| Summary: | 碩士 === 中國文化大學 === 政治學研究所碩士在職專班 === 93 === As the foreign transmitted SARS case happened in March 2003, Taiwan Government had experienced the brewing, bumping, coordination, implementation and evaluation on the aspect of policy making within a short 4-month. As a result, intergovernmental relations became the limelight topic other than the SARS incident in the SARS plague. Led by the SARS incident, this paper started from the concept of intergovernmental relations, the process of public policies and the supervision concept to investigate the intergovernmental issues. Followings are three major points for the study of this paper: 1. intergovernmental interaction, 2. policy analysis, 3. the SARS incident. It is hoped that the intergovernmental interactive relations will be therefore clearly defined, and by using international experience, the intergovernmental interactive model in the national health system will be adjusted so as to find out an operation model which is more feasible without conflict.
By reviewing the references to the related studies of intergovernmental relations, this paper has concluded six study approaches. On the part of legal regulation, there are two types such as: centralization/decentralization of intergovernmental power and division of intergovernmental power. For the dimension of dynamic behavior, it includes intergovernmental vertical behavior, horizontal behavior, intergovernmental cooperation relationship and global intergovernmental theories. In terms of SARS policy, the contentions used for the policy process were referred to the three steps of policy-making, implementation and evaluation processes.
There are seven chapters for this paper described briefly below: the 1st chapter is “Introduction,” which describes the motivation, purpose, method, and structure of this study. The 2nd chapter is “the experience model and theory basis of intergovernmental relations,” it mainly investigates the categorization of research theory for intergovernmental relations and intergovernmental experience model in unitary state system and federal state system. The 3rd chapter is “the macro structure of the intergovernmental health system,” it mainly introduces the legal system and organization structure of the constitutional prescriptions and intergovernmental health system in Taiwan which is a model of unitary-state system, and analyzes the policy structure. The 4th chapter is “the interaction of policy making process,” it points out that the policy conduction is covering three major policy phases and steps as 1.the identification of legal infectious diseases, 2.the close of Hoping Hospital and 3.the institution of “the Temporary Act for the Economic Relief for SARS”, is used to respectively elucidate and investigate its design, analysis and selection of the alternatives. The 5th chapter is “the interaction of the implementation process,” it shows that the policy implementation is conducted through information communication, resource distribution, personnel disposition and operation procedures. The 6th chapter is “the interaction of the evaluation process,” it tries proceeding the evaluation of the policy indicator of SARS as well as its operation, and the assessment of the practical investigation. Finally the 7th chapter is “conclusions,” it recommends the dimensions of intergovernmental interaction and anti-SARS policy, and hopes to be used as the reference for dealing with future epidemics.
With this study, it was found that there are the following specific premises and advantageous/disadvantageous conditions. The specific premises: 1. intergovernmental relations are a unitary state system, 2. intergovernmental authorities tend to be the centralized with separated power system, 3. SARS is a crisis incident, 4. it has already had international precedents, 5. the majority party in the congress is not the ruling party, 6. partisan confrontation exists in intergovernmental relations. Regarding the advantageous conditions, there are: 1. high quality medical care groups, 2. the anti-SARS regulations are intact in general, 3. high consensus between the public and ruling/opposition parties, 4. the fundamental materials and facilities are well-established and easy for access, 5. independent and high penetrated network media. In terms of disadvantageous conditions, there are: 1. the world has not yet precisely identified the etiology and pathogenesis of SARS. 2. Taiwan is not the member of the WHO. 3. Taiwanese people are highly interacted with SARS epidemic areas.
To sum up the study, it was found that Taiwan’s intergovernmental interaction which is the governance of “layer model” according to the discourse of Janet Newman; is an “inclusive-authority model” according to the discourse of Diel S. Wright, is a “mixed corporate model” combining intergovernmental cooperation according to the aspect of John Pierre, is an “agency model” of intergovernmental relations according to the description of John Greenwood, and is a “centralist model” according to the description of Gerry Stoker. The findings illustrate that private cooperation was less involved in the intergovernmental interaction in Taiwan’s dealing of the SARS incident. It was primarily because the incident was dominated by the strongly centralized Government.
In the experience of anti-SARS, it was found that: 1. in the initial stage, there was no strong policy-leading team and intergovernmental vertical relations was confrontational, 2. there had never been any comprehensive plan, and the investments of public health were not effectively enhanced, 3. although quarantine was conducted, it was not thoroughly carried out, 4. although there was disease surveillance mechanism, it was too late in establishment and without intact and updated supervision methods, 5. although there were early case inspecting and reporting procedure, but it was slow pace and did not have early warning function, 6. although there was infectious control, the traffic-isolation planning in the hospitals was not effective, 7. the initial intergovernmental communication was vague, there was no unified spokesperson and to compound with the arbitrary reports from media, the public were not well-educated and communicated.
|
|---|
