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The Promise and Reality of Public Sector Reform – A Case Study of the Implementation of Trinidad and Tobagos Health Sector Reform

Jochelle Greaves Siew

Jochelle Greaves Siew 1


  1. The London School of Economics and Political Science, UK. 1

on Google Scholar
on PubMed

Pages: 94-111

DOI: 10.18488/journal.74.2020.72.94.111

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Article History:

Received: 15 October, 2020
Revised: 09 November, 2020
Accepted: 24 November, 2020
Published: 21 December, 2020


Abstract:

This research examines the relationship between control mechanisms selected for use by central governments during the implementation of public sector reform and the successful implementation of said reform. This investigation is carried out in light of a case study, namely Trinidad and Tobago’s health sector reform. Previous research either offers a descriptive account of what conditions are necessary for perfect implementation or focuses on the debate between top-down and bottom-up approach supporters in terms of controlling implementation. Drawing on both sets of literature, this study goes further by offering insights into the importance of government control over public sector reform implementation by contributing a fresh perspective to existing research – recognition that the actions of the central government can constitute more important explanations for the outcome of public sector reform than those of the implementers. This paper presents relevant interdependent elements needed for determining what type of control mechanisms should be used to control implementing bodies, which include central acceptance of delegated tasks, balance between control and discretion, clear roles and performance goals that accurately reflect policy intent, objective measurement and effective monitoring, and a simple implementation structure. It is found that control mechanisms need to be planned and performed in light of the intent and performance goals of the reform in order for said reform to be successful. These findings provide policymakers with knowledge on how control mechanisms can be better employed in order to improve the performance of the public sector under the reform.
Contribution/ Originality
This study provides an original investigation into how governments can better select and employ control mechanisms during policy implementation to improve the performance of public sectors under reform. It further demonstrates that central governments actions constitute more significant explanations for outcomes of public sector reform than those of its implementers.

Keywords:

Implementation theory, Public sector reform, Textual analysis, Framework design, Organisational control, Organisational change.

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Statistics:

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Funding:

This study received no specific financial support.

Competing Interests:

The author declares that there are no conflicts of interests regarding the publication of this paper.

Acknowledgement:


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