Assessing formal accountability for public policies: the case of health policy in Spain
| Author | Ixchel Pérez Durán |
| Published date | 01 December 2016 |
| Date | 01 December 2016 |
| DOI | http://doi.org/10.1177/0020852314565999 |
| Subject Matter | Symposium on The Gordian knot of public sector accounting and the role of IPSASArticles |
International Review of
Administrative Sciences
2016, Vol. 82(4) 784–806
!The Author(s) 2015
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DOI: 10.1177/0020852314565999
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International
Review of
Administrative
Sciences
Article
Assessing formal accountability
for public policies: the case of
health policy in Spain
Ixchel Pe
´rez Dura
´n
Institut Barcelona d’Estudis Internacionals (IBEI)
Abstract
The aim of this study is to present a framework for analyzing and assessing
accountability for public policies. First, I suggest two dimensions for analyzing account-
ability for policies (the informative/justifying dimension, and the evaluative/sanctioning
dimension), applied to the implementation phase of the policy and, in particular, to three
central elements that make up this phase (the actors responsible, the resources, and the
policy results). Second, I suggest assessing accountability for a public policy starting from
the degree of formalization and, specifically, from compliance with four characteristics
of its regulatory framework: specific, binding, public and autonomous character. Third,
I develop an empirical application of this proposal to the analysis of health policy in
Spain, whose decentralized design, where regional governments are responsible for its
implementation, allows us to analyze the differences in the levels of accountability for
this policy across regions.
Points for practitioners
This study identifies and limits the components that can be incorporated into the
analysis of accountability for public policies by providing an analytical framework that
can be used to measure and compare levels of accountability for different kinds of
policies (e.g. health, education, pensions) in different contexts (e.g. countries, regions,
local governments). In order to test the validity of the proposal developed here, this
article presents an empirical application to the analysis of health policy in Spain, whose
decentralized design allows us to analyze the differences in accountability across
regional governments.
Keywords
accountability, evaluative/sanctioning dimension, formalization, health policy,
informative/justifying dimension, public policies
Corresponding author:
Ixchel Pe
´rez Dura
´n, Institut Barcelona d’Estudis Internacionals (IBEI), Ramon Trias Fargas 25-27 08005,
Barcelona, Spain.
Emails: iperez@ibei.org, ixchel.perez@upf.edu
Introduction
Accountability is understood through the concept of constraints on the exercise of
power. It derives from an act of delegating authority from a principal to an agent.
Given that this act of delegating entails a discretional area, accountability responds
to the need to control the agent (Lindberg, 2013; Romzek and Dubnick, 1998;
Strøm, 2000). Some studies have been centered on the analysis of political mech-
anisms that serve for accountability, particularly during electoral processes, which
are understood as mechanisms for evaluating and sanctioning governmental action
by political representatives (Przeworski et al., 1999). However, although elections
are a fundamental element for evaluating governments, they are not sufficient for
all of the phases, elements and levels that make up public decisions and govern-
mental programs. These have daily repercussions and their evaluation should
not be limited to electoral periods. In this research, I focus on the analysis of
accountability for the principal instrument of government: public policies.
Some scholars, such as Behn (2001), Bovens (2005), Grant and Keohane (2005),
Mulgan (2000), Philp (2009), Romzek and Dubnick (1998), Schedler (1999), among
others, believe that accountability has been interpreted in a diffuse manner,
confusing it with concepts that, although related to it, have their own scope,
such as transparency,control,responsiveness and responsibility. These scholars
have developed conceptualizations of accountability and, although there are
some common areas between them, there still seems to be no agreement that is
generally accepted regarding its conceptualizion (for instance, there are differences
in the inclusion of sanction as a central element of accountability). One issue that
has received little attention in the literature is the measurement of accountability,
particularly the measurement of accountability for public policy as a unit of ana-
lysis, which would clarify what we mean by the concept of accountability in a more
tangible manner. This study seeks to answer three questions: What is accountability
for a public policy? What components should be incorporated into its analysis? And
How do we assess the level of accountability of a public policy?
Having set the objective of avoiding a ‘catch-all’ definition of accountability, in
this article I develop a framework for analyzing and assessing formal accountabil-
ity for public policies. On the one hand, I suggest two dimensions for analyzing
accountability for policies (the informative/justifying dimension, and the evalu-
ative/sanctioning dimension), applied to the design of the implementation phase
of the policy and, in particular, to three central elements that make up this phase
(the actors responsible, the resources, and the policy results). Once this analysis
matrix is established, I suggest assessing the level of accountability for a public
policy starting from the degree of formalization of the legal framework that regu-
lates accountability and, specifically, from compliance with four characteristics: its
specific, binding, public and autonomous character. In order to test the validity of
the analytical framework developed here, I also present an empirical application to
the analysis of accountability for health policy in Spain, whose decentralized design
allows us to analyze the differences in accountability across regional governments.
Pe
´rez-Dura
´n785
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