Three ways to minimise professionals’ resistance to governmental change using the policy alienation model – by Lars Tummers

NHS at Olympic 2012 opening ceremony

NHS staff taking part in the London 2012 Olympics opening ceremony
photo credit: Shimelle Laine via Flickr cc

Why do public service professionals resist some changes, while embracing others? 

Lars Tummers is an expert on the analysis of ‘policy alienation’. He has studied problems that professionals working in a range of sectors – including healthcare, social security and education – face in implementing new government policies. The conclusions he draws challenge the common assertions as to why professionals show resistance to adopting change.


Professionals in the public sector (hereafter referred to as “professionals”) often have problems with change, such as new governmental policies, that they have to implement. This ranges from Israeli teachers striking against school reforms, to British civil servants quitting their jobs as they have problems with New Public Management reforms focused on cost cutting, to US healthcare professionals feeling overwhelmed by a constant flow of policy changes, resulting in tensions, conflicts, and burn-out. An illuminating quote comes from a Dutch psychiatrist who had to implement a new financial policy, known as Diagnosis Related Groups (DRGs):

“We experience this policy as a disaster. I concentrate as much as possible on treating my own patients, in order to derive some satisfaction from my work.”

When professionals are unable to identify with a policy, this can have severe negative consequences. Firstly, it can negatively influence policy effectiveness, as professionals do not execute the policy as intended or even attempt to sabotage it. Consequently, policy goals such as improving safety or lowering budget deficits will not be reached. Secondly, it can have severe effects on the professionals themselves, leading to dissatisfaction and distress. Some professionals even experience burn-out or quit their jobs entirely.

Resistance can be understood using the ‘policy alienation model’

Policy alienation occurs when professionals are unable to identify with a policy they have to implement. Although identification problems are important and have been acknowledged by many scholars, managers and professionals, there is to date no coherent framework for analyzing this topic. We therefore developed a model of policy alienation, building on the alienation literature by eminent scholars like Marx and Hegel.

The policy alienation model consists of two main dimensions: powerlessness and meaninglessness. Powerlessness refers to the feeling of not being able to influence the policy on strategic (national), tactical (organizational) or operational (own work) levels. For instance, professionals feel that they cannot influence the way the policy is being implemented in their own organization. Hence, they experience tactical powerlessness. Meaninglessness refers to the perception of professionals that a policy is not delivering value for society or for their own service users.  For instance, do they feel that they are helping their own service users by implementing the policy?

We used the policy alienation model to analyze the problems of professionals with governmental policies in various settings, ranging from education to healthcare and social security. Based on these analyses, we have developed the following suggestions for how to reduce the resistance of professionals towards governmental policies.

Suggestion 1 – Do not let people participate

The first suggestion is counterintuitive: do not let people participate. Contrary to this statement, many scholars and managers – often coming from fields such as change management and HRM – put a lot of emphasis on employee participation. Some even note that participation is the most powerful lever in gaining acceptance for a change.  Although the impact of influence (here analyzed using the powerlessness notion) is not zero, it is far less important than often argued. Professionals, we found, stated that they did not want to get involved, especially when policies were being developed which were only indirectly related to their own work. For instance, psychiatrists did not want to get involved in the specifics of a new financial reimbursement policy. They wanted to focus on their own work, which was treating patients.

Suggestion 2 – Make more meaningful policies

Rather than focusing especially on participation, it is advised that instead we look at ways to improve the meaningfulness of a policy. Using independent studies, we found that when professionals felt that a policy was valuable for society at large or for their own service users, they were far more willing to implement it. This impact was in all cases stronger than the influence of strategic and tactical powerlessness. Hence, for public professionals, it is more important to see the logic of a new policy than to have the feeling of being able to influence its shaping. However, this is where the problem often lies. Professionals do not believe that the policies they have to implement will have any value. What is needed is to increase the meaningfulness of policies. For instance, this can be achieved by developing pilots before the ‘rolling out’ of a policy nationwide. These pilots could be used to improve the design of a policy, thereby increasing its meaningfulness for society and service users. Another option would be to communicate the policy more intensively, for example by highlighting its urgency and the results already achieved.

Suggestion 3 – Provide autonomy for professionals during policy execution

The third suggestion reflects on the notion of autonomy; one of the defining characteristics of professional work. Operational powerlessness (the inverse of autonomy) can have a strong influence on resistance to implement policies. A high level of autonomy, however, can enhance policy performance through increasing willingness to implement by professionals who are given the room to adapt the policy to the situations of their service users. Related to this, Michael Lipsky (author of ‘Street-level Bureaucracy’) also noted that attempts to control implementers hierarchically simply increases their tendency to stereotype and disregard service user needs. Furthermore, providing autonomy can have several important effects for employees, such as more satisfaction and engagement in their work. This statement seems all the more important given that many feel that their autonomy in their work is nowadays rapidly diminishing.

Conclusion: Accept the power of professionals to implement policies

In the coming years, politicians will, to a greater or lesser extent, strive to make public organizations more efficient, transparent, and service user-focused. As a result, numerous policies will be developed to achieve such goals. Many public professionals will be tasked with implementing policies, and public managers will be asked to administer and oversee their implementation. Hence, politicians, managers, and professionals will be inevitably connected. It is their shared task to serve the public. We hope that this study – and the developed policy alienation framework – will help to increase understanding of how public professionals experience the policies they have to implement and bring to light ways in which policy implementation can be improved.  If this happens, the level of policy alienation of public professionals will diminish, and maybe we will be able to change our perspective and start talking about policy embracement and the power of professionals.

 

Lars Tummers, author of 'Policy Alienation And The Power Of Professionals'Dr. Lars Tummers is an Assistant Professor of Public Management and Public Policy at Erasmus University Rotterdam. He developed a model of ‘policy alienation’ to examine the problems professionals have with new governmental policies. This research was recently published in the book ‘Policy Alienation and the Power of Professionals’ (Edward Elgar, 2013). In 2013, he received a prestigious EU FP7 Marie Curie Grant, which allows him to become a Visiting Scholar at the University of California, Berkeley, for the full academic year 2013-2014. Here, he will combine psychology and public administration research to analyze how civil servants cope with the stress associated with new policies.

Policy Alienation and the Power of Professionals book cover

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