An analysis of public policy implementation with particular reference to public health policy

Abstract

This study investigates the role of public policy and the implementation of public policy with particular reference to public health policy in South Africa from 1910 to 1990. The focus and locus of the public policy phenomenon within the political and administrative processes are also analysed. It is shown that the supposition that public policy is only part of the political process, is incorrect. The public policy phenomenon is subsequently analysed. It is shown that the various levels of public policy impact upon the administrative process and that the policy implementation process is part of the public policy process. In an analysis of the nature and scope of the public policy implementation process, it is argued that public policy implementation, as such, had been an underrated part of the policy process in South Africa up to the 1970's. It is also shown that internal and external variables impact upon the implementation of public policy, namely the generic administrative functions (as internal variables) and certain normative guidelines (as external variables). The external variables that impact upon public policy implementation, namely legislative direction, public accountability, democratic requirements, reasonableness, and efficiency are analyzed. The external variables are used to establish their relevance, or not, to the implementation of public health policy in South Africa from 1910 to 1990. It was found that the external variables figured poorly in the implementation of health policy in the sense that the external variables were brought to bear in an ad-hoc fashion based on crises as it arose, in other words, not on pre-planned actions.

In hierdie studie word ondersoek gedoen na die rol van openbare beleid en die implementering van openbare beleid met spesifieke verwysing na openbare gesondheidsbeleid in Suid-Afrika vanaf 1910 tot 1990. Die fokus en lokus van die openbare beleidverskynsel binne die politieke en administratiewe prosesse word ontleed. Daar word op gewys dat die veronderstelling dat openbare beleid slegs deel van die politieke proses is, verkeerd is. Daar word ook op gewys dat die verskillende vlakke van openbare beleid die administratiewe proses bei'nvloed en dat die openbare beleidimplementeringproses deel van die openbare beleidsproses is. In 'n ondersoek na die aard en omvang van die openbare beleidimplementeringproses word daarop gewys dat openbare beleidimplementering 'n onderskatte deel van die beleidproses in Suid-Afrika tot en met die 1970's was. Daar word op gewys dat interne en eksterne veranderlikes 'n invloed uitoefen op openbare beleidimplementering, te wete, die generiese administratiewe funksies (as interne veranderlikes) en bepaalde normatiewe riglyne (as eksterne veranderlikes). Die eksterne veranderlikes vir openbare beleidimplementering, te wete, wetgewende rigtinggewing, openbare aanspreeklikheid, demokratiese vereistes, regverdigheid, en doeltreffendheid is vervolgens ontleed. Die eksterne veranderlikes word gebruik om hul toepaslikheid, al dan nie, by die implementering van openbare gesondheidsbeleid in Suid-Afrika vanaf 1910 tot 1990 te toets. Daar is bevind dat die eksterne veranderlikes swak, indien ooit, by die implementering van gesondheidsbeleid ter sprake was. Die rede daarvoor is dat die eksterne veranderlikes op 'n ad-hoc wyse ter sprake gebring is omda:t die implementering van openbare gesondheidsbeleid toegepas is op die basis van krisisse soos dit ontstaan het en nie op beplande optredes nie.