De Castro Silveira Coelho, Carlos Miguel (2007)
Ph.D. thesis, University of Birmingham.
This thesis examines the theoretical and empirical relationship between modes of governance and public service efficiency. We argue that different modes of governance yield different levels of efficiency depending on the nature and scale of the transactions upon which they are deployed. The experience of OECD countries is used to examine the effects of different modes of governance on the efficiency of education, health, and social protection systems. In the education sector, the share of public providers is found to exert a negative effect on efficiency whereas the degree of decentralisation of the decision-making procedures of public providers is found to exert a positive effect on efficiency. In the health sector, the introduction of market-type mechanisms to public integrated health systems is shown to have positive effects on efficiency, whereas further movement towards a market model of health care insurance and provision is shown to depress efficiency. In the social protection sector, we conclude that as public social security systems exceed their remit to assist individuals smooth their income across the life cycle and/or states of nature and to provide basic social safety nets to the destitute, the efficiency of social transfers in reducing poverty is damaged.
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