The Realpolitik of Evaluation: Why Demand and Supply Rarely Intersect by Markus Palenberg & Arne Paulson

Author:Markus Palenberg & Arne Paulson [Palenberg, Markus & Paulson, Arne]
Language: eng
Format: epub
ISBN: 9781000201895
Goodreads: 53371647
Publisher: Routledge
Published: 2020-10-08T00:00:00+00:00

Conclusions

The main conclusion is that, in the case of the Norwegian Coordination Reform, an intermediary organization (the RCN), working with the commissioner of the evaluation (the HOD) on the one hand, and the evaluators on the other, in many ways fulfilled its role in mediating between the two sets of actors in such a way that the potential gap in expectations between the two was reduced. Two aspects that contributed to overcome or prevent this potential gap were: 1) the organizational setup, and 2) the experience and competence of the key actors involved.

The organizational setup was characterized by the formation of an ad hoc committee, the Evaluation Steering Committee (ESC), created specifically for the evaluation of the reform, as well as by formal institutional arrangements among the main actors in the evaluation process (the ministry (HOD), the Research Council (RCN), the steering committee, and the evaluators). These institutional arrangements made the expectations to the evaluation clearer, e.g., by facilitating ongoing dialogue between the main actors.

The experience and competence part can be characterized by at least three elements. One element was that the staff of the Research Council had long experience in running large evaluations. Another element was the professional background of the members of the ESC, as well as their common orientation towards formative evaluation and utilization-focused results. A third element was the existence of close and informal networks across university departments and research institutions in public health and evaluation that also involved staff of the Research Council. This might partly be attributable to the fact that this large evaluation was undertaken in a relatively small country (Norway has a population of about 5 million).

Thus, the case shows that the way the evaluation was organized – using an external intermediary organization (RCN/ESC), and the institutional context within which it was undertaken, were important factors in preventing and overcoming gaps between the demand and supply of information in the evaluation of the Norwegian health reform program. In my view, the intermediary also served as a useful platform for critical and constructive dialogue among the HOD, the ESC, and the evaluators, given the RCN’s strong scientific reputation. I believe this dialogue contributed to raise the quality and relevance of the evaluation.

The formative aim of the evaluation was partly fulfilled: for example, the preliminary results from the evaluation were subsequently used by HOD in writing governmental policy documents about healthcare services. The main results of the evaluation, though, were not dramatic and did not initiate any huge political or public debate. In part, this may reflect a declining interest for the Coordination Reform in the face of other political priorities. Another reason may be the fact that one main policy instrument (the co-financing from local governments) was phased out.

Finally, it must be said that the hospitals did not show much interest in the reform. However, the steep increase in the elder population in Norway in the years to come will probably reactivate some of the issues brought to light by the evaluation.

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