Groups of frontline work or policy implementers are street-level bureaucrats. Often, their commitment to providing quality service and engaging in socially useful jobs is hindered by the environmental challenges they encompass, and thus it is impossible to serve clients as they have been trained. Instead, the personnel develops specific patterns of practice that aids them to deal with dynamics which may include inadequate resources and the regular high demand for the services from their clients. On some occasions, the patterns developed by the street-level bureaucrats will be under the provisions of the public policy and with what they target to achieve. Nevertheless, the routines tend to create situations that are unintended by policies implemented by the agencies, and it is not surprising to realize that the person may work against the expected objectives of their agencies and policies.
My recent encounter with a street-level bureaucrat gave me an insight into what it takes to access government services. I have been an athlete since my childhood, and recently I got a chance to compete in one of the prestigious athletic challenges in my hometown. However, after the competition, my breathing got worse, and I had to see a doctor in one of the public hospitals. I informed the doctor that I was having difficulty breathing, but he palmed me off with antibiotics and told me to go back the following week. I realized that every week had a different diagnosis which prompted me to request for an x-ray. It took the doctor several weeks to do the x-ray, and he told me not to expect to see anything on it. When the results were released, the doctor discovered that my lung had collapsed. He referred me to a lung consultant, but I was still put on the 10-week waiting list. I was in a lot of pain, and I tried my best to request the doctor to give the matter priority, but I had to wait. Finally, the consultant listened to my chest and said: “You don’t have asthma, but there seems to be a foreign body in your lung, you need a bronchoscopy.” I was surprised because at age 13 I had been diagnosed with asthma and he was giving a contradicting report. I underwent surgery, and I remember during my stay at the hospital, one of the nurses took away my oxygen mask and put it out of reach. I stopped breathing and was saved by my mum who had checked in and saw me bleeding severely, she screamed and called another nurse who attended to me. The cost of bills in the hospital was enormous and comparable to the private hospitals. It was only after being transferred to a private hospital that I regained my consciousness, and I have been cured and living a normal life.
The encounter with the state level bureaucrats was generally a negative experience. In the first instance, the doctor did not take my illness seriously and gave me antibiotics without doing any tests on my body. The doctor also kept posting diagnosis although he knew that I was undergoing a lot of pain. Although there were a lot of patients that the doctor was supposed to treat, he should have used correct judgment in such a situation. Additionally, he gave wrong results after my diagnosis, stating that I didn’t have asthma yet I had prior knowledge that I had been diagnosed with asthma since my childhood. Through poor service delivery, the health professionals caused my lung to collapse. Additionally, the nurses were also unprofessional by depriving me of oxygen supply which made me almost die. The services offered in the hospitals were below the set standards which creates the impression that access to government services was ineffective because the intention to fulfill the policies of their agencies was not fulfilled.
The street-level bureaucrats I encountered hindered public policy of their agency in several ways. First, there was a denial of quality services by the health workers. The personnel acted with negligence and did not do their best to provide quality services. The public policy of their agency requires them to ensure that all people secure good and quality healthcare. Additionally, their agency requires that they provide medically justifiable services. From the context of my encounter with the state bureaucrats, on some occasions, they gave medically unjustifiable services. For instance, the healthcare worker wrote prescriptions of antibiotics without necessarily doing a test and establishing the cause of illness before arriving at conclusions of the suspected disease. The healthcare professionals acted in uncertainty and laxity during the delivery of services.
The state-level bureaucrats did not provide equal services. All the patients should be treated equally. On the contrary, the personnel used discrimination in delivering their services by spending more time with some patients than others. Additionally, the agencies public policy of providing affordable services to all people was neglected. The costs of treatment were high was high and unaffordable. The services should be affordable especially to those who cannot access private services which have high costs implications. It is the aim of the agencies that the needy people get a platform to access care services, but that was not the case during my encounter with the healthcare workers. From the encounter, there is a significant distinction between what the service providers are supposed to do and what they are doing. Nevertheless, many factors contribute to poor service delivery.
The article helped me to understand the encounter with the street level bureaucrat. The authors clarify that the behavior of street-level bureaucrats is shaped by the nature of their work and the conditions surrounding them. The authors emphasize that for them to respond to the challenges, they come up with simplifications to reduce complexity and have control over their work and manage stress. It is through these routines that they take actions that do not correspond to the necessary policy directives. The state-level bureaucrats are also faced with a chronic shortage of resources and a relatively high demand for their services (Shafritz & Albert 417).
In public hospitals, the ratio of healthcare workers to patients is compromising. One healthcare provider is supposed to attend to many patients per day which creates unconducive environment and fatigue. In my encounter with the doctor, it is possible that the doctor was offering poor services because of the pressure from the environment and expectations from his agencies. In such situations, the healthcare provider is likely to work against the intended objectives. The street-level bureaucrats are likely to shift their decision making to where there are no clients, and this is the reason why it is common for them to transfer responsibilities to lower level officials and referring clients to other agencies leading to poor service delivery. There is also a possibility to develop procedures intended to punish clients who don’t respect their routines, and that is why the doctor kept postponing the diagnosis as a form of punishment because of the extra work he has.
The various experiences that clients encounter in their urge to access government services offered by state-level bureaucrats. One may encounter a positive experience on some occasions and a negative experience on other events. However, it essential to understand that there are so many underlying factors that contribute to service delivery which are influenced by public policies and environmental factors.
Shafritz, Jay M, and Albert C. Hyde. Classics of Public Administration. , 2017. Print.