January 2002
A BOOST FOR HEALTH SERVICE DELIVERY?
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Will next year's proposed elections of US-style mayors in England significantly alter the approach to policy, priorities and service delivery? To find out, Brian Baker spoke with a cross-section of directly-elected mayors and professional city and county managers in the United States

In May this year, about ten mayors will be elected to lead English towns and cities, and more will follow. The Government is encouraging authorities to introduce directly elected mayors, and polling results issued in December revealed that there is much public support for the concept. In the US, some cities have executive, or "strong"â mayors who appoint staff and run the administration, while others have a mayor within the council and a city manager to whom the staff, including most senior managers, are answerable. These are known as "weak" mayors. Professional city managers naturally favour the latter model, but most also recognise that many cities have successful executive mayors.

Local responsibilities for public and environmental health are split between cities, which have mayors, and counties, which do not. Since the September 11 terrorist attacks, several mayors have strengthened public health staffing. Mayors in the US deal extensively with state and federal government agencies, as much of the legislation is at state level - it is as the champion and advocate of the city that many excel. In major cities, the mayor is influential on regional bodies. As in the UK, these have responsibility for infrastructure and planning for the future, but are fairly weak, nomination-led bodies. In San Diego, city mayor Dick Murphy has proposed that cities and counties surrender their land-use planning powers over strategic transportation infrastructure projects to the region. Environment and conservation are prominent targets for his first four-year term, and his first "State of the city" address includes clean-up of beaches and bays, and a major switch to renewable energy. His task force aims to halve beach closures and warnings by 2004, and push through a programme of capital improvements, education, enforcement and general plan changes. In Madison, Wisconsin, clean air is a high priority for "strong" mayor Sue Bauman, who is taking steps to ensure that the city will be at the forefront in working closely with the private sector that greenhouse gas emissions are reduced. Recently, she hosted a conference with fleet operators in the area, at which experiences of alternative fuels were shared and the latest information about state grants and equipment and technology was provided. Now there is an action plan to assist fleet owners switch to alternative fuels. However, mayoral influence is not always good. In Arizona, pollution causes a visible brown cloud over the valley conurbation.

But unlike Mr Murphy, Phoenix mayor Skip Riszma, chairing a task force on regional change, is taking a cautious approach to cities giving up power over strategic policy and projects. There is fear of voter punishment if freeways are not widened, for example, while people can be tough on mayors in referenda on funds for key projects. In the US, the Business Improvement Districts (BIDs) are influential advocates. Denver Downtown Partnership chief executive, Anne Warhover says: "The BID has weighed in on issues which impact on cleanliness or safety and strongly backed a new ordnance to that effect in the city last year." In Nebraska, the Downtown Lincoln Association (DLA) manages three BIDs and basic cleaning services within them on contract from the city council. DLA chief executive, Polly McMullen, says: "The mayor has been crucial to the successes we have had in regenerating the area and partnering with the private sector." Generally, NGOs are in favour of mayors and Kevin McCarty, spokesman for Surface Transportation Project says: "We would like to see mayors given more authority over how resources are allocated locally and regionally. That would be likely to yield better decisions."

According to Radhika Sarin, head of research at Zero Population Growth, which produces the influential "Kid friendly cities" reports, "having an active mayor's office is important to creating a good quality of life. Many people, especially in the smaller cities, depend on that channel to get their voice heard on social issues. A lot of good initiatives come out of the mayors' offices, like providing good parks and creating after-school programmes." In Kansas City, Missouri, Mayor Kay Barnes lost a local tax vote for a light rail system, but other initiatives have worked. Ms Barnes' Housing Commission recommended more housing provision in the city for all income groups and proposed a target of 10,000 additional units in the central areas by 2010. Ms Barnes then set an interim target of 1,700 more homes by 2003, which is being met. With her mixed-use central city vision she is determined to use her role to increase its population after 30 years of decline. While she must keep taxes level, she has successfully boosted core services. According to Ms Barnes, "I implemented a new basic services programme called 'serviceFIRST'. This focuses on five areas of highest concern to citizens in Kansas: street maintenance, snow removal, abandoned vehicles, bulky item pick-up and illegal dumping, and storm water management. We have seen great responsiveness on the part of city staff and open lines of communications between citizens, elected officials and staff keep these issues at the forefront of everyone's priority lists."

Her new annual mayors report card reinforces this and measures performance in basic services, including tree trimming times, water quality, food inspection performance and housing condition ratings. In addition, food safety has been boosted under Ms Barnes. "In 2000, after the realisation that our health department was facing budget deficiencies which were causing cutbacks in its food safety programmes, we directed more funding for additional food inspectors to ensure they are fully staffed and operating at high levels," she says. Accountability can be enhanced by contests between competing individuals for mayor, because programmes have been clear and publicly debated. Many mayors are the only official elected city wide and their offices are accessible. "I have an open door policy and just about everybody contacts me," says Ms Bauman. Bonnie Ridley Kraft, city manager in Gresham, Oregon says: "Mayors and council members come in with a slate of promises. These have to be accomplished through paid staff. It is important that those paid staff recognise that we are here to implement those policies." In Gresham, eight senior staff are employed on executive contracts. "My goal is to hire the best people in their profession and I then want to retain them. I now have a team that thinks holistically," she says. Arizona law provides for most staff to function at the city manager's pleasure. In practice, the powers are often used sparingly. "The mayor has the power to hire and fire," says Dominique Thornton, Middletown, Connecticut's "strong" mayor. "However, I like to follow the rules. I have not sacked any senior managers yet, but I did initiate five-year contracts for the highest positions. At the end of that there is the opportunity to say thank you and goodbye." Ms Thornton won her third two-year term last November, and says that voters strongly influence priorities. "I ran on improvement to our parks and recreational areas. Subsequently, I implemented a four-year capital spending programme on them," she says. But what happens when the system produces a dud? Ms Thornton comments that "if the mayor is no good, the system will stand still. You may go backwards compared to other towns."

Despite service improvements, Ms Barnes believes that Kansas city should switch to a strong mayor system and the electorate is set to decide this year. "I believe a change to a form of government with the mayor as chief executive officer would create the opportunity for our government to be more streamlined, faster-paced and more responsive to citizens," she says. Local public health and other services are provided by counties outside the cities. Charlotte Nash, chief administrator of fast-growing Gwinnett, in Georgia, says that the population rose by 67 per cent in the 1990s. "Our biggest task is to fund the water infrastructure we need," she says. "We have to operate like a city and our chairman leads much as a mayor would." The Atlanta region is a sprawl capital in the US. In 2000, only 10 per cent of its 4.2 million people lived within the city boundaries. In the city, air quality will get worse before it gets better and infant mortality and low birth-weight rates are high. Recent surveys on congestion and child-friendly policies placed it worst of all major cities. In November, Atlantans elected Shirley Franklin, a perceived political outsider, as mayor. She takes over this month and is expected to be a good agent for change. In the US, mayoral influence is increasing as the country becomes increasingly more urbanised. But how sustainable are these urban or suburban districts? According to Ms Bauman, "the towns that surround Madison still want to allow quarter acre building plots, and do not want multi-family housing or to share in housing low income people. They still haven't woke up to climate change."

Optimistically, she believes that the end of greenfield development is in sight. Gresham is a leader in smart growth, but as Ms Ridley Kraft warns, "a lot of people are unhappy with densification policies. They want to keep their cities suburban." Lee Clancey, who chaired the Brownfields Commission of the influential US Mayors Conference, says "we must start to recycle land, but mayors and cities will need much more financial help from the Federal Government in cleaning up former industrial sites." She led the way in Cedar Rapids, Iowa, where she was mayor until this month. "We are now re-developing 30 acres of brownfield land near our downtown," she says. "If I had not initiated the activity it would never have happened. The sites had been derelict for years. I secured grants from Federal and State Government and it is now being cleaned up and developed." Ms Clancey describes the mayor's job as "a position that allows one leverage for the benefit of a community in a way which no other position can." Although the voters denied her a fourth term, they changed dramatically in her six years in charge. From a virtual standing start, the city now collects as much in recyclables as in garbage from Cedar Rapids householders. Lee Clancey lost an election, but term limits force some mayors to retire undefeated. Ms Barnes thinks this is wasteful and should only apply where an incumbent has served for more than eight years. In Denver, Anne Warhover illustrates the practical effects. Her partnership projects with the council are stalling at present. "Our mayor is term-limited and the city is not motivated," she says. Clearly an aspect of the structure to avoid here. Brian Baker is a freelance journalist and can be contacted by e-mail at bakerjournalism@aol.com

PUBLIC ATTITUDE SURVEY
Key results of a DTLR survey on public attitudes towards directly elected mayors in 10 large UK towns and cities, published on 14 December 2001, include the following points: - the majority of residents that responded to the survey believe the leading councillor of their council should be elected by the public; - a third of all residents responding in the survey would be more likely to vote in a mayoral election than in an election for their local councillor; and - over half of respondents said it was very likely that they would vote if a referendum were held to decide whether their town/city should have an elected mayor. The full report, Survey on public attitudes to directly elected mayors, can be downloaded from: www.dtlr.gov.uk or in hard copy, price £16. Tel: 01709 891318.