The process of transfer: The micro-influences of power, time and learning
| Date | 01 October 2020 |
| Author | Sabine Saurugger,David Peter Dolowitz,Rodica Plugaru |
| Published date | 01 October 2020 |
| DOI | 10.1177/0952076718822714 |
| Subject Matter | Articles |
Public Policy and Administration
2020, Vol. 35(4) 445–464
The process of transfer:
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DOI: 10.1177/0952076718822714
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David Peter Dolowitz
University of Liverpool, UK
Rodica Plugaru
University Grenoble Alpes, CNRS, Sciences Po Grenoble, PACTE,
France
Sabine Saurugger
University Grenoble Alpes, CNRS, Sciences Po Grenoble, PACTE,
France
Abstract
To date, there have been a number of studies that have examined how policies move
from one jurisdiction to another. However, few of these studies have examined the
micro-interactive effects of actors. This is necessary to understand how actors shape
outcomes over time. The aim of this paper is to engage with this micro-level literature
through an empirical study of policy transfer in the field of architectural norms in
hospital construction in post-Soviet states. To do this, we generate several theoretical
assumptions to link the transfer literature to wider debates in the governance frame-
work. The goal is to discover how the power of actors interacts in the policymaking
processes to influence outcomes over time and in light of learning. What we hope to do
is bring the interactive and dynamic effects that occur between agents attempting to
shape the transfer process back into the transfer picture. The aim is to show that power
flows and that these flows alter the shape and outcome of the transfer process.
Keywords
Agency, Moldova, policy transfer, power, time, Ukraine
Corresponding author:
David Peter Dolowitz, University of Liverpool, 8-14 Abercromby SQ, Liverpool L69 7WZ, UK.
Email: dolowitz@liv.ac.uk
446
Public Policy and Administration 35(4)
Introduction
In July 2018, a new health care issue animated the public space in Republic of
Moldova, a small post-Soviet country: doctors issued fake diagnosis of pneumonia
for children (especially babies) in order to complete the hospital beds requirement
and receive State subsidiary. Or as one paediatrician reported:
what happens there cannot be called medical treatment. In these hospitals, whatever
the problem you go with, the final diagnosis is pneumonia...They don’t respect any
protocol. Why? Because doctors and directors are interested in putting such diagnosis.
This is done because the financing of hospitals depends on the number of the patients
they have. (http://agora.md/stiri/47537/pediatrul-mihai-stratulat–despre-doua-spitale-
pun-copiilor-diagnoza-pneumonie-pentru-a-face-bani–reactia-spitalului–guvernului-
si-cna)
To understand this issue, one needs to know a few things about the hospital
reforms in post-Soviet states. In 2000, Moldova and Ukraine launched hospital
reforms aimed at reducing the number of hospital beds and modernising the build-
ing infrastructure. Both actions were linked to Soviet inheritances: during the
existence of the Soviet Union, a large number of hospitals were constructed
based on sanitary and building standards commonly issued for all Soviet republics
(the State standards or GOST and Construction rules and regulations or SNiP).
These followed the principles of the planned economy more than the healthcare
needs of each Soviet republic. During the first decade after independence, both
Ukraine and Moldova started reducing the number of hospitals and focused on
developing the primary healthcare facilities. Despite these reforms, the number of
hospital beds remained an important source of funding. At the same time, the
problem of the obsolescence of the inherited hospital buildings also remained
unsolved, pushing patients to look for costly surgeries abroad.
In an era of globalisation and increased interdependence, a number of questions
relating to the import, export and mixing of policy models should be considered
when examining policy change and development. One way to capture this is
through the concept of policy transfer and its analysis of the circulation of
policy norms, institutions and technologies (Dobbin et al., 2008; Dolowitz, 2017,
2018; Dolowitz and Marsh, 1996, 2000; Graham et al., 2013, 2014; Hadjiisky et al.,
2017; Stone, 2000, 2017; Shipan and Volden, 2008). While a range of scholarly
work has attempted to capture these dynamics, much of this has been done through
the lenses of globalisation and diffusion. These studies often adopt an institution-
alist explanation, using variables such as political systems, elections, path depen-
dencies, laws, socio-cultural norms, institutionally informed tacit knowledge and
perceptions. In adopting such explanations, many studies downplay the relations
between actors and the power struggles constantly occurring (Gilardi, 2012;
Graham et al., 2014; Maggetti and Gilardi, 2016) and how these struggles shape
the final outcome of the policy process.
Dolowitz et al.
447
To bring these elements back, this article will focus on agency and time. While
adopting an actor-centred perspective is not a new idea (Dolowitz and Medearis
2009; Powell and DiMaggio, 1991; Sabatier and Jenkins-Smith, 1993; Scharpf,
1997; Wolman, 1992), this article will use it in combination with the transfer frame-
work to examine how agent interactions shape policy outcomes. The reason for
focusing on agent interaction is that preferences tend to be established through
interaction with other actors. The second factor, time, is crucial, as the policy
transfer processes generally takes time and operates at different tempos. Within
these actors’ will often be in communication with and across networks, feasibly
altering positions, which will influence short and long-term preferences, resources
and power configurations. Hence the time, timing and tempo of interactions and
actions influence the transfer and outcome processes (Bulmer et al., 2007; Peck,
2002, 2011; Plugaru 2013, 2016; Radaelli 2000; Wood, 2015a, 2015b). Actors will
make use of their knowledge during the transfer process to advance their prefer-
ences in three ways: instrumentally, conceptually and strategically. As such, it is
important to stress that interactive effects change as power shifts during the trans-
fer and policymaking processes. Understanding how these changes are reflected in
the way actors become involved in the process is crucial to understand the prob-
ability of transfer taking place and in what form. In other words, ‘while institutions
make things possible, people make things happen’ (Saurugger, 2013; Zahariadis,
2014: 28).
To study the role and interactions of actors, power and structures in the transfer
process in Ukraine and Moldova, this article will develop a series of assumptions
which allow us to examine: (1) How power relations influence the transfer and
mixture of policy models from one context to another? (2) What influence time,
timing and tempo have on actors’ behaviours and relations? (3) How contextual
frames shape behaviour and how this shapes the policies that are subsequently
transferred and implemented.
Methodology
This article adopts a case study methodology to examine the movement of ideas
and polices from West to East, focusing on the key actors and agents and their
changing relationships over the course of the movement and implementation pro-
cesses. The first step was to conduct a critical literature review of the recent empir-
ical literature involved in the study of policy transfer focusing specifically on
agency in the transfer process between international and national actors. From
this, we identify a series of factors that our study on the transfer of architectural
norms from France, the United Kingdom, and Germany to Ukraine and Moldova
can help unpack and advance.
We chose the modernisation of post-Soviet states as an empirical base for two
reasons. While a number of studies examine the influence of the European Union
on these countries (Europeanisation and European neighbourhood policy), a large
part of those still underestimate the influence of national and international
448
Public Policy and Administration 35(4)
variables other than the EU’s on policy change (Saurugger and Surel, 2006; see also
Walker, 2018). Second, while both countries are former parts of the Soviet Union,
the power structures operating between actors at the domestic level are substan-
tially different. During the era of the USSR, both Ukraine and Moldova had a
common Soviet corpus of architectural norms for hospital building: the SNIP and
GOST Soviet technical rules and standards. At the same time, Ukraine had more
resources than Moldova for hospital building as it hosted the subsidiary of the
main Soviet architectural institute for healthcare facilities (‘Ghipronyizdrav’).
Thus, during and after the Soviet era, Ukraine inherited more experienced consult-
ants and architectural facilities than Moldova in the field of hospital building. If we
see that power relations both amongst domestic actors and between domestic and
foreign actors, time and timing influence the transfer of architectural norms to
Ukraine and Moldova in similar ways, despite their different initial situation, the
internal but also external validity of our assumptions can be considered to be
stronger (Beach and Pedersen, 2013: 146; Blatter and Haverland, 2012).
This article is based on qualitative process-tracing approach. In the context of a
broader research project, we conducted a three-year participant observation,
mainly focused on the Kiev hospital project, by assisting the major meetings
between the French and British architects and the Ukrainian...
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