Navigating the implementation of "New Directions" in a region of British Columbia : who's at the helm? : a study in the social organization of knowledge

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dc.contributor.authorLarson, Patriciaen_US
dc.date.accessioned2024-08-14T20:59:49Z
dc.date.available2024-08-14T20:59:49Z
dc.date.copyright1997en_US
dc.date.issued1997
dc.degree.departmentFaculty of Human and Social Development
dc.degree.departmentSchool of Social Work
dc.degree.levelMaster of Nursing M.N.en
dc.description.abstractThis thesis examines the implementation of a distinctive form of health policy in a region of British Columbia in the early 1990's. This policy mandates the involvement of citizens in health policy planning and implementation. The study asked, " through what opportunities (activities, decisions) can / does the Regional Health Board establish regional priorities, objectives, and plans in order to develop a regionally-defined character for health care? and "how does this policy get put into practice through everyday activities of real people?" The study uses data gathered as a community attempted to implement an innovative health policy "New Directions" through the development of a regionalized health planning body (a Regional Health Board) and using community development with its inherent emphasis on citizen participation as its major strategy. The experiences of staff and trustees of the Regional Health Board as they attempted to negotiate a local priority, the transfer of direct responsibility for mental health services and programs from the Ministry to the region, have been examined using the qualitative methodology called institutional ethnography. In this analytic method, the experiences of those trying to implement a locally-responsive form of health planning become the entry point for explicating the wider web of social relations which shape these experiences. The study argues that the "New Directions" focus on citizen participation motivated at least in part by contemporary fiscal difficulties took a different direction than the community-held view of participation which was informed by principles of community development. The approach to implementing policy through citizen participation taken by Ministry officials, on the one hand, and citizens working in conjunction with the Board trustees and staff, on the other hand, were quite dissimilar and incongruent. Each group failed to see that they both were working according to a set of practices that was congruent with their different approaches. This research offers insights into how the new managerial technology of more participatory administration disrupts conventional public administration practice, but does not alter the exercise of centralized power, even in the more decentralized state organization which was being put in place through this policy and related Ministry practices.
dc.format.extent88 pages
dc.identifier.urihttps://hdl.handle.net/1828/18543
dc.rightsAvailable to the World Wide Weben_US
dc.titleNavigating the implementation of "New Directions" in a region of British Columbia : who's at the helm? : a study in the social organization of knowledgeen_US
dc.typeThesisen_US

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