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
| Identifer | oai:union.ndltd.org:HKU/oai:hub.hku.hk:10722/180061 |
| Date | January 2010 |
| Creators | Hui, Lai-hang., 許禮亨. |
| Contributors | Ng, MK |
| Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
| Source Sets | Hong Kong University Theses |
| Language | English |
| Detected Language | English |
| Type | PG_Thesis |
| Source | http://hub.hku.hk/bib/B47299551 |
| Rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works., Creative Commons: Attribution 3.0 Hong Kong License |
| Relation | HKU Theses Online (HKUTO) |
Page generated in 0.0022 seconds