Book Review: Measuring the Performance of the Hollow State
| DOI | 10.1177/1035719X0900900113 |
| Date | 01 March 2009 |
| Published date | 01 March 2009 |
| Author | Claire Kelly |
| Subject Matter | Book Review |
BOOK REVIEWS
Book reviews 67
Title: Measuring the Performance of the Hollow State
Authors: David G Frederickson and H George Frederickson
Publisher/year: Georgetown University Press, Washington DC, 2006
Extent/type: 218 pages, paperback
Price: A$39.95/NZ$51.95 from Footprint Books which offers a 15% discount to AES members,
phone +61 2 9997 3973, email <info@footprint.com.au>, website <http://www.footprint.com.au>
ISBN: 978-1-58901-119-9
Measuring the Performance of
the Hollow State examines the
introduction of the Government
Performance and Results Act
1993 (GPRA) in the United
States; and considers the impact
of the legislation on federal
performance measurement
arrangements (including agency
performance and program
outcomes) in five agencies in the
US Department of Health and
Human Services (HHS).
Background
Purpose of the legislation
The GPRA aims to make
improvements in public
administration in the following
areas: the public’s confidence
in government, program
effectiveness, customer
service and accountability,
service delivery, congressional
decision-making, and the
internal management of federal
government agencies.
The legislation seeks to
address perceived inefficiencies
and ineffectiveness in federal
government agency operations
by requiring federal government
agencies to:
establish strategic plans for a ■
period of three to five years,
which describe the broad
goals and objectives of the
agency
develop annual performance ■
plans incorporating measures
against which agency
performance can be reported
annually.
GPRA implementation
Implementation of the legislation
did not commence until late in
1997 when the first round of
strategic plans was due. The
time gap between the passing of
the bill and its implementation
suggests that agencies were given
sufficient time to plan for the new
approach. By 2005, agencies had
provided Congress with seven
reports including performance
and results measures. The
authors make no comment on the
quality of these reports.
Who are third parties?
The terms ‘hollow state’,
‘government by proxy’ and
‘shadow bureaucracy’ are all
used to illustrate the separation
between the financing of
government services and
the actual delivery of those
services. In the context of HHS,
third parties including state
and territory governments,
commercial and non–profit
health care intermediaries and
carriers, Native American tribes,
scientists and medical schools
deliver federal health services.
These organisations implement
federal government programs
by way of grants, mandates or
contracts, or are organisations
that are regulated by the federal
government.
More importantly, these
third parties can be organised
into what the authors refer to
as ‘articulated vertical networks
of third parties’. These are
essentially networks of service
delivery involving extended
chains of subcontracting
arrangements. The literature
suggests that network settings
can result in goal confusion,
less overall clarity regarding
performance expectations
and fewer reliable reporting
mechanisms. As a consequence,
these forms of service delivery
prove challenging for traditional
public sector management as
new administrative tools need
to be developed to promote and
maintain expected levels of public
accountability. Implicit within
GPRA is the assumption that
federal government agencies are
responsible for service delivery;
consequently, expectations
of third-party performance
measurement are not clearly set
out in the legislation or policy. As
a result, there is a gap in guidance
as to how agencies effectively
measure their performance and
that of their networked deliverers
in this environment.
Agency selection
To analyse GPRA application,
the authors chose to examine a
selection of agencies within HHS.
The authors considered that
the department was ideal for an
analysis of GPRA implementation
because of its size and because
it includes a diverse range and
type of agency. The following
five were selected for in-depth
analysis on the basis of variations
in their missions, policy tools and
third-party implementers:
the Health Resources and ■
Services Administration
(HRSA)—prime function:
national health programs
the Centers for Medicare and ■
Medicaid Services (CMS)—
prime function: provision of
health insurance
the National Institutes ■
of Health (NIS)—prime
function: research and
training body
the Indian Health Service ■
(IHS)—prime function: health
services to American Indians
and Alaska Natives
the Food and Drug ■
Administration (FDA)—prime
function: industry regulator.
Each of the agencies
selected carries out their prime
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