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DOI: 10.1111/spol.12048
VOL. 48, NO. 1, FEBRUARY 2014, PP. 107–117

REVIEWS

The Politics of Public Sector Reform: From Thatcher to the Coalition

By MICHAEL BURTON
Basingstoke: Palgrave Macmillan, 2013. ISBN 978-0-230-36365-6; £25.99
(pbk).
This timely and ambitious book is well placed to engage with current debates
about the public sector. It is accessibly written and will be of use to researchers
and students in social policy and politics. The themes of decentralization of
powers, bureaucratic target cultures, the imposition of private sector values in
the public sector, and the trend from universal provision to individualized
responsibility (under the mantra of consumer choice) emerge throughout.
Burton is to be commended for covering a vast array of recent public sector
reforms in one volume, but what the book provides for in breadth it lacks in
critical depth.
Four main sections focus in turn on the background, drivers and key public
services involved in reforms, and the role of performance regimes, each
drawing on short case studies. Part 1 provides a useful introduction to the
historical context of public sector reforms from the early 1980s to the present,
focusing on the reflections of government ministers and public bodies. It draws
heavily from autobiographical accounts provided by Prime Ministers but less so
from critical policy perspectives. For example, explicit attention to the influ-
ence of neo-liberalism in framing current policy is almost entirely absent from
the book.
The rhetoric of the governments of these periods, such as addressing
‘welfare dependency’, is not questioned enough, but Part 1 suggests a broad
path of development in public sector reform through successive Conservative
and Labour governments. Prime Ministers have often sought to impose a
personalized reformist mission in office while often operating within terms laid
down by their predecessors. For example, despite rhetorical distancing, local-
ism and the devolution of powers to local governments were similar themes in
both Labour reforms and the Coalition’s ‘big society’ policies (pp. 151–4).
Part 2 addresses the drivers of reform. First, the paradoxically isolated role
of the Prime Minister’s Office in relation to the Whitehall machine and the
infiltration of business practices into Number 10 are discussed. Second, the
Treasury chapter includes case studies of efficiency programmes and private
finance initiatives. Third, the role of Parliament chapter describes the public
scrutiny provided by select committees. Fourth, the role of consumers and
competition in reform is explored. Successive government reforms such as
Major’s Citizen’s Charter, Blair’s emphasis on public sector markets, and
Cameron’s ‘big society’ all suggest a transition from citizens to consumers of
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public services. Some critical consideration of the political uses of ‘choice’ and
markets is included here.
Whitehall, the National Health Service, local government, the police,
welfare and schools are the key public services considered in Part 3. The civil
service has been subject to a combination of ‘constant change and deep inertia’
(p. 109). Burton skilfully highlights the multiplicity of factors involved including
ministerial short-termism, the ‘cumbersome’ civil service, silo mentalities and
the proliferation of non-departmental public bodies. A number of case studies
make up the chapter on local government, including the errors of short-
termism whereby Labour’s ‘Total Place’ pilots for pooling budgets were swiftly
cut by the Coalition, only to be resurrected as ‘Whole Place’ community
budgets. The last two chapters could be expanded, given the highly politicized
nature of welfare and education reforms. A glaring omission is the politically
charged introduction and subsequent increases in tuition fees for higher
education.
Part 4 is shorter than the other parts, and briefly addresses measuring and
monitoring performance, and the international context. The first two chapters
in this section describe the perverse incentives that emerged from Labour’s
strongly centralized target culture, which was subsequently reduced by later
Labour administrations and especially by the Coalition. There are implications
for accountability in the Coalition’s preference for members of the public to act
as ‘armchair auditors’ rather than measurement and monitoring by central
government. This has led the Public Accounts Committee to criticize the policy
of ‘data dumping’ online, which can be ‘incomprehensible to the ordinary
member of the public’ (p. 238). The international context chapter provides
some insights but feels tacked on and does not go into enough comparative
depth.
In sum, Burton’s account is an ambitious and largely successfully realized
overview of public sector reform, but is ultimately weakened by an implicit
acceptance of the case for austerity and offers only a cursory discussion of
some of the criticisms of public sector reforms. Austerity politics, challenged
elsewhere (see Hay 2013), is not critically considered in this book. Without a
deeper engagement with austerity, and related debates such as ideologically
driven welfare state retrenchment, the particular motives behind, and out-
comes of, private sector involvement in delivering public services, and the role
of a neo-liberal form of managerialism that guides much public sector policy-
making, the politics of public sector reform is underplayed. Nonetheless, Bur-
ton’s book has a huge scope which may preclude this amount of critical depth,
and it provides an accessible, insightful, broad ranging and historically
contextualized entry point into current debates about public sector reform.
References
Hay, C. (2013), ‘The British growth crisis: a crisis of and for growth’, SPERI Paper No.1,
http: / / speri.dept.shef.ac.uk/ wp-content/ uploads/ 2013/ 01/SPERI-Paper-No.-1-
%E2%80%93-The-British-Growth-Crisis-FINAL1.pdf (accessed 2 September
2013).

Steve Corbett, University of Sheffield

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Social Work and Social Policy under Austerity

By BILL JORDAN and MARK DRAKEFORD
Basingstoke: Palgrave Macmillan, 2012. ISBN 978-1-137-02063-5; £22.99
(pbk).
This short book answers the need for a text addressing the socio-political
contexts of welfare within the UK, and in particular the impact of austerity
measures on the practices of social work within the four devolved countries.
Despite its UK focus, Jordan and Drakeford draw upon their wide knowl-
edge of social policy and welfare issues from other European countries
and expand the critique in a global context; indeed, it is unlikely that the
nuances of contemporary and historical changes could be understood
without such a lens.
The book itself is timely and builds upon Jordan’s social policy canon and
Drakeford’s earlier social work analyses, and demonstrates the wide knowl-
edge base that each of these authors brings to this area. Their thesis from the
outset suggests that the austerity measures introduced since 2008 represent an
entirely new challenge for social work and social policy and their interrela-
tionship. The realities of this are thought to subsist in a demand or ultimatum
for radical transformation or retrenchment in welfare. Perhaps this still masks
the late modern turn towards risk and control concomitantly shown within
social policies and social work and their increased brief to determine the ‘who,
what, where and how’ in respect of private lives, and, importantly, across
shared group commonalities, showing a Manichean approach to the ways in
which global society is working to support capital (an assumed often unques-
tioned good) against the overt goals and capabilities of those within those
societies (associated with the binary to capital’s good). This is given weight by
the arguments of increasing insidious control post-attacks in New York (9/11),
Madrid (11/M) and in London (7/7). Jordan and Drakeford argue that the
creeping subversions of liberty will be challenged by the precariat but require
intergenerational support to succeed. The growth of surveillance society is
also shown to be mirrored in social work’s increasing control of families and
wider social action. Indeed, the shift in balance from ‘care’ to ‘control’ –
something which, of course, permeates social policy and welfare throughout
history – is exemplified in the marketization and commodification of care
services using the example of Southern Cross care homes and the rupture to
dignified human care seen in Mid Staffordshire NHS Trust.
The book is bounded by a critical introduction to late capitalism, neo-
liberal assumptions and the impact on society, globally but filtering down to a
UK focus in Chapter 1 and a concluding chapter which considers some of the
social, economic and legal approaches that have been taken to the current
climate of austerity whilst indicating more positive ways forward based on
redistributive policies and actions. It is heartening to see concepts of redistri-
bution being heralded once more not only as a political stance but also in an
erudite and closely argued manner. Sandwiched between these two chapters
are six essays problematizing capitalism and welfare, and ranging from the
search for welfare policies which enhance work cultures as a means of fixing
a supposedly broken society, social order, health and social care, community
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action, family relations and justice across the generations and the search for
new sustainable ways of being.
The chapters themselves explore the contexts and histories of welfare and
the questions which repeat themselves. Jordan and Drakeford illuminate the
discourses associated with privileging certain expectations such as employ-
ment and marriage, pointing out the dichotomies and contradictions created
when considering childcare and family care. Whilst some within the Coalition
government or, indeed, amongst the Labour opposition may, no doubt,
dismiss the book as a political exercise, they would be hard-pressed to discount
its measured messages, preparedness to seek new ways of practising social
welfare and enacting policy.
One thing I think has been missed from the work and would strengthen its
thesis, is a discussion of the potential of capabilities which, unfortunately, is
relegated to one or two passing references. Creating such a discussion would
allow Jordan and Drakeford to focus on the development of resources of
people and communities to construct novel approaches to welfare and local-
ized policies and to seek the sustainability that is recognized and sought in a
new redistributive framework.
The importance for the disciplines of social policy and social work rests in
it drawing attention again to the intertwined relationship of social work and
state and the tensions thus created which can, if not checked and resisted by
the many excellent social workers and others enacting social policies on the
UK, lead to the curtailment of freedoms for wider society and people who, for
whatever reason, are marginalized or disenfranchised.
This is a book which I have recommended to students on my history of
social welfare course and, although contextualized by the time, will continue
to do so as it exemplifies the evolving constructions of welfare and thought in
the UK.

Jonathan Parker, Bournemouth University

Federalism and Decentralization in European Health and Social Care

Edited by JOAN COSTA-FONT and SCOTT L. GREER
Basingstoke: Palgrave Macmillan, 2013. ISBN 978-0-230-28524-8; £60.00
(hbk).

This book takes the reader on a journey across European health and social
care systems with the mission of integrating and clarifying evidence on an
under-researched and yet politically salient phenomenon – decentralization.
Costa-Font and Greer bring together seminal theoretical debates and empiri-
cal findings from the fields of economics and political science to chart out a
new exciting area of research – the political economy of decentralization and
health. They clearly define decentralization as ‘a change in the allocation of
authority in which powers shift to smaller territorial units of government’.
They then formulate three guiding questions, which are addressed consis-
tently in ten country-specific chapters: ‘what does decentralization mean, why
does it happen, and what are its effects?’.

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The first part of the journey covers tax-funded systems and takes the
reader from the south to the north of Europe. Gilberto Turati starts out
with a lively and illuminating discussion on efficiency and equity in the
Italian Servizio Sanitario Nazionale over the last 30 years. He then dares to
look into its future and predicts that it will be shaped by the structural
tensions between the centre-north and south regions. Joan Costa-Font turns
his attention to the paradigmatic case of Spain, where decentralization is
linked to democratization and modernization. He cogently and eloquently
argues that although decentralization has succeeded in reducing regional
inequalities, soft budget constraints present a major challenge for the future.
Scott L. Greer masterfully discovers and rigorously explores the asymmetry
of territorial politics in the UK, which manifests itself in constitutional
decentralization on the one hand and policy centralization on the other. He
makes a strong case against decentralization being considered health policy
in its own right. Jon Magnussen and Pål E. Martinussen present a compre-
hensive account of the Norwegian healthcare system in the context of the
other Nordic countries. They expertly bring to the fore the contrasting
trends of centralization, decentralization and re-centralization over a long
time horizon.
The second part of the journey covers social insurance systems and takes
the reader from the east to the west of Europe. Katarzyna Kuć-Czajkowska
and Małgorzata Rabczewska lead an exemplary discussion on decentraliza-
tion in Poland in the context of post-communist democratization in Central
and Eastern Europe. They skilfully compile rich evidence showing how the
initial decentralization of ‘problems rather than resources’ led to the subse-
quent re-centralization of health policy-making. Birgit Trukeschitz, Ulrike
Schneider and Thomas Czypionka provide a lucid and impressively detailed
institutionalist analysis of federalism in the Austrian health and social care
system, discuss its performance and make important suggestions on how to
improve it. Margitta Mätzke offers an excellent study of health and social care
policy in Germany. She aptly focuses on the distributional tensions arising
from centralized policy-making and decentralized implementation, and then
boldly questions whether federalist institutions have become obsolete in
Europe’s oldest social insurance system.
The journey continues by following the historical diffusion of German
social insurance innovation westwards. David K. Jones dexterously investi-
gates the intricacies of French territorial politics through interviews with
officials at multiple levels within the newly created regional health agencies.
He pertinently places this reform into a historical perspective, scrutinizes its
likely impact on actual policy, and discusses obstacles to its successful imple-
mentation. Janet Laible produces a thorough and convincing analysis of the
impact of federalization on health policy interests and institutions in Belgium.
She compellingly demonstrates how nationalist and regionalist politicians
have politicized health policy, turning it into a contentious battleground in
constitutional reform. Berit C. Gerritzen and Gebhard Kirchgässner make a
major contribution to our understanding of the influence of federalism on
health and social care by critically examining the crucial case of Switzerland.
They adeptly highlight the leading role of cantons in the Swiss health system,
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characterized by outstanding quality of care and innovation, but also by high

costs, a lack of transparency, and the absence of a consistent national health
policy.
To conclude, the merit of this book is that it takes the reader on an exciting
journey into the previously uncharted territory of the political economy of
decentralization and health in Europe. Each country-specific chapter is written
by some of the leading experts on those countries’ health and social care
systems. They present cogent and well-argued evidence to show, in a compara-
tive perspective, how territory works in health policy. At the end of this exciting
journey, the reader arrives at the rigorous conclusion that there is no single
model of decentralization in Europe, but rather ‘a heterogeneous array of
models that reflect very different political, historical, and policy logics’. This
book is a must-read for anyone seriously interested in decentralization in health
and social care, as well as in other areas of social and public policy.

Pavel V. Ovseiko, University of Oxford

The Sociology of Health and Illness

By SARAH NETTLETON
Cambridge: Polity Press, 2013, 3rd edition. ISBN 978-0-74564-601-5;
£19.99 (pbk).

Sarah Nettleton’s The Sociology of Health and Illness, now revised for a 3rd
edition, has long been a presence on many undergraduate reading lists. There
was a ten-year gap between publication of the first two editions, and the
second edition reflected the many developments which had taken place in
the field of medical sociology in that decade; this 3rd edition comes a
comparatively speedy five years later, and hence the differences between
the latter two editions are not as radical. The earlier editions were valued
for their rigorous and accessible overviews of the seemingly ever-growing
field and I have little doubt that this latest update will prove equally as
popular.
The introductory chapter begins by describing how our ideas of what
counts as health and illness have changed dramatically over the last 50 years.
No longer do we think solely in terms of hospitals, doctors and nurses, being
sick and being cured; health has become a ‘ubiquitous motif’ throughout our
life course and in our daily lives, with a plethora of magazines and TV
programmes telling us how to be healthier. The introductory chapter sets out
very clearly the breadth of topics which sit under the umbrella of sociology of
health and illness, from the formal institutions of medicine through to indi-
vidual responsibility via social context and lay knowledge. Having set out ‘to
communicate and encourage a critical and analytical approach to the study of
health, illness and disease’, the author then introduces the reader to the
difference between sociology of medicine and sociology in medicine, and sets
out the core approaches to the subject using Clive Seale’s organizational
device to show different ways of looking at the in/of dichotomy, and different

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levels of investigation (individual, social, societal). A key theoretical approach

to understanding health, social construction, is explored in Chapter 2, where
the student is introduced to the notion of problematizing issues which may
appear self-evident and unproblematic, such as how we look at the body, and
how medical ‘facts’ are understood. This leads into a discussion of medical-
ization, and a brief mention of a new and expanding area of sociology, the
sociology of diagnosis.
With that solid underpinning behind them, readers are then introduced
to a series of important topics and concepts in the following eight chapters.
The chapter on lay health beliefs, lifestyles and risk tackles an area which,
in terms of the sociological literature, is huge; indeed, there is a whole
journal devoted to health and risk alone (Health, Risk and Society), and this, I
think, points to one of the dilemmas with a book such as this. The author
acknowledges at the beginning that her concern was as much with what she
left out as what could be included, and with any introductory textbook of
this nature, there is inevitably going to have to be a fairly ruthless filleting
knife applied to the available material. Having said that, each chapter ends
with annotated suggestions for further reading, and the inclusion of these
reading lists and a very comprehensive bibliography will enable students to
pursue ideas that grab their interest, and to develop their learning and
thinking about specific topics.
Further chapters go on to discuss chronic illness and disability (another
huge area), the sociology of the body, the sociology of lay-professional inter-
actions and social inequalities. A chapter on modernism and the changing
social relations of healthcare work is another chapter, like the early ones,
which focuses on the conceptual underpinnings of the topic; as the author
points out in this and in the last chapter, on developments in health policy,
change is happening so fast that it is more important to have the conceptual
resources necessary to make sense of change than to know the fine details of
previous policies.
One chapter contains new material, and this is the chapter on the sociology
of health technology. As the author mentions, when the first edition of this
book was published, the idea that anyone might check their symptoms on the
internet, or have their health monitored at a distance, would have seemed
bizarre. An insightful sociological examination of this expansion of medicine
is both necessary and welcome.
Overall, this new edition is a comprehensive and welcome updating of what
was already an essential text. Nettleton takes her readers through a substantial
and comprehensive introduction to some of the most important debates in The
Sociology of Health and Illness, and gives them pointers for where to go next. This
book will be of great use to students of sociology of health and illness, whether
social scientists or those studying for more vocational degrees but looking for
a sociological grounding in their field. It will give them a thorough and
readable introduction to the broad range of topics with the sociology of health
and illness, as well as contemporary debates in the field, and as such deserves
its place on reading lists.

Sally Brown, Durham University

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The Bureaucrat and the Poor: Encounters in French Welfare Offices

By VINCENT DUBOIS
Aldershot: Ashgate, 2010. ISBN 978-1-4094-0289-3; £55.00 (hbk).
The Bureaucrat and the Poor is an English-language translation of Vincent
Dubois’ La Vie au Guichet (literally, life at the desk) which was published in
France in 1999. In this book, Dubois examines the relationship between
reception staff and welfare recipients in two French benefit offices. The book
builds upon Lipsky’s (1980) work on street-level bureaucracy and draws
upon the sociology of Bourdieu and Goffman. The fieldwork was conducted
in 1995 and included around 900 observations of face-to-face encounters
between reception staff and their clients. These observations were comple-
mented by formal interviews with 22 staff and 120 interviews with welfare
recipients.
The book focuses on bureaucratic encounters at the reception desk of
family welfare offices. The desk is symbolic of the divide between the state and
the people. Bureaucratic encounters are part of the administration’s daily
grind – a world apparently made up of anonymity and routine. However,
the author dispels the false dichotomy that often characterizes interpretations
of bureaucratic interactions. Impersonal bureaucrats and standard clients
do not exist: ‘only social agents with individual personalities who, within
certain conditions and limits, are required to play the role of impersonal
or standardised bureaucrat and client’ (p. 3). The book is divided into
three parts.
Part I explores the relationship between reception staff and their clients.
Dubois shows that the relationship is unequal because the organization’s role
as a paying body induces claimant deference. The claimant’s lack of knowl-
edge of institutional mechanisms sustains this inequality. Nevertheless, he
shows that staff are aware of their power and may be uncomfortable with it.
Dubois concludes that the function of the reception desk is not only to appease
rancour and impose self-control on the client but is also a mechanism for
reasserting supposedly universally shared values.
Part II examines the roles, identities and experiences of reception staff. The
ability of staff to take part in the definition of their role is facilitated by the
relative isolation of reception staff within the administrative organization;
the random manner of their recruitment; the absence of preliminary training;
and their loosely defined function. This leads to a compromise between
institutional logics and personal dispositions. Dubois shows how the personal
dispositions of agents vary, as does the priority accorded to protecting the
recipient’s rights and exposing fraud.
He finds that a degraded staff position (due to growing workloads,
complexity and the dead-end nature of the job) mirrors the social decline of
those seeking help. Staff disillusionment is compounded by the limitations of
the job which prevent the relief of the misery of welfare recipients. Staff
members tend to react by self-withdrawal or becoming more involved in
their work. This phenomenon may apply to many street-level bureaucrats,
as ‘the state’s left hand’ tends to be more dedicated when the right hand
resigns (Bourdieu et al. 1999: 183). Staff have to reconcile the opposite

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demands of self-preservation (using a bureaucratic identity) and self-exposure

(demonstrating empathy). Too much of the former does not fit the reality of
the job, whereas too much of the latter undermines the well-being of staff.
Part III focuses on the broader institutional and policy systems. A particular
focus is on flaws such as computer-related problems and other irregularities
which can threaten the relationship between the two parties. He argues that
injustices are much more problematic for staff because they highlight the
contradictions of the system that they apply and thus the legitimacy of apply-
ing it even though it is key to their position.
Dubois is less sure-footed when he turns his attention to the motivations
and behaviours of recipients. We do not gain an in-depth understanding of
their lives and how this shapes their interactions with the bureaucrat. Rather,
the focus is on various strategies deployed by individuals, such as docility,
silence and defiance. Similarly, violence is viewed in an instrumental way, i.e.
as a strategy of the last resort of the underprivileged or a mode of self-
assertion. However, this seems to be at best a partial explanation of the
violence blighting welfare offices. He goes on to argue that the desk has
become a place of self-expression for those deprived of the main venues of
identification and social relationships: work and family. This is an interesting
proposition but ultimately is unconvincing, given that recipients are not
drawn from several consecutive generations of unemployment and it is likely
that many retain some contact with the labour market by engaging in pre-
carious forms of work.
Much has changed since the original fieldwork was conducted. The pres-
sures placed on frontline staff have grown exponentially. The economic crisis
and neo-liberalism have led to rapidly growing caseloads in many welfare
offices and the growing immiseration of the poor. The culture of welfare
organizations in many western countries has been transformed from a primary
concern with determining benefit eligibility towards more personal conversa-
tions about clients’ lives and behaviours. Meyers et al. (1998) encapsulate this as
a change from ‘people sustaining’ activities towards a ‘people transforming’
role. Frontline workers have also had to increasingly focus on outcomes and
contribute towards the realization of organizational targets. Fletcher (2011)
argues that discretion remains an enduring feature of frontline practice and
may be cherished in times of low morale for its ability to allow staff to maintain
their self-esteem. Nevertheless, this is a first-rate account of the treatment of the
poor in French welfare offices and provides an excellent comparison to similar
US studies.

References
Bourdieu, P. et al. (1999), The Weight of the World, Palo Alto, CA: Stanford University
Press.
Fletcher, D. R. (2011), Welfare Reform, Jobcentre Plus and the street-level bureau-
cracy: towards inconsistent and discriminatory welfare for severely disadvantaged
groups? Social Policy & Society, 10, 4: 445–58.
Lipsky, M. (1980), Street-Level Bureaucracy: Dilemmas of the Individual in Public Services, New
York, NY: Russell Sage Foundation.

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Meyers, M., Glaser, B. and MacDonald, K. (1998), On the front line of welfare
delivery: are workers implementing policy reforms? Journal of Policy Analysis and
Management, 17, 1: 1–22.

Del Roy Fletcher, Sheffield Hallam University

Policy Transfer and Learning in Public Policy and Management

Edited by PETER CARROLL and RICHARD COMMON
Abingdon: Routledge, 2013. ISBN 978-0-41569-181-9; £85.00 (hbk).

This is a useful study on policy transfer that reiterates for me the importance
of edited collections in social science. If one wants to get up to speed on policy
transfer and learning one could do worse than reading it from cover to cover.
Not that it is a simple encyclopaedic account of where we are in this field, but
rather contains a useful collection of studies from around the world. The
strength being that this rather diverse (in a good way) collection of studies is
united by tackling the issue of public policy through the lens of policy transfer;
so it ticks both boxes of being a reasonably interesting study of various policy
initiatives, and an investigation, theoretical or otherwise, of a current research
programme.
What is policy transfer? As the name suggests, it is more-or-less the transfer
of some aspect of policy – be it ideas, inspiration, design, instruments, outright
copying or whatever – from one jurisdiction to another. This can be between
countries, within different jurisdictions within a single country, and even
across time periods. There are other approaches which overlap or simply have
different labels – diffusion, learning, lesson drawing, harmonization – perhaps
adding to the sometime vagueness. However, a certain slipperiness at the
edges does not discount policy transfer as useful organizing principle;
although perhaps the seemingly interminable attempts, including by scholars
in this book, to further specify typologies that label each and every type, can
be somewhat tedious.
It is not a new idea by any means, despite claims otherwise. Students of
colonial history in particular have noted the importance of colonial heritage in
‘coercive’ transfer of law, agencies, constitutions and other agencies to new
regimes. There are attempts to tie aid to required policy positions. Policy
transfer can be voluntary, as part of a rational policy search for solutions; or
it can simply be a another item in the variegated, political and highly ideo-
logical tool box of policy-making, used to justify a myriad of policy changes or
simply to hide the fact that substantive policy change has not occurred.
Sometimes it is simply a new policy label or snatch of rhetoric that is trans-
ferred, and things continue much as before.
There are still many unanswered questions in the policy transfer literature.
What is a successful transfer? Successful for whom? Often, success seems to be
equated with the transfer of particular policy instruments – implementation
success perhaps. The study in Chapter 1 of Saudi Arabia and Georgia seems
to treat policy transfer success in this way as the adoption of some widely
accepted programme of ‘good governance’. Partial success only is achieved,

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with both countries, and elites within those countries, resisting and adapting
reforms largely pushed from elsewhere. The study in Chapter 2 of govern-
ment performance initiatives between England, Scotland and Wales is
perhaps useful in the context of understanding this policy transfer ‘success’.
Constituent counties of Great Britain often have significant policy differences
perhaps less apparent to outsiders who confuse England with the rest of Great
Britain, and this chapter is useful is showing how nationalistic and political
factors shaped and channelled policy learning in different and sometime
divergent ways. Studies of Australia and South America show how policy
transfer is absorbed and channelled through path dependency and existing
institutions, and the interplay of interests and actors. Australia’s federal system
allows for experimentation on policy initiatives, perhaps leading to consider-
able divergence. Joining international organizations can assist in policy
harmonization/transfer as Chapter 6 notes, echoing studies on policy conver-
gence made elsewhere, while policy transfer is often a useful means for
‘catching-up’ sometimes through copying, as Chapter 4 on Estonia and Latvia
shows.
Chapter 5 is a particularly useful survey, showing how decentralization of
the Malawian health sector was resisted through bureaucratic self-interest and
institutional constraints. But it leaves unanswered questions. For some it was
a failure, but for some policy elites, adaption and resistance might well be a
‘success’. ‘Success’ is a social construction, and might depend on where one
stands. Was there evidence this programme would work in any event? Why
was it an answer to the problems Malawi was facing? If policy is transferred
‘successfully’ in a narrow sense of implementation success, does this lead to
better policy outcomes? How? As such, despite all the protestations otherwise,
I feel some policy transfer literature has not fully embraced notions that, at
heart, policy-making is seldom directed at rational problem solving, and
transfer is simply another aspect of the political, ideological and messy
garbage can which is government. It may also lead to worse policy outcomes.
However, the better chapters in this collection make a good attempt at
engaging with these issues, and so this book is a useful addition to the
literature.

Shaun Goldfinch, University of Nottingham

© 2014 John Wiley & Sons Ltd 117

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