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The Two Case Studies Compared

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Bargaining Power

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Abstract

Bargaining power is shown to be the driver of non-incremental policy change and variation in a thought-provoking comparative analysis of two health policymaking case studies. England’s policymakers were able to integrate a pay-for-performance scheme design into contractual negotiations with the British Medical Association, leading to increased funder influence over general practitioners and opportunities to improve population health outcomes. Contemporaneously, New Zealand’s policymakers lacked these powers, delivering a much smaller scheme. Kingdon’s Multiple Streams Framework fails to offer adequate explanations for the policymaking in these two majoritarian, parliamentary political systems. Recommendations are made for modifications to the Framework to recognise the importance of institutional context in the Politics Stream, variation in entrepreneurial activity and policy outcomes (not just outputs).

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Notes

  1. 1.

    http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/primary-care-data-and-stats

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Authors and Affiliations

  1. School of Government, Victoria University of Wellington, School of Government, Wellington, New Zealand

    Verna Smith

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  1. Verna Smith
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Smith, V. (2018). The Two Case Studies Compared. In: Bargaining Power. Palgrave Pivot, Singapore. https://doi.org/10.1007/978-981-10-7602-2_8

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