Policy Alienation and the Power of Professionals
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Policy Alienation and the Power of Professionals

Confronting New Policies

Lars Tummers

This eloquent book by Lars Tummers develops a framework to understand these important issues with policy implementation, using the innovative concept of ‘policy alienation’. Policies in healthcare, social security, and education are analyzed. The conclusions challenge the common assertions regarding the reasons why professionals resist policies. For instance, the impact of professional influence, often viewed as an end in itself, is nuanced. Lars Tummers reveals that it is far more important for professionals that a policy is meaningful for society and for their clients, than they have an influence in its shaping.
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Chapter 5: The impact of New Public Management and professionalism on policy alienation

Confronting New Policies

Lars Tummers


The previous chapters provided a background of the alienation concept (Chapter 2), defined and conceptualized it (Chapter 3) and provided a quantitative measurement instrument (Chapter 4). This background is useful for the current chapter, whose goal is to identify the most important factors that influence the degree of policy alienation felt by public professionals. In other words, why do professional feel alienated from a policy? This goal is achieved using a qualitative comparative case study, allowing us to study whether the factors that influence the degree of policy alienation are similar across different public domains. This is theoretically relevant, as it contributes to the debate on pressured professionals. Indeed, although scholars such as Exworthy and Halford (1998; see also Noordegraaf, 2007) note that there are a number of factors creating professional pressures, this has yet to be examined thoroughly on the level of actual policy implementation. This chapter studies in detail various national, organizational and policy factors that could influence the degree of policy alienation felt. First, I will discuss the possible influence of New Public Management and professionalism on policy alienation, which results in a theoretical framework linking possible antecedents to policy alienation. Using case studies of insurance physicians and secondary school teachers implementing policies, I will determine the most important factors influencing policy alienation.

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