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Decentralization Introduction

Decentralization Introduction. Richard B. Saltman Emory University and European Observatory on Health Systems and Policies Visiting Professor, LSE Health. Many Thanks. Higher Education Innovation Fund , Department of Business, Schools and Innovation

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Decentralization Introduction

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  1. DecentralizationIntroduction Richard B. Saltman Emory University and European Observatory on Health Systems and Policies Visiting Professor, LSE Health

  2. Many Thanks • Higher Education Innovation Fund, Department of Business, Schools and Innovation • LSE Health/NHS Confederation Rachel Irwin, co-ordinator at LSE Stephen Groombridge and Michael Wood, co-co-ordinators at NHS Confederation

  3. Thinking about Decentralization I (from European Observatory 2007 book) Decentralization is: • an “area” or a “zone” of activity, rather than a single strategy • an “umbrella concept” with multiple, often conflicting interpretations and perspectives

  4. Thinking about Decentralization II • Decentralization has three “functional dimensions”: - Political (policy/strategy) - Administrative (operational management) - Fiscal (raising funds/financial management) These overlap and often conflict with each other

  5. Thinking about Decentralization III Two broad arguments in favor of decentralization: - “democratizing” argument: “closer to the people” - “efficiency” argument create competition and choice between local public units

  6. Thinking about Decentralization IV Rise of Re-centralization in Europe: - re-centralizing political decision-making - re-centralizing fiscal control over funding - consolidating administrative decisions Rejecting Decentralization? Sharing authority across different levels of government?

  7. Our Distinguished Presenters • Jeni Bremner, Director, European Healthcare Management Association, Brussels • Antonio Duran, Principal, Tecsalud, Seville, Spain • Jon Magnussen, Professor, Norwegian University of Science and Technology • Scott Greer, Assistant Professor, University of Michigan, USA; Visiting Fellow, LSE Health

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