How Can Government Become Responsible? Trajectories, Meanings and Intentions

• Published in: China review (Hong Kong, China : 1991) China : 1991), 2008-10, Vol.8 (2), p.1-13
• Main Author: Li, Linda Chelan
• Format: Article
• Language: English
• Subjects: Accountability; Administrative agencies; Authoritarianism; Bias; Bureaucracy; Bureaucrats; Commodification; Corruption; Democracy; Elections; Ethics; Government bureaucracy; Government officials; Health services; Hospitals; Intergovernmental relations; Local government; Medical treatment; Paradoxes; Physicians; Political discourse; Political systems; Politics; Professional ethics; Public administration; Public finance; Rural areas; Supervision; Terminology; Trajectories
• ISSN: 1680-2012

[...]in terms of substantive content, the discussion does not exhibit a structural bias in favour of either the objective or the subjective dimension of responsibility. There is no pretension that these movements towards responsible government were anything more than limited and partial. [...]as both papers similarly point out, these limited achievements in responsible government have often taken place as a side product beyond the original intention of the authoritarian state actors. The idea or pattern of responsibility ... may summarily and abstractly be defined as the idea of an agent's action as response to an action upon him in accordance with his interpretation of the latter action and with his expectation of response to his response; and all of this is in a continuing community of agents.19 As the subjective project of the earlier decades - "making everybody responsible" without much external supervision - had floundered and corruption cases escalated (which suggests the failure of the subjective efforts), the party leaders have eventually come around to the need for more vigorous objective means of responsibility, so that the once-shelved ISR received priority attention and its promulgation was expedited after more than a decade of delay. The answer is found in a combination of subjective and objective conditions: a changed perception amongst government leaders (not the public) of the expected role, and responsibility, of the government in medical care provision; cutbacks in government resources to the medical sector; the collapse of the social and administrative infrastructures, urban and rural, that had supported and financed medical care before 1970s; the subsequent development of incentive and appraisal structures in the hospitals and in local government finance that encouraged, and fed on, the commodification of medical care; and finally the weakening of the traditional professional ethics of physicians which required the provision of adequate treatment to the needy.