Vassilis Karokis-Mavrikos

The COVID-19 pandemic tested state preparedness across the globe and exposed cross-sectoral deficiencies in infrastructure, resources and policymaking patterns. However, the prospects of the pandemic facilitating lasting institutional change have received limited attention. This study explores the drivers and resisting forces underpinning Greece's ongoing digital governance transformation during conditions of crises through a Multiple Streams lens. The analysis is informed by original primary data from elite stakeholders across four policy areas and extends from policy adoption to implementation. The study concludes that the simultaneous surfacing of administrative deficiencies, the enhanced value acceptability for innovation and a series of cross-sectoral spillovers facilitated the introduction of digitization initiatives on an unprecedented scale. However, centralization and cultural resistance from both bureaucracies and the public during implementation pose strains to the completion of the transformative process. The paper's insights contribute to the young but highly topical research agenda on digital governance transformation drivers.

The Multiple Streams Framework has enjoyed vast success as a framework for the study of policy change, especially in the agenda-setting stage. An emerging challenge in the literature concerns connecting policy design and implementation to determine why some structural reforms successfully establish new policy paradigms and others fail. Seeking to contribute to this research agenda, we present a longitudinal process-tracing MSF application to the case of Greek public health policymaking, centered on two focusing events: the 2003 SARS outbreak and the Covid-19 pandemic. The first triggered the institutionalization of public health policymaking for the first time in Greece’s modern history (bill 3172/2003) and the second tested the degree of entrenchment of the new paradigm nearly two decades later. We base our analysis with primary sources, including 62 elite interviews and a survey of 261 Greek public health policy stakeholders conducted in 2020. We identify the drivers which led to public health policy change in 2003 after two decades of resistance and the resisting forces which impeded reform. Furthermore, we evaluate the reform’s implementation trajectory and identify the mechanisms decoupling the streams. We conclude that pervasive features of the policymaking process, which remained unaddressed during policy adoption, continued manifesting during implementation, leading to policy failure despite innovative goals and means.

While national policy styles have (re)gained academic attention in recent comparative public policy work, the concept still needs a widely accepted operationalization that can allow the collection and analysis of data across contexts while steering away from construct validity threats. We build on Tosun and Howlett's (2022) work and employ a mixed-methods approach, which relies on exploratory factor analysis and hierarchical cluster analysis. We put forth an operationalization, using Bertelsmann's Sustainable Governance Indicators (SGI) as proxies, that achieves conceptual clarity and distinctiveness, informational robustness, and statistical power. Ultimately, we construct two composite indicators—mode of problem-solving and inclusiveness—calculate them in 41 countries and present policy style classifications based on their combinations. We report the distribution of countries across four policy styles (administrative, managerial, accommodative, adversarial) and conclude with an analysis of the clusters, assessments of robustness, and comparison with other national policy style classification schemes.

How do policy entrepreneurs affect policy change in environments of institutional instability? The literature has predominantly explored policy entrepreneur strategizing in contexts with established institutional settings. In this paper, we argue that under conditions of institutional fluidity and a weak and politicized public administration, venue creation is the more frequently encountered and the more likely successful strategy. We define venue creation as the entrepreneurial strategy of setting-up institutional arrangements of finite duration, predominantly in the form of committees, delegated exclusively with designing reforms. We test our hypothesis in the Greek health policy sector. We explore two policy instances: the unsuccessful attempt at a public health reform in 1992 and the successful introduction of radical policy change for public health in 2003. We employ a process tracing approach spanning thirty years, processing primary data (elite interviews and documents) applying the Multiple Streams Framework (MSF). We find that under conditions of institutional fluidity and administrative weakness, policy entrepreneurs failed in their pursuit of change using venue shopping in 1992 but succeeded through venue creation in 2003, confirming our hypothesis. We conclude with insights for contingent policy entrepreneurship success, the MSF and patterns of policymaking in Greece.

The COVID-19 pandemic has been challenging and testing of public health systems across the globe, engaging them in a prolonged scrutinization of their functions, capacity and resources. While in theory, this process can yield invaluable insights for future policy design and mitigate future adversity, it demands a suitable mode of evaluation. Often, innovative and ambitious legislative frames are a far cry from policymaking realities plagued with institutional and operational deficiencies. As a result, we decide to move past assessments of the de jure status quo and examine the de facto modus operandi through the eyes of the systems' participating agents. We focus on the case of Greece, a country which boasts a modern public health systemic design, aligned with contemporary public health thought and international trends. We develop a new framework iteration for public health system performance evaluation, founded on prominent templates. We rely on elite surveying insights from 261 public health policy stakeholders in Greece, collected between 15.07.2020 and 13.12.2020. We capture the effect of the COVID-19 pandemic both in a latent fashion, through the timing of our survey, and in a direct one, through explicit inquiry. Our results show that the functions of the Greek Public Health System are disproportionally developed, relevant resources come to be narrow in scope and outcomes are suboptimal, failing to fulfill identified aims. Moreover, high centralization, the absence of public health expertise and undeveloped evaluative channels prevent failures from instigating adjustments. The COVID-19 pandemic has brought the system's deficiencies to light forcefully and highlighted the essentiality of scientific inputs. Our conclusions point to an ill-alignment between the system's mission and the ideational orientation of its stakeholders, which is likely to contain structural change if it remains unaddressed. We identify future research agendas and present policy directions for the Greek public health system.

This chapter discusses the Greece’s policy capacity and trust and explores how they shaped the national response. The country's response has subsequently shifted to a more regionally nuanced approach, changing the dynamics of crisis management and partially amending our original centralization hypothesis. In terms of policy capacity, the country exhibits top-heavy concentration of powers, a hierarchical mode of decision-making and implementation, and a high degree of constant institutional change and jurisdictional ambiguity. Beginning with the establishment of the Greek National Health System, in 1983, the sector has been defined by immense centralization, jurisdictional conflict, narrowness in policy outputs, and continuous formal and informal rapport between the government and a highly integrated policy community. To be sure, centralization is still the norm-after all, policy styles cast a long shadow onto the future-but trust and the direction of response appear to wax and wane, further buttressing our argument for an interactive effect of style and trust on national crisis response.

In the United Kingdom, the influence of parliamentary select committees on policy depends substantially on the ‘seriousness’ with which they approach the task of gathering and evaluating a wide range of evidence and producing reports and recommendations based on it. However, select committees are often charged with being concerned with ‘political theatre’ and ‘grandstanding’ rather than producing evidence-based policy recommendations. This study, based on a survey of 919 ‘discretionary’ witnesses, including those submitting written and oral evidence, examines the case for arguing that there is political bias and grandstanding in the way select committees go about selecting witnesses, interrogating them and using their evidence to put reports together. While the research finds some evidence of such ‘grandstanding’ it does not appear to be strong enough to suggest that the role of select committees is compromised as a crowdsourcer of evidence.