在治理中鑲嵌民主：公民參與在公共治理的實踐與調和

<p>本書採Kingdon（1984）多政策流（multiple policy streams）的研究模式，從個案的角度進行治理與參與的嫁接。作者以臺北市政府作為一個民主實驗場域，進行個案層次的觀察，最後提出行政的化解方向。呼籲隨著公民參與作為民意納入的多元途徑，必須完整納入不同意見，才能使前端執行者依其專業能力，收斂民意形塑合理的政策方案，推動公民參與機制。行政機關也需具備選擇公民參與機制彈性，讓第一線執行單位能夠選擇公參工具的使用時機及用途。</p>

Shaping of the evidence-based substitution conceptual framework of the original medicines to generic counterparts in Ukraine

The aim. To develop conceptual framework of the strategy for a reasonable transition from original to generic medicines by complex implementation of proper bioequivalence studies and sufficient therapeutic drug monitoring management. Materials and methods. To conduct the study, we used the lists of medicines included in the state reimbursement program “Dostupny Liky” (Affordable Medicines), and materials of reports on medicines public procurement provided on the website of the Ministry of Health of Ukraine and the National Health Service of Ukraine, as well as information data on the results of studies of the quality and effectiveness of these drugs provided by the Rx-Index website. In the course of the study, the methods of logical analysis, SWOT analysis, and statistical evaluation of results, Kingdon’s Policy Streams Approach and the method of flowcharts construction were used. The concept of evidence-based medicine substitution formation in Ukraine was designed applying the Policy Streams Approach. Results. The analysis of public procurement programs for drugs for the period 2018–2020, as well as the analysis of drugs included in the new list under the “Dostupny Liky” (Affordable Medicines) program, carried out in the course of the study, showed that the level of evidence of data on assessing their effectiveness remains low. At the same time, more than 1.5 billion UAH (~ 50 mln USD) is spent annually on the purchase of such drugs and reimbursement of their cost, and the question of the optimal selection and monitoring of pharmacotherapy with these drugs remains open. A structural model has been developed, in which three basic levels are identified: provision of regulatory and financial components, executive and the level of implementation of the results. The SWOT-analysis of the strengths and weaknesses, as well as external opportunities and threats for the implementation of the conceptual framework made it possible to substantiate the advantages and reveal the possibilities of attracting clinical centers of universities and research institutions to the implementation of the concept. A framework for the interaction of a research center with health care institutions in the implementation of therapeutic drug monitoring was developed for low-income and low-middle income countries on the example of Ukraine. Distribution of responsibilities was proposed and the basic principles of interaction between performers of therapeutic drug monitoring were highlighted. Conclusions. Based on the results of the analysis of the evidence of the quality and effectiveness of drugs included in public procurement and in reimbursement programs, the key problems of organizing pharmaceutical provision of an appropriate level of quality for a number of chronic diseases requiring lifelong therapy were identified. The conceptual framework of evidence-based original medicines substitution to generic counterparts have been formed; and the ways of its implementation in the conditions of scarce financial resources on the example of Ukraine have been substantiated

The Shape of Public Governance in Taiwan: Penetrating the Boundary between Public Management and Public Policy

Despite a wealth of research on public governance and development of public administration in East Asian countries, there have been few studies of public governance in Taiwan. The articles in this symposium are empirical cases of public governance in Taiwan, in the intersection between public management and policy, covering both the central and local governments, and including both qualitative and quantitative methods, with research designs that use data that are cross-sectional, longitudinal and panel analysis. The substantive topics examined include open governance, public service motivation, management innovation, civil resistance, policy streams, and public human research management. Each paper concludes with policy and management implications.

Seventy years of the British National Health Service: problem, politics and policy streams

The British National Health Service (NHS) celebrates its 70th birthday on 5 July 2018. This paper examines this anniversary through the lens of previous anniversaries, exploring two strands of political debates and NHS documents. It draws on the basic ‘multiple streams model’ of Kingdon that argues that an issue reaches the agenda when the policy window opens to allow the coupling of three independent streams – policy, problem and politics. It is found that there appears to be some discontinuity in the problem stream; some periods of relative consensus and sharp political differences in the politics stream; and sharp variations over time in the policy stream. While it is clear that there have been both continuities and discontinuities in the problem, politics and policy streams over the past 70 years, they have rarely come together to result in a policy that has taken it off the agenda.