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Governance Structures in Local Social Policy

Analytical framework and comparative analysis of two German cities on the example of elderly care policy

Ralf Och1 Universität Hamburg

draft2

paper for presentation at the conference

Transforming Care

Copenhagen

26-28 June 2008

1 Contact: ralf.och@uni-hamburg.de 2 An earlier version of this paper was presented at the ESPAnet Conference 2007 in Vienna (http://www2.wu-wien.ac.at/espanet2007/11_Och_Ralf.pdf).

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Introduction Social policies differ not only in terms of the national framework, but also, as comparative analyses from the Scandinavian domain have shown in the last few years, from a regional or municipal perspective (Burau and Kröger 2004; Kröger 1997; Trydegard and Thorslund 2000). However, at the moment there are few comparative analyses that have focused on the structures of steering of local social policies3. An attempt will be made here to bridge this gap from an analytical governance perspective. ‘Governance’ is understood here as the political organisation of the steering of a social policy. Social policy it self is the output of these steering. With the concept of ‘governance structures’, I’m describing the fundamental patterns way in which the carriers of policies coordinate their action (Evers 2006). For the elderly care sector, it is already a traditional characteristic of the German welfare state for there to be a meshing of state-hierarchical elements on the one hand, and elements of market supervision and the exertion of influence of organisations and actors in the realm of civil society on the other (Benz 2004; Evers 2006; Bode 2007). These governance structures are also generally characteristic for the area of local social policy (Heinelt 2004; Schubert et al. 2001).

The central question addressed in this study is therefore: How can local governance structures be analysed and compared?

At this point, a new approach to the investigation of local governance structures will be introduced, in which a distinction is made between two different levels of analysis:

1. Institutional governance structures: The concern here is with governance structures that are established through institutional, welfare state regulations and with actors that are involved in these structures via regulation. This generally concerns multi-level governance (Benz and Eberlein 1999; Peters and Pierre 2001).

2. Actual governance structures: These include the way in which actual political governance proceeds; the institutions, organisations and other actors that are actually involved; and the type of relationships – for instance network relationships – that these actors form among themselves.

In this paper, I will argue that the institutional governance structures, which are established by law on higher political levels, i.e. on the level of nation state or the federal states, set a mixed framework of governance elements which is in priniple uniform for the local level. This institutionally pre-defined mixed framework is varied in the actual governance structures through context-related and path-dependent factors on local levels, which are therefore of particular significance for local comparisons of social policy. Consequently, there are two aims: Firstly, the distinction between the two dimensions of local governance structures should facilitate the separation of local influences from those of higher governance levels, and secondly, the analysis of the mixture of governance elements of a governance structure described by a certain constellation of actors will highlight the level of the collective capability to act, which in turn determines its ability to formulate and implement policies.

In the first part of this paper, the existing analytical approaches to the issue of local governance structures will be discussed (section 2). In the following section (section 3), our own approach for comparing local governance structures will be introduced. This approach will be used in the fourth section, with the example of two German towns, for an analysis of 3 Social policy here is understood here as the output of governance processes with the aim of shaping the (local) care system (c.f. Backhaus-Maul 1994).

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local governance structures for elderly care. In addition, first considerations to develop a typology of local governance structures will be presented. In the final section, the key findings will be summarised.

Several Approaches for the Analysis of Local Governance Structures There has been a vast amount of literature on the theme of governance in the different fields of social studies for some time.4 In the author’s university online catalogue alone, there are 38 electronic journals available from the most diverse of academic fields such as geography, medicine, economics, politics, management and law with the term ‘governance’ in the title. For researching the wider concept of local governance, there are several threads under the label of urban, local or regional governance, which in turn can be subdivided into various schools of thought. This is not the case for social policy research. Back in 2003, Mary Daly concluded that governance is ‘now quite widely used as a frame of analysis, although not in social policy’ (Daly 2003: 113). Thus, the literature for local social policy research appears to be substantially clearer, even if in the meantime some publications have been published, which stress the use of the concept for local social policy due to its emphasis on the involvement of actors of civil society in policy-making and its embedding into national contexts (Burau and Kröger 2004; Damgaard 2006). The central question of this section is: On the basis of which variables can governance structures of local policy be analysed?

Actors and the constellations of actors are a central factor of any governance perspective. Almost by definition, this applies for process-oriented network approaches, but it also applies to the structure-oriented analyses, as forms of action coordination describe the behaviour of actors. In many approaches, the problem of how an actor constellation of a local governance structure comes into being and which groups of actors play a role there is seen as an empirical question that is determined by the interests of the respective actors or local factors (Burau and Kröger 2004; DiGaetano and Strom 2003). Others adopt a more normative position here (Bovaird, Löffler and Parrado-Díez 2002b). However, it is often taken for granted that political and civil society actors are a part of the structure of actors. Pierre points out, however, that ‘the inclusion or exclusion of different actors and the selection of instruments — is not value neutral but is embedded in, and sustains, political values above and beyond urban partisan division’ (Pierre 1999: 390). Damgaard (2006) shows in his study that the composition of local political networks in the Danish local labour market policy is also hierarchically pre-structured by law. A similar situation can be seen in German care policy, as the empirical section of this paper will show. All in all, it can be ascertained that the constellation of the actors in local governance structures is neither purely coincidental nor driven exclusively by interests or values. Rather, a significant part of the actor structure is already institutionally ‘set’ through regulation on the higher governance levels. The relevance that these fixed actors can gain in policy-making, and which further actors from which of governance levels are included in the local government structure, however, is dependent on many factors.

4 For a more political science based overview, see Benz; Lütz; Schimank, and Georg Simonis (Eds.) (2007); Kjaer (2004); Pierre and Peters (2000) or more generally Schuppert (Ed.) (2005). This list is by no means exhaustive. For a critical look at the uses of the concept for the analysis of social policy, see Mary Daly (2003).

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Generally speaking, governance can be used to explore policies from a process-oriented or structure-oriented perspective (Pierre and Peters 2000: 14ff; Kooiman 2005; Mayntz 2005). The former stresses the involvement of non-state or civil society actors in the political process and the nature of negotiation of the policy-making. Networks are thus a prominent feature of these approaches (Börzel 1997; Hajer and Versteeg 2005; Rhodes 1997; Rhodes 2007; Torfing 2005). The latter in no way negates the existence of networks and that their significance has increased. However, compared to the process-oriented perspective, it stresses that governance goes beyond networks, because this is only one specific form of political governance, and hierarchies and markets must also be considered as a form of action coordination in policy analysis (c.f. Benz 2004; Bovaird, Löffler and Parrado-Díez 2002a; Döhler 2007; Jessop 2004; Mayntz 2004; Mayntz 2005; Pierre and Peters 2000). This indeed seems to be the case when local social policy is analysed, which is continually incorporated into a mix of different governance mechanisms established at higher political levels (Burau and Kröger 2004; Damgaard 2006; Evers, Lewis and Riedel 2005; Pierre 1999; Pierre and Peters 2000). Consequently, not least for this reason, a more structural approach will be adopted in this paper.

A relatively straightforward point can be established from the outset: Local social policy is embedded in and shaped by the social policy of the nation state concerned (Burau and Kröger 2004; Evers, Lewis and Riedel 2005; Pierre 1999; Sellers 2002). This national context of institutions, politics and nation state traditions exerts a direct and indirect influence on the shaping of local policy. A direct influence of the nation state level mostly arises through hierarchical governance elements such as laws, directives or programmes. The nation state exerts an indirect influence on local policy-making through the type of regime, its welfare culture and its political and economic traditions (Jessop 1999; Pfau-Effinger and Geissler 2002; Pierre 1999). Both forms of influence establish the framework in which local social policy can perform. However, this framework often leaves considerable room for manoeuvre by the actors. The question as to how the higher-level influence(s) can be theoretically and empirically conceived is not fully answered in the literature. The influence of national differences between Finland and the United Kingdom in relation to local governance, for example, has been analysed by Burau und Kröger (2004) through the dimension of centralisation vs. decentralisation of the central state institutions and policies regarding local care policies. According to Sellers (2002), the local implementation and administration of national policies is influenced by hierarchical influences from supra-local politics, national parties and interest groups as well as the respective type of market economy and welfare state. In addition, Pierre (1999: 375f) also cites the character of the policy sector. National politics and state traditions explain, according to his perspective, the observed effect that local elites tend to reach similar decisions. Here, it is proposed, however, that the influence of higher levels should initially be limited to an analysis of the institutional regulations relevant to policy. The focus lies with the composition of actors and the structuring of the action coordination between them. Other trans-local factors of local variation such as cultural influences or actors from other levels should only be factored into the analysis if they can be explained neither by the policy-relevant institutional regulations nor on a local basis.

Institutions and institutional systems are another central complex of variables in the analysis of local governance. They can be defined more generally, for instance by Pierre, as reflections of values and norms (Pierre 1999: 375), or by Burau and Kröger as ‘national welfare institutions’, which together with the welfare policies ‘define the space in which local politics

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takes place and as such also indirectly influence (local) policies of community care’ (Burau and Kröger 2004: 806). DiGaetano and Strom (2003: 362f), on the other hand, define political institutions as ‘the organizational means by which collective decisions are made and carried out. These include political parties, interest groups, governing bodies and agencies, and more recently partnership arrangements that give organization and definition to the political process’. For the purpose of this paper, it seems to me to be of more value to define ‘institutions’ more sharply than Pierre, or Burau and Kröger, for example, but also more narrowly than DiGaetano and Strom. As a result, two aims should be achieved: the effect of institutions from different political levels on the local level should be more clearly observable, and institutions should be able to be more strictly separated from actors. Institutions are generally speaking social models or structures ‘which steer it [the action] in a direction, without “consideration” of the directions which would theoretically be possible’ (Berger and Luckmann 1969: 58). Political institutions can be defined as ‘formal or informal routines, norms and conventions embedded in the organizational structure of the polity or political economy’ (Hall and Taylor 1996: 938, c.f. March and Olson 1995).

In this rather narrow form, institutions also procure access to forms or types of action coordination in governance structures. Action coordination means how a certain group or population of actors arrange or coordinate their activities and thereby reach a certain degree of collective action competence to be able to solve problems of collective action and to minimise ‘free rider’ problems (c.f. Olson 1997). This problem is thus principally a central one if, as in governance structures, the policy shaping has to be carried out through extensively autonomous actors. The degree of collective capability to act becomes higher, the stronger the binding of the actors to the collective decision (c.f. Mayntz and Scharpf 1995). The safeguarding of collective decisions takes place through institutions, norms of regulation adherence and the associated legitimisation and/or sanctions (c.f. Berger and Luckmann 1969; DiMaggio 1988; Lepsius 1990). The governance literature generally refers to markets, networks and/or hierarchy/organisation as the fundamental coordination mechanisms, and rarely the community. The extensive literature on this theme cannot be listed here.5 To my knowledge, only Bodil Damgaard (2006) has tried to realise this analytical approach of governance networks in the field of social policy research. She investigates using the example of local networks of Danish employment policy what the main features are determining network governing, and argues that the existence of networks does not necessarily lead to “network-governing”.6 More important is the autonomy that a policy network has in the policy process. She operationalises this binomially: complete autonomy corresponds to ‘network governing’. However, if the engagement of the network is limited to one or more phases of the policy process, she speaks of a hierarchical mode of government (Damgaard 2006: 677). This process is certainly suited to the analysis of an individual element of an area of local social policy. However, it is not really practical for the characterisation of a local social policy as a whole or specific areas thereof because the democratic hurdle of the city parliament has the coordination mode of majority voting. Moreover, Pierre and Peters (2000)

5 For a short overview of governance, see: Pierre und Peters (2000), for a somewhat more detailed description see Benz; Lütz; Schimank and Simonis (Eds.) (2007); a general but more detailed description is provided by Scharpf (1997) or Wiesenthal (2000). 6 She highlights an important distinction: ‘(a) policy networks as a way of organizing stakeholders; and (b) policy networks as constituting a mode of governing (in this case network governing). Making this distinction the key concept of network autonomy may be analysed at both levels – vis-à-vis both policy networks and network governing’ (Damgaard 2006: 673-691).

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point out that even within one governance perspective, the significance of individual policy stages can vary. For the purposes of this paper, slightly modified types of action coordination will be used, as proposed by Mayntz and Scharpf. The reason for this is, as Schimank (Schimank 2007: 34) formulates, that market, hierarchy or networks are ‘from an analytical point of view, not yet elementary enough’, in order to create stages of action coordination that consistently build on one another and to construe the resulting collective action ability with sufficient selectivity and consistency.7 Mayntz und Scharpf propose a four-stage scale, which shows an ascending collective action ability: one-sided or mutual adjustment; negotiation; voting and hierarchical decision-making (Mayntz and Scharpf 1995: 61f; see also Scharpf 2001).8

Beyond the complexes of variables discussed, there may be further ones intrinsic to the analysis of local governance structures, but which in my opinion are highly dependent upon the local context, such as the local welfare culture or the pressing problems that the actors face.

Own Reflections on the Analysis of Local Governance Structures Governance structures, like processes in local social policy, contain on the one hand structures that are institutionally pre-determined on a higher political level through policies, and on the other hand, concrete patterns of interaction and networking between the relevant actors. For the comparison of governance structures, it can be assumed that institutional governance structures tend not to vary on a local level.

The Concept of ‘Local Governance Structures’

Local social policy is understood here as the output of governance processes9 in a municipality with the aim of shaping the local public provision system, its amount and quality standards and its prices (c.f. Backhaus-Maul 1994: 527). ‘Local governance structures’ in the field of social policy is understood here as the meshing of different governance elements in the area of the political governance of social policy on a local level. Political action on different governance levels influences the mix of these governance elements. By emphasising the political character of governance, I am following the argument of Pierre (1999: 376), that a very wide definition of governance that refers to any given private-public exchange would

7 Wiesenthal argues that the coordination forms of market, community and organisation are ideal types – he sees networks as a hybrid type. In a pure form, these would not be realistic, nor would they be ‘the best co-ordination means’. ‘Only through the combination with elements of other co-ordination means, i.e. as “plural forms” (Bradach/Eccles 1989), would the performance maxima or (in the case of the market and organisations) the efficiency maximum be reached’ (Wiesenthal 2000): 62, italics in original). 8 One-sided or mutual adjustment: ‘Coordination only occurs such that the individual actors adjust themselves for themselves (and even without the knowledge of the interdependence of their actions) to the other influential conditions of the action situation’, Negotiation: this draws upon ‘explicit, but factual and time-limited specific (and normally bilateral) agreements between actors’, Voting: the security of the veto position in negotiations ‘is taken by those involved when collectively binding decisions are made through majority voting in democratically created ‘associations’ or political bodies’; Hierarchy: ‘The collective capability to act finally reaches its maximum ‘when both the decision-making and the availability of collective activity resources are transferred – if need be, dependent on diffuse support – to a hierarchical authority’ (Mayntz and Scharpf 1995: 61f). 9 i.e. through the formulation and implementation of political decisions and measures.

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lead to virtually everything being called governance, resulting in the concept loosing any significant meaning (c.f. Bovaird 2005; Bovaird and Löffler 2003; DiGaetano and Strom 2003: 373; Pierre and Peters 2000). This also implies that a rather state-orientated perspective is being taken because precisely in social policy the state continues to be ‘the key political actor in society and the predominant expression of collective interests’ (Pierre and Peters 2000: 25). In my opinion, ‘governance without government’ is not a plausible option in (local) social policy.

The local governance structures to be analysed for the production and implementation of local social policy involve:

• A (relatively stable) set of relevant actors that have an influence on policy within a city or on a political field of a municipality.

• A certain arrangement of types of action coordination, relationships and resource flows between the relevant actors.

Two Dimensions of Local Governance Structures

The approach introduced here differs significantly from the existing approaches for the analysis of governance structures in local social policy, as an analytical distinction is drawn between two dimensions of governance structures:

• Institutional governance structure and

• Actual governance structure

a) Institutional Governance Structure

The institutional governance structure is established and/or implemented on the higher governance levels through (inter)national or federal law, political programmes, edicts etc. It provides a framework mix of governance elements and contains institutionally defined:

• Actors who can potentially exert influence on local policies,

• Tasks and resources, as well as their distribution among actors,

• A institutionally defined framework mix of market, competitive, cooperative or hierarchical governance elements, which fundamentally governs the interactions between these actors.

Actors

Institutionally defined actors can on the one hand be state actors on a local level or their counterparts on a higher level, but on the other hand also consist of certain groups of non-state actors that operate on the local level. In this regard, it is possible that institutionally concrete actors or else relatively indeterminate groups of actors are named, whose concrete composition is dependent on local conditions. Therefore, it firstly needs to be analysed which institutional regulations of the higher governance level are relevant to the local social policy problem and which concrete actors and further groups of actors come into question as potential political actors of the local governance structures through these institutional

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stipulations. For example, the institutional regulations for German elderly care determine that, among others, the state, federal states, municipalities, nursing care funds and care institutions should ‘work closely’ together for the care of the population (§ 8, chapter 2 SIB XI)10.

Tasks and Resources

However, the regulatory framework not only defines who is considered as an actor, but can also describes which tasks this actor has to fulfil and which resources can be applied for this. This includes the creation of a legal or material framework, infrastructures etc. Furthermore, the institutional framework already makes a prior stipulation regarding the distribution of resources among the actors. To apply the SIB XI: the federal states are, for example, responsible for the provision of an efficient, numerically and economically sufficient care structure (§ 9, chapter 1, line 1). The resources available are hierarchical governance tools in the form of the creation of local law regulations for the implementation of the long-term care insurance law and the setting of economic incentives via subsidies (c.f. Eifert and Rothgang 1999).

Relationships

Through the institutional framework, (interdependent) relationships between actors are also defined. These relationships between the actors on this level can be of a hierarchical nature, e.g. when an actor has received a certain right of control through the institutional framework; they can be on a trust basis or of a market nature. An example of hierarchical governance is the extensive monitoring of the conducting of care laid down in the regulation of nursing homes and homes for the elderly (“Heimrecht”). An example of market-based governance can be seen in the shaping of relationships between the care provider and recipient (e.g. Rothgang 1997).

To summarise, the legislative framework on the national and federal level11 of the political system generates on the local level an institutionally predetermined governance structure, which contains a defined set of actors with their tasks and resources and links these to one another. This structure is the same within any given governance level (nation state, federal state) and can thus serve as a starting point for the analysis of the actual governance structure on the local level on the basis of which local differences can be examined.12 Changes in this dimension derive from the changes in the institutional regulations determining the governance structure.

b) Actual Governance Structures

10 SGB XI, the eleventh social security code, is the framework legislation of the German nursing care insurance. 11 The paper implicitly acts upon the assumption (as does the project that forms its basis) that a national comparison is sought. For an international comparison, however, additional variables and dimensions need to be considered, which are in part mentioned in the aforementioned literature, e.g. regime type, the national (political) culture etc. 12 A similar suggestion is made by Pierre and Peters (2000: 25) when they argue ‘that in order to be able to understand the full nature of governance and its effects on control in society, we must depart from the state of affairs before the challenges emerged’. Although this is undoubtedly true, this paper does not explore the question of the development of local governance structures, but rather their differences. Therefore, I will use the institutional governance structure as a starting point for the comparison.

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The examination of institutional governance structures represents the necessary first step in the analysis of local governance structures in social policy, but it cannot make a sufficient statement about the totality of the actors operating on the local social policy level, their relevance to the political process, their actual relationships to one another and the coordination mechanism that prevails between them. Therefore, the actual governance structure must be investigated in a second analytical phase for a comparison of local governance structures. The actual governance structures can theoretically be congruent with institutional governance, but in practice the institutional governance structure can be reshaped through additional regulatory elements and actors from the state and/or civil society areas. Bovaird et al (2002b: 13) have, for example, identified six groups of actors from case studies in different European countries, which play, or should play, a role in local governance structures: (individual) citizens, the voluntary sector13, for-profit organisations, media organisations, representatives from higher-level politics such as the government or Parliament, and local authorities. However, they also conclude that in particular the participation of citizens in the political process does not yet have the desired status (Geißel 2005). The institutionally pre-formed relationships between the actors will in turn be reshaped through the development of formal and informal relationships of resource exchange between them (e.g. Heinelt and Kübler 2005; Rhodes 1997) and the development of a specific interaction logic (e.g. DiGaetano and Strom 2003; Torfing 2005). Consequently, the ‘excess’ of actors, resource deployment, relationships and tasks and interaction rules are described in terms of the institutional governance structure, which forms the locally specific mix of action coordination. Thus, the actual governance structure contains the operative set of components for the formulation and implementation of local social policies:

- of relevant actors,

- their actual relationship arrangements with the exchanged resources, and

- a dominant coordination mechanism, which highlights the collective action ability of the relevant actors for the development and implementation of a particular local social policy (Mayntz and Scharpf 1995: 61).

This set can be analysed in terms of the first two points analogously to policy networks, as they can be described through their actors, relationships and boundaries (Adam and Kriesi 2007; Kenis and Schneider 1991; Rhodes 1997). The final point, however, must go beyond the logic of networks, since, as stated above, networks constitute only one possible form of coordination.

Identification of the Actually Relevant Actors

First of all, it can be assumed that the concern in terms of actors in local governance structures is mostly with collective actors or their representatives (Marin and Mayntz 1991: 14), who are integrated in the governance structure on the one hand through their function, but on the other hand also through personal relationships (Schubert et al. 2001). An actor can be seen as relevant if he fulfils three criteria: Interest in an issue (e.g. the care policy of a city), monitoring capacity, i.e. capability of observing changes in the field of local care policy and reacting to them politically, and mutual acknowledgement between the members of the actual governance structure (c.f. especially Jansen 2002; Kappelhoff 2000; Kenis and 13 The authors include in this context political parties and unions along with the welfare associations.

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Schneider 1991). A central question, therefore, concerns which actors are even involved, or indeed not involved, in the policy process (c.f. Daly 2003) and thus become a part of the governance structure. Depending on the characteristics of these three conditions, the degree of inclusion of actors as well as the types of actors can strongly vary and thereby determine the form of the network or prevailing coordination mechanism (c.f. Schimank and Wasem 1995).

Analysis of the Relationships between the Actors

The relationships between the actors of the network serves as formal and informal communication channels and for the exchange of resources (Börzel 1997; Kenis and Schneider 1991; Rhodes 1997), such as financial or personal services, information or political support as well as the negotiation of rules of the regulation formation in the sense of Kooiman’s ‘meta-governance’ (e.g. Kooiman 2005). The thus resulting rules of policy-making can be described as ‘governing logic’ (DiGaetano and Strom 2003: 365) or as a ‘basic institutional consensus’ (Mayntz 1993: 45ff). The extent of the coherence of the actors’ aims, interests and ideas has an influence on the relationship structure and the prevailing coordination form insofar as the complexity and conflict potential (Kickert and Koppenjan 1997: 53-58) as well as the interaction-orientation of the actors (Scharpf 2000) in the actual governance structure are dependent on it.

The Analysis of the Dominating Coordination Form

As mentioned above, the four-stage scale of action coordination developed by Mayntz and Scharpf which shows an ascending collective action competence will be used here: one-sided or mutual adjustment; negotiation; voting and hierarchical decision-making (Mayntz and Scharpf 1995: 61f; c.f. Scharpf 2001). In the first case it is sufficient to observe and/or anticipate the actions of others and one’s own reaction for the coordination; a collective capability to act is marginal. In the second case, every side has the possibility to undermine the collective capability to act, either through the interruption of the negotiations or through a legal or actual veto position. The third level of collective capability to act occurs when collectively binding decisions are created by defined majorities through voting. The highest degree of collective capability to act is allocated through the hierarchical decision ‘of a hierarchical authority – if necessary reliant on diffuse action support’ (ibid: 62).

The institutionally defined framework mix as well as the concrete local governance structure contains regularly ever more governance elements simultaneously, meaning that it is then a matter of specific implementation, which as a general rule produces a more distinctive dominance of one of the governance elements.

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Comparative Analysis of Local Governance Structures of Elderly Care in Germany In the following section, the approach for comparing local governance structures will be applied using the example of two German cities. The central question regards the similarities and differences of local governance structures in central relationships of the state actors with the civil society actors, which are central for the shaping of the local social policy. Furthermore I will introduce reflections on a typology of local governance structures in social policy.14 The field of German care policy is especially suited to this question, because through the introduction of the German long-term care insurance in 1995/1996, an extensively uniform institutional framing of this policy field has taken place nationwide.

Care is understood here in the sense of the social care concept, as aid for elderly people who cannot accomplish their physical, daily, emotional or mental needs without external help (c.f. (Daly and Lewis 1998). ‘Policies vis-à-vis care’ or ‘care policies’ should be understood here as regulations and resources, by means of which publicly operating actors in state and state-supportive fields (state administrations and institutions, state-supportive institutions such as nursing care funds) govern the way in which care is organised and provided (c.f. Evers 2006).

Methodological Procedure

For the comparison of local governance structures introduced here, two former West German cities have been selected, which show extensive similarities in fundamental contextual factors.

Characteristic City A City C

Federal state Lower Saxony Hesse

Mayor Social Democratic Party since 1986

SPD from 1984 to 2006; Christian Democratic Union since 2006 only

Inhabitants (2003) 84,586 74,100

Median age (2003) 42.5 37.2

Proportion of persons over age of 80 in % (2003)

5.7 4.3

GDP/inhabitant in € (2003) 27,151 27,514

Source: Bertelsmann 2005; Genesis-Online; State Statistical Office Hesse, own analysis

14 The research basis for the comparison used here is the DFG project: ‘The local restructuring of elderly care – cultural bases, actors and action conditions’, which the team of authors is currently carrying out under the leadership of Birgit Pfau-Effinger at the University of Hamburg. In the project, we are asking to what extent and in which ways the cultural values – which have played a central role since the 1990s in the supranational and national discussions about the welfare state and social services – especially quality, market relativity, efficiency and participation and which also form a fundamental cultural basis for the long-term care insurance law of 1995/1996, are adapted on the level of local welfare cultures and implemented in the local care policies. On the basis of the approach of the local care arrangement (Pfau-Effinger, Birgit 2005a, b) we are pursuing these questions through a comparison of four medium-sized German cities with between 70,000 and 100,000 residents. Two of the cities are in the former East German states and two in the former West German states.

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Both cities are traditionally working-class, which is reflected among other things in a long-standing dominance of the Social Democratic Party15 in the two cities. In City C, the SPD Lord Mayor was replaced by a Christian Democratic Union candidate last year. The two cities have a comparable economic power and lie in heavily Protestant Federal states. Differences exist firstly in terms of the status and relationship of Lord Mayor and city council, which can be traced back to the respective municipal constitutions of their Federal states and do not need to be considered further here. Secondly, according to the Municipal Code of Hesse, City C has not been independent city since 1974, which means that it is able to transfer its responsibilities in terms of municipal social policy to the administrative district in which it lies, and indeed has done so to a certain degree. Nevertheless – as I will show further below – precisely in the area of care policy there is a close cooperation between city and administrative district.

The analysis of the governance structure took place through document analyses and guideline-based interviews with local experts and actors of the governance structure. For each city, we interviewed 2 - 3 experts (in each case one administrative position and one non-statutory welfare), who also compiled a freely structured network picture. The selection of partners for each of the 10 actors’ interviews per city ensued on the one hand according to central institutional positions (heads of social departments, chairpersons of social committees, administrative leadership positions and in part clerks’ positions) and on the other hand, above all for actors from civil society, according to the identification of relevant actors on the basis of expert interviews. In City C, due to the particular institutional structure, in addition, one expert and two actors from the administrative district were surveyed. However, the interview phase is not yet fully concluded, and the results are therefore of a preliminary nature.

Institutional Governance Structures of Local Elderly Care Policy in Germany

The central (hierarchically) institutional regulation for the care of elderly people is the eleventh Social Security Code (SIB XI). It defines the groups of central actors for the social safeguarding of care needs, defines them in relation to one another and defines their aims.16 The regulations of the health and social legislation as well as the regulation of nursing homes and homes for the elderly are also significant in part.17 Key goals are directed at ensuring the self-determination of those in need of care, the quality to be assured and the efficiency of the organisation of care. Overall, the concern in terms of the care policy negotiation on individual levels of the political system is thus with the quality, extent and costs of the care services.

The decisive actors for the guarantee of care are the federation, federal states, municipalities, care organisations (providers), nursing care funds and the Medical Review Board of the Statutory Health Insurance Funds (MDK). They are brought together by the collective responsibility for ‘efficient, regionally structured, local and complementary outpatient and inpatient care provision for the population’ (§ 8 chapter 2, line 1, SIB XI, c.f. §§ 9 and 10 SIB

15 The SPD is the Social Democratic Party and the CDU the Christ Democratic Union, they are the two main political parties in Germany. The first one can be considered more on the left wing and the second more on the conservative wing of the political spectrum in Germany. 16 c.f. on the genesis and the aims of the long-term nursing care insurance e.g. Haug and Rothgang (1994); Pabst (2002) or Rothgang (1997). 17 The corporate actors potentially involved in the governance structure are not significantly increased as a result, since the nursing care funds are a part of the insurance companies and the social policy legislation is carried out by the social assistance authorities, which in this case are the municipalities.

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XI).18 The general regulatory competence of the federation is underpinned by the federal states in their own regulations. However, the SIB XI merely assigns a notable responsibility to the federal states in terms of safeguarding the care infrastructure (§ 9 SIB XI). Beyond the federal states, the nursing care funds in cooperation with the MDK on the one hand and the providers on the other hand appear to be the central actors for the shaping of local care policy, because the nursing care funds are the central actors in the completion of care contracts, and through the MDK, which they control, in terms of the classification of care needs and quality control.19

At the latest in terms of the arrangement of quality, scope and costs of care between the insurance companies and providers, the individual municipalities come into play for the first time, inasmuch as they are providers of social security (which is again regulated according to federal law). They then have to approve both the care contracts between insurance companies and providers and the results of the yearly cost negotiations. As the lowest unit of federal state, the municipalities do not have any power of their own to shape legislation. However, due to the municipal self-administration fixed by basic constitutional law, they are obligated to organise the services of general interest of the citizens in accordance with local needs as part of the effective social legislation (cf. Naegele 2004). The individual federal care laws provide the municipalities with differing scopes of influence for this purpose (Pabst 2002: 214).

The ‘Heimaufsichtsbehörde’ (authority for supervision and consumer protection for care homes – in the following: ‘home supervision’ or 'Heimaufsicht') is a further actor equipped with control rights in terms of quality and costs of care. Its far-reaching powers result from the legislation for inpatient institutions in elderly and adolescent services. The tasks and responsibilities of this home supervision authority are (still) regulated to the greatest possible extent in a uniform manner across the whole federal Republic, but the organisational structure and provision of resources ensues on the federal state level, meaning that it is allocated partly on the state level and partly on the municipal level. Following § 20 HeimG (home care legislation) (2002), it operates a work team for quality assurance, in which the MDK, the state associations of nursing care insurance funds and the providers of social security work together.

18 In addition, the care is framed by further federal and federal state regulations, which in part influence the care laws (such as the regulation of nursing homes and homes for the elderly or the regulations for the social safeguarding of life); these regulations will only be used in the analysis here when they play a role in the shaping of local governance structures. 19 On the upper levels of the political system there are on the whole diverse relationships between the state, federal states, nursing care funds, providers’ associations and other interest groups, which cannot be considered further here (c.f. Eifert and Rothgang 1999; Hesse-Schiller 1996; Naegele 1999; Pabst 2002; Schmidt 2002; Schöllkopf 2002; Strünck 2000).

14

Graph 1: Institutional governance structures in elderly care according to SIB XI.

Source: author’s own

For our two cases, this institutional governance structure is identical on the local level, with the exception of three points that can be traced back to federal state law. 20

State-Specific Aspects of Institutional Governance Structure

In the representation of the institutional governance structures of our cities, three points are changed compared with the former general representation:

In City C, there are two municipal general actors, the city and the district. In Hesse – in contrast to most other states – cities with between 50,000 and 100,000 inhabitants are no longer independent cities but are rather so-called special status cities. This means that they

20 Firstly, home supervision can be found both on a local level (Lower Saxony) and on a federal state level (Hesse). Secondly, the care law in the federal state of Lower Saxony is anchored on the facultative implementation of local care conferences. These institutional regulations also define actors and their tasks and relate them to one another. Actors who are expected to at least participate are representatives of the local authority bodies, care institutions and nursing care funds. In addition, further ‘individuals, especially representatives of people in need of care and care personnel’ can attend (Care Law of Lower Saxony (NPflegeG) 1996).

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belong to the surrounding district but in part carry out (social) municipal tasks themselves, delegate them to the district or attend to them together with the district. For example, as of recently, district C is the provider of social security for the municipal area and consequently the negotiation partner for patient care charges. The city is solely responsible for the so-called ‘open’ old-age assistance (i.e. assistance not related solely to professional care, such as general advisory services etc.). Together, they carry out the planning of old-age assistance and the maintenance and steering of the advisory and coordination centre.

The second point concerns the status of the home supervision. In Hesse, the home supervision is based on the state level, while in Lower Saxony, it is allocated to the municipalities (Schnabel, Getta and Schmitz 2004), and in City A, moreover, it occupies a dual role with the department of old age assistance. This gives rise to certain restrictions in the steering capabilities for the municipality in the inpatient area, which is not the case in Hesse.

Moreover, in the law regulating conditions of care in Lower Saxony (1996), the optional care conference in City A is used for the arrangement of care policy.

An Approach to Comparing Actual Governance Structures

As yet, there are only a small number of different typologies for comparing local governance, which originate from the urban governance debate and have the aim of describing the governance of cities in general. These tend to be more process-orientated and based upon different criteria. For instance, Pierre (1999) identifies four ‘models of urban governance’ (managerial, corporatist, pro-growth and welfare), which he describes in relation to nine criteria (policy objectives, policy style, nature of policy exchange, nature of public-private exchange, local state-citizen relationship, primary contingency, key instruments, patterns of subordination, key evaluative criterion). DiGaetano and Strom (2003) differentiate between five ‘modes of governance’ (clientelistic, corporatist, managerial, pluralist and populist), which they characterise through four features (type of key actors, governance logic, governance principles and political aims).

By contrast, it is suggested here that the actual governance structures should be distinguished according to the two dimensions that are reflected in the two central elements of governance structure – the actors and their method of action coordination.

16

Governing logic: predominant type of action coordination

Degree of inclusion of the actor structure

Mutual adjustment

Negotiation Voting Hierarchy

Weakly inclusive Small sample of

(types of) actors

widely independent

Small group of

(types of) actors

which are

interdependent;

exchange of

resources

Small group of

(types of) actors

which are bounded

by membership;

exchange of

resources

Small group of

(types of) actors

which are

subordinated to a

authority; exchange

of resources

Strongly inclusive Large sample of

(types of) actors

widely independent

Large sample of

(groups of) (types

of) actors which

are interdependent;

exchange of

resources

Large sample of

(groups of) (types

of) actors which

are bounded by

membership;

exchange of

resources

Large sample of

(groups of) (types

of) actors which

are subordinated to

a authority;

exchange of

resources

Table 1

The first dimension is the degree of inclusion of the structure of actors. It describes the range and the scope of the potential groups of actors involved in the political governance. The degree of inclusion is low when the relevant actor structure only features a few types of actors (public, for-profit, non-profit, people concerned etc.) and/or contains a limited number of actors. The inclusion is high when the governance structure has a large number of actors and/or types of actors. The second dimension represents the dominant type of action coordination in which local care policy is developed and implemented. This is determined by the predominant feature of the governance structure. I am following here the argument set forward by Pierre and Peters, that ‘[t]he continuous exchange between the public and private blurs the distinction between policy formulation and implementation because much of the policy will be given its final design as it is being implemented’ (Pierre 1999: 376f). As a result, the decisive point of policy-making in governance structure can in theory barely be predetermined.

The Actual Governance Structures in the Two Cities

For the sector of the care of elderly people, it is traditionally characteristic in the German welfare state that state-hierarchical elements on the one hand, and elements of market supervision, the exertion of influence by civil society organisations and the actors on the other are intertwined (Benz 2004; Bode 2005; Bode and Firbank 2007; Evers 2006). Against this background, for the actual governance structures, certain differences and similarities emerge: Only in city A are there other actors in addition to the institutionally defined actors and their relationships. These are first and foremost organisations from the non-profit sector, or state and local organisations such as care training colleges or housing associations. On the other hand, many of the institutionally predefined actors are not involved in the local governance structure in city C, whilst there are more included in the case in city A. In both cases, the

17

federal states merely function on a level of normal contact within the administration of local governance structure and through the institutional regulations described above. It is striking that in both cities, certain groups that are fundamental for the organisation of care are not involved in the creation and implementation of local policy measures. In particular, this concerns the group of doctors, private service providers and the families that administer care themselves. The latter, however, at least have an indirect opportunity to exert influence through the cities’ senior citizens’ representation or the home supervision authorities laid down in the home supervision law. In both cities, the city parliaments are the bodies, which, following the consultations with the social committees, ultimately make the decisions for policy formulation.21 In both cities, the charitable providers are more strongly organised and included in the governance structure to a greater degree than the civil society actors. The latter, in turn, are more strongly integrated than the for-profit providers.

The central difference between the governance structures in the two cities lies in the sections of the policy processes in which the decisions regarding care policy are prepared and realised. They differ in the degree of inclusion of the actors and in the prevalent type of coordination.

The governance structure in city A is characterised by the large number of actors and types of actors included, and by the fact that the prevalent type of action coordination is mutual adjustment. By contrast, the governance structure in city C can be seen as a negotiation system with a narrowly limited and thus weakly inclusive structure of actors.

Governing logic: predominant type of action coordination

Degree of inclusion of the actor structure

Mutual adjustment

Negotiation Voting Hierarchy

Weakly inclusive City C

Strongly inclusive City A

Table 2

21 Providing that the administration does not have the possibility or right to decide. The type of action coordination at this point of the policy process is thus voting (see above).

18

This central finding can be illustrated in the following graph:

Graph 2: Actual governance structures in local care policy

Source: author’s own

Figure 2 shows in a simplified form the local governance structures in the two cities investigated. As in figure 1, the institutional governance structure on the local level is represented by the actors who are linked by different coloured lines. This structure is represented by the actual governance structures through the actors linked by coloured lines which label the coordination form like figure 1. The most important aspects of the actual governance structures in the two cities shown above will now be briefly described and then classified according to the typology introduced above.

City A

The governance structure can be described as a strongly inclusive network with a relatively high number of actors and types of actors, which mainly interact through bi- or multilateral cooperation. The structure can be subdivided into two sub-networks, in which the state actors occupy the interface position. The above designation of strongly inclusive mutual adjustment is based on the importance of the first network for the organisation of care in the city; the also established steering structures which are based on negotiations are, in my opinion, of lesser importance.

The first and in favour to the local governance structures more interesting sub-network here is a large network with weak connections. Its central form of coordination is the mutual adjustment. Here, active actors are essentially located in the city. The active actors on of the part of the municipality essentially come from different areas of administration (social welfare

19

office, local health authority, home supervision/open elderly care support), which cooperate strongly with each other. By contrast, politics – with the exception of the director of the welfare committee – is comparatively inactive. The second large group of actors encompass the providers, which in turn fall into three categories. The first type includes the welfare organisations, whose relationship to one another is also marked by a certain level of internal competition, but who can generally agree on a collective position compared to the city, and who distance themselves strongly from the for-profit organisations (A-A-3). The second type includes a relatively large number of for-profit providers, who since the introduction of nursing care insurance have been flooding both the inpatient and outpatient areas of the market, which for their part cooperate partially (A-E-1, A-A-4). The third type of provider is the city itself, which, uniquely in our sample, offers both inpatient and outpatient services.22 In addition to these direct care providers come further civic society actors: Two housing associations and a sports club (which offers programmes for the elderly), which again essentially cooperate with individual welfare organisations; nursing care funds; representatives of those affected and the care training college.

Such a large number of extensively autonomous actors is no longer governable in a closed negotiation system (Schimank and Wasem 1995). In addition, the city itself occurs as a provider of care services and elderly assistance projects, and does not finance external services itself, so that aside from the essential exchanges of information between the state and non-state actors, hardly any further resources are exchanged between the state and non-state actors which could give rise to negotiations. Thus, the actors in the administration advise every actor with the aim of utilising possible funds of the state, and because of their institutional position are in permanent contact with all other actors. Nevertheless, due to the fact that the city provides home supervision, the state can, within certain limits, have an impact on the quality of inpatient provisions hierarchically or in negotiations.

In order to be able to give governance impetus under these conditions in relation to the quality of care and care services, the public actors from the administration have developed a voluntary care conference in the care law of Lower Saxony into a forum for exchange dedicated primarily to the theme of care quality, which had long been discussed in the city prior to the introduction of the nursing care insurance. The social welfare office in the city distributes invitations to all of the above-mentioned actor groups, but interested citizens can also take part. The actors come to see what the current central themes are and what others are doing (A-E-2: 9). There are no direct influences from city actors on others or vice versa. The extent to which civil society actors adopt and adapt themes such as a special concept for caring for dementia depends upon their expectations of development of the care market23. An interviewee in the city characterised the governance structure that has emerged through the care conference with an open system:

‘I say that it is a type of artesian well. We talk about it in the care conference and then at some

point it bubbles up in a completely different place. But you get the feedback at the latest at the

topping-out ceremony or opening: it was only at this event that I really came to understand that.’

(A-E-1: 29)

22 In order to illustrate the existing competitive pressure, it should be mentioned here that up to 2007, the number of inpatient beds in A has almost trebled since the introduction of the nursing care insurance, especially from the for-profit providers (A-E-1). By contrast, the number of beds in city C has remained the same (C-E-1). 23 Schimank and Wasem term such a relatively unspecific input of state actors in the constellation of actors as a shotgun strategy (Schimank and Wasem 1995: 199).

20

‘Most of the care services meet up within the care conference. Good. That is, people see each

other, say hello, themes are discussed in the framework as input from the administration. Of

course you can make a contribution yourself, but in the end it comes from the organisers from

the city of Wilhelmshaven. And people go there to see and be seen … Yes, that’s how it is.

People swap ideas but it’s more like, well, what can I learn from others, what can I infer from it

for myself and change.’ A-E-2: 9f).

Moreover, the fact that the nursing care funds are also represented at the care conference and that the city itself is involved in the care cost negotiations has helped in terms of the introduction of dementia concepts to achieve cheaper care rates (A-E-1).

The second sub-network exists between municipal actors from the administration; the social welfare office and the home care body in particular stay in close dialogue with their counterparts in neighbouring communities and agree upon pricing and the quality standards to be enforced. Coordination ensues here clearly through the negotiations for which - in the context of the institutionally set boundaries - the sides involved must agree upon an outcome (A-E-1; A-A-1).

However, on the whole, the prevalent action coordination between the state participants is mutual monitoring and adjustment, which need not rule out bi- or multilateral negotiations, since they do not affect the entire structure, but rather must be seen as individual coalitions within the governance structure.

City C

The central characteristic of the governance structure is that it is organised as a weakly inclusive negotiation system. There is a tight (personal) interdependence between the political / administrative actors and the representatives of the free welfare, i.e. to simplify it somewhat, only two relatively closed groups of actors are facing each other here – a state group and a civil society group. These two groups of actors have launched several long-term or temporary committees, which – aptly – are named steering committees and are concerned with the shaping of local policy measures. Other actors have practically no access to these committees. For the field of care policy, these are principally the advisory and coordination steering committee (BeKo) and the steering committee in charge of planning elderly care

The first serves purposes of steering (in a literal sense) of what is surely the most important measure in the city from the perspective of costs: the running of the advisory and coordination centre (BeKo). Beko’s tasks target two areas: acting as a service provider for those in need of care and their relatives, and the coordination of assistance services. As a service provider for the people affected, BeKo advises the entire administrative district about care assistance, prices and finance options available. BeKo does not arrange professional care assistance, but does offer, partly in cooperation with other bodies, training courses and discussion groups for carers of the elderly. The task of coordinating the care services is considerably more difficult and as with the advice services requires an intensive monitoring of the market. The coordination thus works the best in the fields that are not shaped by the market and in which there is therefore no competition.

And the NEW thing is, in the past the municipalities were in many cases just the financial

backers, so through subsidies and proof of use, you’ve probably heard if it…but they sit,

through the fact that they sit in person on the steering group, basically the head of the social

21

departments of the city of Gießen and the head of the social department, it’s changed now, also

from the administrative district of Gießen or just representatives, they have an influence on the

content of the work, so really quite concrete, and that’s also kind of exotic, and at the beginning

it was fairly difficult because it didn’t exist in the past. So politics here really intervenes with

the work IN A QUITE CONCRETE WAY’(C-E-2: 2)

The steering committee for elderly care planning is the (temporary) extension of BeKo, as it works to capture the assistance needs of the city and surrounding area, and derive policy recommendations for the city and administrative district. Collective actors sit on both committees and are often the same people: the head and administrators of the social department, the heads of the four welfare associations and the head of BeKo. Whilst the steering committee BeKo is therefore concerned with the implementation of policy that has already been resolved, the steering committee for elderly care planning is in charge of governing the formulation of future policy. The governance logic is that of negotiation in both cases, because the decisions are not reached by majority voting, but rather through settling on a result. This evaluation is also not weakened by the fact that the negotiation results in individual cases still need to be confirmed by the majority of the city delegates. For, on the one hand, the political representatives are members of the majority coalition, meaning that the implementation of the decisions can happen more easily, and on the other hand, through the involvement in the steering of the implementation, they in turn have a considerable influence on the final design of their measures (c.f. Pierre 1999).

Consequently, it also becomes clear that the governance in the two cities is concentrated in very different areas. Whilst the public actors in city A try to affect the quality and prices of the care, and thereby have to accept a significantly weaker impact on governance, the public actors in city C concentrate significantly on the area of care policy, in which with the collaboration of the welfare associations, they can expect a more direct impact. These areas are open elderly care and family care. By contrast, in the area of professionally administered care, in particular outpatient care, no discernible influence arises.

Conclusion The division into institutional and actual governance structures proposed here enables, compared to other approaches for the comparative analysis of local governance, the specific structural characteristics to be extracted. Since the elements of governance structures common to all cities are first of all identified, the influence of the higher governance levels can be ‘controlled’. The investigation of the degree of action coordination, by contrast, allows the target area and the extent of the collective action ability of the local governance structure to be assessed. Both aspects are integral to the explanation of variations in local policy.

Two cities were compared, which in terms of their contextual background and institutional governance structures were relatively similar. However, the results of the study show that the actual governance structures in the care policies of the two cities clearly vary in terms of the degree of fragmentation of the structure of actors. They also differ clearly in their ‘governing logic’, that is to say the prevalent type of action coordination.

The governance structure in city A is shaped by a plurality of actors and types of actors which are to a great extend independent to each other. Since the main mechanism of coordination is the mutual adjustment, the degree of collective action ability is low and therefore the ability to

22

policy making. In city C however the weakly including negotiation system between the local state actors and the actors of the welfare organisations exists for many years and had not been queried through the implementation of the social care insurance. The involved actors are in a stronger interdependent relationship than it can be seen in city A and concrete political aims and means can be negotiated – the degree of collective action ability is much higher than in city A. In order to be able to identify the causes for these similarities and differences, further analysis is necessary, which has not yet been completed.

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