UBC Theses and Dissertations

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UBC Theses and Dissertations

Mapping alternative systems of accountability in residential long-term care in British Columbia and Ontario Langford, Brynne Amery


Cases of abuse and neglect frequently arise in residential long-term care facilities. This thesis studies the systems of accountability within the residential long-term care sectors of British Columbia and Ontario. Using structured comparative case studies and documentary analysis it categorizes existing mechanisms of accountability into the five conceptions of accountability established by Bruce Stone. These are: parliamentary control, managerialism, judicial quasi-judicial, constituency relations and market. It then applies Richard Mulgan’s theory of accountability deficits to identify areas where the current mechanisms fail. Overall, it finds that contemporary reliance on alternative service delivery for the delivery of residential long-term care has significantly increased the need for new and different systems of accountability. The thesis then assesses how mechanisms of accountability can be adapted while maintaining a system that includes alternative service delivery. Changes will require clear definitions of the role of accountability mechanisms and emphasis on preventative mechanisms. Improving systems of accountability in long-term care is important, as there will be increased pressure on such systems from an ageing Canadian population. This thesis contributes to the Canadian public administration literature by examining the relationship between alternative service delivery and a complex hybrid accountability system.

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