Abstract :
[en] Contemporary health policies constitute a real challenge in terms of collaborations, in the sense that they request cross-sectoral or cross-organisational collaborations (Clavier & Gagnon, 2013; Crosby & Bryson, 2010) as an answer to complex societal problems (Daviter, 2017). Beside this, those new policies also show an evolution in the policy piloting process as an increasing responsibility is delegated to field actors for interpreting those policy plans, strengthening the role of local communities within the production of public action (Bureau & Sainsaulieu, 2011; Dubois & Orianne, 2012; Genard, 2007). Those new health policies open the doors for the emergence of new intermediary professional roles, including the network coordinators.
With this paper, our objective is to empirically illustrate and understand those coordinators’ place and role in the Belgian forensic mental health (FMH) policy piloting and implementation processes. The FMH policy shows a clear evidence regarding this twofold trend. Six mandated local networks gathering local stakeholders were created in order to (1) organise the development of (cross-) sectoral collaborations as well as to (2) implement the policy vision at the local level. For each network two coordinators were mandated by the public federal authorities.
This paper is based on a qualitative research combining three different methods of data collection. It includes policy and network document analysis, thirty-five semi-structured interviews with stakeholders from the FMH field and fifteen observations of (federal and network) meetings. This methodology allowed us to follow the implementation and construction processes of the FMH policy plan since 2016 at different levels of action.
Our research allowed us to understand that FMH coordinators play a key role regarding the twofold trend of contemporary health policies. The paper will show that they are sorts of “reform leaders” (Denis & Van Gestel, 2015), responsible for managing the implementation process. Each coordinator is both the “delegated translator” (Thunus, 2014) of a policy plan as well as the local stakeholders’ spokesperson. Furthermore, as for middle managers and boundary spanners, they are responsible for disseminating new ideas and knowledge across organisational and sectoral boundaries (Kimble, Grenier, & Goglio-Primard, 2010; Oldenhof, Stoopendaal, & Putters, 2016; Pichault & Schoenaers, 2012; Radaelli & Sitton-Kent, 2016). Coordinators are thus “more than passive linking pins, transmitting senior manager instructions unquestioningly down the organization” (Harding et al., 2014, p.1215).
This knowledge translation and sharing allow to articulate the different stakeholders’ visions, interests and to ‘align among differences’ (Quick & Feldman, 2014). Horizontally, the coordinator draws linkages between local actors, allowing him to produce a coordinated action. Vertically, the coordinator forms the link between street-level implementation actions and formal stated policy (Gofen, 2013) and thus ensure a continuous mutual adaption between ‘what is wanted’ and ‘what is done’. In conclusion, we aim to demonstrate that the coordinator thus emerges as one of the key players of contemporary policy making and implementing processes, to whom a certain political responsibility is indirectly transferred since they directly influence the production and the structuring of the public action.
