LIST OF PANELS

In a post-covid era, many countries are revisiting health and social care systems with a shift in focus from technical to distributive efficiency for equity, access and resilience.  Reforms are wide reaching, from governance and financing to new models of workforce participation, role shifting and system integration.

The aim of this panel is to delve into the mechanics of health and social care systems reform, by exploring mechanisms of change across system layers.

Policy sciences have long been interested in theories of policy change in a bid to better understand the context in which reforms are charted and how they lead to desired outcomes. Several strands of scholarship focus on ‘mechanisms of change’ as the key unit underlying causal relationships through attending to the underlying building blocks of policy design and its unique implementation process and outcomes (van der Heijden et al., 2021). In contrast to realist evaluation approaches which aim to assess whether policies achieve their stated objectives within stable policy processes through theorising causation, less attention has been paid to discerning the discrete mechanisms of change which operate across the trajectory of system reform – at various levels of government and transcending locations of authority and modes of control (Tenbensel, 2020, p.117). Against the constant tinkering with policy design by government to optimise the achievement of policy goals, a mechanistic approach is an opportunity to delve into how policy reform operates through a focus on ‘realistic causation’ (Capano & Howlett, 2021, p.142) of what will occur when change is applied to policy tools and instruments wielded by government, and to account for the foreseeable, or unforeseeable, impacts or consequences of reform.

Policy change – including the design, tools and instruments used by government, interactions and relationships that shape the achievement of policy goals – is a core issue at the centre of devising effective solutions in interconnected and complex policy systems. In this panel we aim to explore how policy reform produces behavioural changes during and after implementation, such as first- and second-order changes at the individual, group and sub-system levels (Capano & Howlett 2021), to better understand the dynamics of reform involving complex assemblages of actors, institutions and organisations with disparate motivations and interests.

We aim to bring together and deepen this scholarly work to explore the potential, and the realisation of, a mechanisms of change approach to policy reform in health or social care contexts.

Capano, G., & Howlett, M. (2021). Causal logics and mechanisms in policy design: How and why adopting a mechanistic perspective can improve policy design. Public Policy and Administration, 36(2), 141-162. https://doi.org/10.1177/0952076719827068  

Tenbensel, Tim. (2020). How do governments steer health policy? A comparison of Canadian and New Zealand approaches to cost control and primary health care reform. Policy Sectors in Comparative Policy Analysis Studies. (pp.115-131) Routledge.

van der Heijden, J., Kuhlmann, J., Lindquist, E., & Wellstead, A. (2021). Have policy process scholars embraced causal mechanisms? A review of five popular frameworks. Public Policy and Administration, 36(2), 163-186. https://doi.org/10.1177/0952076718814894  

In this panel we explore health and social care system reform taking a mechanisms of change approach.

Papers should explore policy reform through a lens which focuses on identifying the mechanisms which create change. We are interested in papers which focus on the health and/or social care sectors, including (but not limited to) primary care, health system integration, mental health, disability, aged care and health equity. We are particularly interested in papers addressing the following themes:

Examples of health and policy system reform characteristic of post-Covid shifts towards allocative efficiency, equity and system integration.
Comparative approaches to policy reform involving causal mechanisms
Comparison of reform elements as way to identify, describe and explain the nature of reform and construct models to explain observable outcomes and their variance
Exploring how reform leads to behavioural changes within health or social care systems at the individual, group and sub-system levels
What opportunities does a mechanisms of change approach offer compared to other theories of change methodologies
Challenges associated with taking a mechanistic approach in complex causal chains of policy reform
We invite empirical, normative, theoretical, as well policy-in-practice papers that illuminate change mechanisms in health policy or social care contexts or to health or social care issues. 

We welcome papers from disciplines that include (but are not limited to) health or social care policy, public policy, public administration and management, interpretive policy analysis, political science, political economy and comparative public policy.