Street-level bureaucrats and policy implementation in times of crisis: evidence from Greece during the Covid-19 pandemic

Political determination for public policy is often cited as a key element in the success or failure in the implementation phase (Exadaktylos and Zahariadis, 2014). Nonetheless, beyond central coordination, implementation success or failure further depends on how people at the street-level respond to guidance and assess the implementation strategy. In times of crisis, problems of coordination, clear communication, problem tractability and resources become critical elements in facilitating or constraining street-level bureaucrats in implementing a central policy (Zahariadis, Petridou, Exadaktylos & Sparf, 2021). During the Covid-19 pandemic, a major public health crisis, policy is carried forward by doctors, nurses and other health professionals. Using a Multiple Streams lens, this paper examines how the opinions of street-level agents on the government’s response strategy feed into the success or failure of policy implementation and shape the trajectory of future policy making? The paper uses the case of Greece, projected as a success story in the fight against Covid-19. Despite long-term underfunding, many years of austerity and a negative public attitude towards government intervention, the Greek National Health System showed considerable resilience and the expertise of health professionals was used in a depoliticised way to drive policy decisions and implementation on the ground. The paper brings in new evidence from a nation-wide survey of doctors and pharmacists, evaluating the government’s response, the role of experts, and the role of the public in implementing policies in the combat against Covid-19. The main conclusions contribute to (a) understanding the effectiveness of the national health system to confront new or consecutive waves of the pandemic, (b) exploring the perceptions of street-level agents on the evolution and impact of the pandemic, (c) mapping out the evaluation of doctors and pharmacist of the National Health System, public health agencies, paramedics, experts, political actors, international organisations and the EU during the pandemic and (d) shedding light on the effect of street-level agent evaluations on past implementation and future policymaking.