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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Political economy and public health governance: a comparative study of Hong Kong, Singapore and Taiwanfrom the 19th century to 2000s

Hui, Lai-hang., 許禮亨. January 2010 (has links)
This dissertation seeks to understand the relationships between the evolving political economies and modes of public health governance in Hong Kong, Singapore and Taiwan from the 19th century to nowadays. It is argued that from a political economy perspective, a suitable institutional set-up is important in providing political resources necessary for the evolution of public health governance. This dissertation looks specifically at political resources that include authority, legitimacy, finance and knowledge. The uneven distribution of these political resources across the polity determines the power gradient amongst different actors. Institutional set-up is also important because it governs the interaction between different actors who are in various ways dependent upon one another. From the 19th century, the polity of these three jurisdictions experienced drastic change under the banner of colonialism. The colonial governments were preoccupied with advancement of colonial interest. With the unrest in the polity, the colonial governments realised the importance of authority and knowledge in perpetuating their existence. At the same time however, the ignorance towards cultural affinity of colonial subject deprived the governments of their ability to regulate the life of the latter. The contradiction was strongly reflected in the two British colonies where there were clashes over the application of public health law and regulation. Japan, by contrast, was more able to garner authority because of her tactics to couple traditional control with modern policing. In the post-war era, the political economy of these three jurisdictions departed from one another. In Hong Kong, the colonial set-up shifts from regulatory-led to developmental-led institutional set-up. Similar tendency can be observed in Singapore and continued after her independence. Bureaucratic authority became the most available resources for government to mobilise. In strong possession of authority and finance, the government was increasingly able to introduce expansionary measures. This is accompanied by the rise of rational planning in Hong Kong and Singapore. As a result, there witnessed bureaucratisation of public health governance which shaped the dependent interactions between the authorities and citizen and the sporadic contribution from charities and overseas organisations. Taiwan departed significantly from these two jurisdictions. The inception of Kuomintang’s authoritarian regime attempted to continue the regulatory-led institutional set-up from the colonial regime in the 1950s. Whilst authority became abundant, financial resources were drained away to military project. International agents became the key actor to contribute to the functioning of public health governance. In the 1970s to 1990s, the fiscal crisis arising from exponential increase of public expenditure and the international policy discourse of deregulation led to the declining ability of tax-based direct provision of health care. There displayed a greater willingness to rely on more actors and more instruments to divest the responsibility of the government. However the negligence about the potential trade-off between authority and finance limited the dynamics of coordination between different actors. The sudden outbreak of the SARS episode in 2003 unveiled the problem of underinstitutionalisation of polity. It unsettled the role of power and authority of government as demonstrated in Singapore and unleashed the latent power of civil society in the arena of public health as seen in Hong Kong and Taiwan. It also illuminated the role of knowledge in dealing with uncertainty in an institutional set-up. / published_or_final_version / Urban Planning and Design / Doctoral / Doctor of Philosophy

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