A.S. (Cocoa)
- Nursing/RN A.S. (Melbourne)
- Patient Care Assistant PSAV(Titusville, Palm Bay)
- Pharmacy Technician A.T.D.(Melbourne - Starting Spring 2018)
- Phlebotomy PSAV (Cocoa, Palm Bay - Starting Fall 2017)
- Physical Therapist Assistant A.S.(Melbourne)
- Practical Nursing/LPN PSAV (Melbourne)
- Radiography A.S. (Melbourne)
- Respiratory Care A.S.(Melbourne)
- Surgical Technology (Melbourne)
- Transition to Associate Degree Nursing / RN(Titusville)
- Veterinary Technology A.S. (Cocoa)
Contact Us
Cocoa Campus
Nursing and Health Sciences Admissions & Advising Office
1519 Clearlake Road
Cocoa, FL 32922
Building 20, Room 233
Fax: 321-433-7579
Email: email@example.com
Melbourne Campus
Nursing and Health Sciences Admissions & Advising Office
3865 N Wickham Road
Melbourne, FL 32935
Building 15, Room 101
Fax: 321-433-7579
Email: email@example.com
Important Forms
Health Experience Form
Permission to Release Education Records
Transcript Request Form
Should Students need to make an accident claim, they can obtain claim forms and information from their instructors or download the following PDF forms:
Student Insurance Claim Form
Student Insurance Certificate
Student Insurance FAQ & Claims Handling Information


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Sometimes the greatest love is letting go.
A compelling drama that explores the different meanings of being a parent through the gritty, realistic lives of the struggling, blue-collar Porter's, and the privileged Campbell family. Their lives intersect, intertwine and collide, all for the love of a little boy. This film bravely exposes the humanity in each character reminding us that we each have the potential to be the best and worst versions of ourselves at any time.
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The Santa outfit
You only have to walk past Ann Summers and look in the window (well,OK, a month ago) to see that Santa can be sexy. A nice little red dress with white trim again leaves something to the imagination. Sadly, Tina in that pic down there has laid that idea to rest. A little self-respect, eh love?
The more tasteful Santa cossie is much more alluring in our book. And the kind of thing your real girlfriend might, just might actually wear if you asked nicely. After giving her an amazing Christmas gift and claiming it's just to get in the spirit of things, natch.
Above: Claris from Christmas NiGHTS, Santa from The Sims 2: Holiday Stuff (yes, a bloke - sorry), Kasumi and Tina from DOA2 and DOAX2 respectively and a real girl from Ann Summers


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10,000 days ToolCDMore from "Tool"
14,99 € You save 11% / 2,00 €
Product Details
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Tracklist - 10,000 days
- 1.Vicarious
- 2.Jambi
- 3.Wings for Marie (PT 1)
- 4.10.000 days (Wings PT 2)
- 5.The pot
- 6.Lipan conjuring
- 7.Lost keys (Blame Hofmann)
- 8.Rosetta stoned
- 9.Intension
- 10.Right in two
- 11.Viginti tres
EMP Editorial Team (03.04.2006)
The wildest rumours have been circulating in the internet about the new album of the Californian cult band. Talking of guest appearances of Josh Homme (Q.O.T.S.A.) or Scott Reeder (ex-Kyuss). Or it being the last Tool epic because singer Maynard has become a Jesus freak. All bullshit as you will see: "10.000 days" does completely without guests or bible religious lyrics and rather features eleven new songs offering in 76 minutes everything this band stands for: a heavy brew of progressive rock and gloomy soundscapes. With razor sharp staccato guitars, groovy killer bass guitars, blasting double bass drums and a singer so expressive as if he sings for his life. Which he does maybe. Because in the complex songs of up to eleven minutes he tells the mysterious story of a modern Jesus figure. A saviour supposed to free the world of George W. Bush, right-winged mass media and multinational large combines and who is completely overtaxed with this task, however. If this is a parody on the current religious illusion in the U.S. (see: Intelligent Design) or pure cultural pessimism can only be safely answered by Tool themselves.
Tell us what you think about "10,000 days" and receive a 10% voucher within 24 hours.
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text:
2.75 acres in Sedgwick County, Kansas
Call Debbie Haukap, Coldwell Banker Plaza at 316-644-9114 for more details. Attached plat shows available 2 acre lots. Garden Plain Schools close to Hwy 400 access and approximately 20 minutes from west Wichita and Dwight D Eisenhower International Airport. Underground electricity is already provided.
Kellogg ( Hwy 400) west to Garden Plain Exit - south to stop sign which is Harry St - west to 311th St W - south to Seidl Dr - west into subdivision
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Debbie Haukap
Coldwell Banker Plaza Real Estate - W 13th
Other Land for Sale in Sedgwick County
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NOTE: The information contained herein is provided as general information only and has been obtained from sources deemed reliable. It is provided without any guaranty, warranty or representation, expressed or implied, made by Lands of America, or any related entity, as to the accuracy or completeness of the information. The information is presented subject to errors, omissions, change of price or conditions, prior sale or withdrawal without notice. Prospective purchasers should make their own investigations, projections and conclusions concerning the information.


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Morning Briefing: Hungarian Forint on Top Watch List
Central European markets with the exception of the Hungarian forint are seen trailing sideways Monday amid no news flow expected.
In Budapest, the forint will eye talks and an announcement by the Hungarian government and the Hungarian Banking Alliance Tuesday on a pact to aid troubled mortgage debtors. Plans to fix the Swiss franc-forint rate has already moved spot rates, while further details on fixing the Japanese yen-forint and euro-forint rate could bring additional excitement early this week, coupled with an announcement on a possible extension the extra banking sector tax through 2014. The special bank tax was to expire at the end of 2012.


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- 3
Understanding Fuel Surcharge
A fuel surcharge is an extra payment to help cover the cost of your fuel. The surcharge became popular around the time fuel went over $1.20/gallon. Most large carriers include a fuel surcharge in their rates. This...
- 4
Cheapest Way to Start Your Own Trucking Business
There are many companies that offer a lease to prospective drivers with little or even no money down and no credit check. Some of these companies even offer training to help drivers get their CDL and some practical on...
- 6
How I Made Over $1000 in the Stock Market Last Week
I want to be clear I am not making $1000 every week. This was just a really good week for me, the kind I want to have more of. I trade stocks. I am something between a day trader and a swing trader. The definition...
- 2
How the Standard Meal Per Diem Deduction Works for Truck Drivers
Don't miss your biggest tax deduction ...the average OTR driver is on the road for about 320 days a year ... that's about $18,880 that you can write off on your taxes


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Bradley Jaden and Carly Anderson among Wicked tour cast
Theatre News11 May 2016
Elf (Plymouth Theatre Royal)
Reviews11 Dec 2014
The Coronation of Poppea (Snape)
Reviews25 Oct 2013
Love, Lies and Lust (Hornchurch)
Reviews4 Oct 2013
Tristan Gemmill is Beverley Knight's Bodyguard from September
Theatre News14 Jun 2013
Casting announced for Night of 1000 Stars, Hal Prince honoured
Theatre News1 Feb 2013
Aladdin (St Albans, Alban Arena)
Reviews29 Dec 2012
The DIY Nativity (Cambridge, The Junction)
Reviews7 Dec 2012
Hamlet: The Undiscovered Country (Norwich, The Hostry)
Reviews5 Nov 2012
Hard Places (Colchester, Mercury Theatre Studio)
Reviews12 Sep 2012
Peter Pan (Hornchurch, Queen's Theatre)
Reviews29 May 2012
1000 Voices celebrate 'Best of British' with Bonneville
Theatre News17 Apr 2012
Equus (tour – Bury St Edmunds, Theatre Royal)
Reviews18 Mar 2012
Can't Pay? Won't Pay! (Hornchurch, Queen's Theatre)
Reviews13 Mar 2012
Satin 'n' Steel (Hornchurch, Queen's Theatre)
Reviews9 Feb 2012
Cinderella (Hornchurch, Queen's Theatre)
Reviews6 Dec 2011
The Jungle Book (tour – Watford)
Reviews20 May 2011
Aladdin (Hornchurch, Queen's Theatre)
Reviews9 Dec 2010
Aladdin (Watford Palace Theatre)
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Free Tickets for Gold Lamps
Theatre News9 Nov 2010


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This qualification is designed to help you win your first office job or help you return to work after a break by equipping you with demonstrable, practical skills by the best known name in office skills training.
In as little as 5 weeks, you could have your Pitman Training "Introduction To Office Skills" diploma and be on the way to building a great new career in administration.
The great thing about this office skills training programme is that you choose 4 subjects from the list below, to ensure that you pick exactly the right office skills for the current jobs market and to suit your personality.
You can learn to touch type (or if you can already do so, we'll improve your speed and accuracy),
learn the key products in the Microsoft Office suite including Word, Excel and Outlook or learn elementary bookkeeping skills.
Our aim is for you to graduate with good all-round office skills.
Learn at times to suit you, taking advantage of our long opening hours and enjoying the support of our friendly, experienced trainers.
Enquiring from the Manchester area? Click here for further details.
Office Skills Training – What Is Covered.
This Office Skills Diploma programme is tailor-made for you. Simply choose any four subjects from the following list:
- Touch Typing for Beginers
- Keyboard Speed Development (for experienced touch typists)
- Audio Transcription Level 1
- Communication At Work (basic English grammar, writing skills, telephone techniques)
- Effective Business Communication
- Business English
- Word Part 1 (beginner's to intermediate word processing)
- Word Part 2 (for advanced Word users)
- Excel Part 1 (beginner's to intermediate spreadsheets)
- Excel Part 2 (for advanced Excel users)
- Outlook (emails, diary management, office organisation)
- PowerPoint
- Beginners' Bookkeeping (elementary bookkeeping for business)
- Understanding Business Accounts
- Health & Safety
- Go Get That Job
If you already have a high degree of skills in some of the modules, you may not need to sit them again, simply taking the exam to prove your competence on your way to earning your full diploma.
Our friendly course advisors will advise you on whether you're ready for "exam-only."
Enquiring from the Manchester area? Click here for further details.


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- Description
Protect your hands from hot pans with this lovely pair of heat resistant Double Oven Gloves in our fresh and summery Swallow design, part of the Swallow collectionof kitchen textiles, fine bone china, oilcloth and stationery.
Sophie has captured the elegant gliding and diving of the beautiful Swallow in this lovely pale sky blue fabric. A practical gift for getting those piping hot casseroles out of the oven and great for anyone who collects our Swallow range.
The Double Oven Glove is 18cm x 84cm and is 100% cotton. The reverse of the Glove and inside each hand pocket there is a special heat resistant fabric. There is also a handy 'loop' in the middle of the glove so you can hang it up in your kitchen.
For details on the care and wash recommendations of all our kitchen and interior textiles products, please refer to our 'Fabrics Product Care Information.'
Perhaps also consider a Swallow Tea Towel or a Swallow Apronfor some co-ordinated cooking!
- Part of the Swallow Collection
- Heat resistant
- Hanging loop
- 100% cotton
- 18 x 84cm
- Machine washable
- Care
For details on the care and wash recommendations of all our kitchen and interior textiles products, please refer to our Fabrics Product Care Information.
All natural fibres will shrink a bit when washed. However, washing our cotton fabrics at excessively hot temperatures will cause more shrinkage than usual. Please follow the washing guidelines on the product label as detailed below.
- Size
The Double Oven Glove is 18cm x 84cm.
- Delivery
UK Standard Delivery: £2.95 (3-7 working days) FREE if you spend over £50.
UK first class Delivery: £4.95 (1-2 working days).
UK Next Working Day Delivery: £7.95 (Order must be placed before midday).
Saturday delivery available if order placed by 12 noon on Friday: £12.95.
International Delivery: from £8.40 to Europe (allow 14 working days), from £10 to rest of the world (allow 14 working days). Calculated at checkout.
For more details see our Delivery information page.
- Reviews
Feefo Reviews - Average 100% (11 reviews)
Date Score Customer Comment Our Response 03-Nov-2016 Product:
Excellent 19-Sep-2016 Product:
This was a repeat order...having already got a pair of Chicken oven gloves knew that the quality is superb and no burnt hands. Bought the swallow pair for myself and the hare for my daughter moving into her new flat. Delighted with designs and quality Highly recommend 24-Nov-2015 Product:
The product is lovely and practical! Maybe I would prefer it to be delivered in its own plastic bag to protect it further. 15-Oct-2015 Product:
Couldn't decide between all the lovely fabrics so ended up buying 2! 29-Jun-2015 Product:
Gorgeous - good quality item 25-Jun-2015 Product:
Beautiful, excellent quality and super quick delivery. Seriously impressed. 20-Jun-2015 Product:
Excellent 04-Mar-2015 Product:
Beautifully made, pretty design and looks lovely with the matching hob covers. 25-Jan-2015 Product:
Very pleased 22-Dec-2014 Product:
I love the pattern/colour and I know they are excellent oven gloves as I already have some. These are for my daughter who saw mine and wanted some herself! 09-Oct-2014 Product:
Good Read more reviews on Feefo
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