Almost Like a Play’: Discretion and the Health Care Innovation Working Group Emmet Collins



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Almost Like a Play’: Discretion and the Health Care Innovation Working Group
Emmet Collins1, Carleton University

Emmet.Collins@carleton.ca
Paper presented to the 2015 meeting of the Canadian Association of Programs in Public Administration, May 25-26 in Toronto, Ontario.
Draft- Do not cite without permission

Introduction


The study of federalism and intergovernmental relations has a rich history in Canadian political science. Many of Canada’s best-known political scientists have written on the topic (see for instance Simeon 1972, Smiley 1974). Despite this attention, certain aspects of federalism remain understudied in Canada. One such aspect is the role of informal relations in intergovernmental relations (IGR). Various authors have recognized that informal relations are important (Dupré 1985, Inwood et al 2011), but this is where the existing literature leaves us. As an “under-institutionalized” federation (Cameron and Simeon 2002), Canadian IGR frequently rely on ad-hoc, informal relations in order to produce work. These relations constitute a potentially important form of discretion among Canadian civil servants working in IGR. This is certainly the impression that the existing literature leaves us with.

Part of a larger work which explores the issue of informal relations in IGR, this paper uses a study of the Health Care Innovation Working Group (HCIWG or the working group) to garner a better sense of the role and importance of informal relations. Using Ostrom’s theory of Institutional Analysis and Development, I attempt to reconcile the inherently individual nature of informal relations with the broader institutional context of federalism in Canada. I argue that in the case of intergovernmental relations, contextual factors limit the space for informal relations and create major constraints on the exercise of discretion. This is not to suggest that they are unimportant, but that in the case of IGR, other factors have a significant limiting impact. Informal relations are important in creating positive work environments and in enabling rapid communication, but do not appear to have substantial policy impacts.

The paper is structured in the following way. I begin with a literature review which covers the role of informality in bureaucracies generally and within Canadian intergovernmental relations specifically. This is followed by section which defines terms and explores the theoretical framework which frames this paper: Institutional Analysis and Development (IAD). I then bring in the specific case study around which the paper is centered, the Health Care Innovation Working Group. The working group is described and analyzed from the perspective of practitioners2. Finally, the IAD framework is applied to the HCIWG, uncovering the ‘rules’ that govern informal relations in that context.


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