Beryl Radin was in employment with the HHS (“Department of Health and Human Services”) and she served there for two times. In her book, “The Accountable Juggler: the art of Leadership in a Federal Agency”, Radin narrates about how NHS suits itself into the encompassing political world. Applying an imaginary NHS secretary who is gearing up for his turn of confirmation hearings as a storyline mechanism, Radin vividly portrays that responsibility confronts that come in the way of administering NHS which has more than 60000 staffs who manage more than 305 programs and with an annual budget of more than $ 400 billion.
With help of her past experience, she tries to illustrate the frequent inner workings of American government. Through her book, Radin tries to illustrate how public administration reforms perused by American government have not brought the estimated results at federal level. According to Radin, NHS has more than 300 schemes and top executives have to deal with varied issues and cultures. Thus, secretary of NHS cannot make changes employing hid command – and –control systems.
Some of the NHS schemes have clear transparency in their goals and some other NHS schemes involve goals in which there are no clear cut views on the exact method to solve them. Radin’s book deals with vignettes of individuals who concern about performance, but their work is humiliated by the standards that are employed by demands of performance. There are many occasions where government employees are held responsible for schemes over which they do not have command.
In her book, Radin visualizes accountability as a restriction which comes in the way of secretary of NHS handling fiscal, legal, political, and professional. The accountability is not uniform in nature within the different categories of employees but differs on the programs and people within NHS. When one regard the breadth of NHS policy portfolio, the complexity of management and accountability challenges will become visible. Administration of NHS program is more diversified as the top manager i. e. secretary of NHS has to administer Medicaid and Medicare, the Administration on Aging and the Food and Drug Administration.
The simile “jugglery” connotes to the art of keeping in air various main policies of NHS department and political pressures that must be managed for the smooth administration of NHS. The intergovernmental and interagency policies are likely to be juggled at the policy implementation stage. Different policy instruments right from array of various kinds of monetary grants to local governments and nonprofits to the direct extension of services are also being juggled by NHS.
Depending upon the culture of the units involved, the policy relationships will be varying. For instance, the culture at the Centers of Medicaid and Medicare will be different from that of the cultures of the Food and Drug Administration or scientific and medical culture at the Center for Diseases Control Radin says that juggling demand equal dexterity on the political side as NHS has to cater the demands from the various interest groups like Congress and the White House.
To cater the needs of these groups will be more demanding. For instance, NHS has to submit exhaustive budget details, to assist in drafting legislation, to reauthorize programs like Head Start and to testify at oversight hearings. Thus, Radin explains that a NHS secretary has more onerous duty by not offending important interests of the US government and to carry out his duty and administer his department with sole aim of fulfilling U. S president’s agenda.