The Dynamics of Programmatic Action: the Role of Transactional and Institutionalization Processes Over Time

The “programmatic action framework” (Bandelow, Hornung, Smyrl 2021; Hassenteufel, Genieys, 2021) provides empirical evidence on the role of small groups of individuals, sharing a similar analysis of a policy problem sustaining a common policy change program (including orientations, arguments and instruments) giving them a collective identity and acting strategically as a collective actor driving policy change. The focus on the analysis of the social construction of these programmatic groups (through positional analysis, the analysis of professional trajectories, and relational analysis) and their role in the policy process (especially the formulation of public policies and decision-making) hints their key role as drivers of policy change. But an extension of the framework seems necessary to better catch two key dimensions for the understanding of the dynamics of programmatic action over time . The first one is the analysis of the interactions between programmatic actors and other actors outside the State, especially interest groups. They can be grasped by a transactional perspective focusing on the co-construction of actors and policies through the policy process (Ansell, Hassenteufel, Zittoun, 2024). The second one is the importance of implementation in policy processes, a policy stage less taken into account in the programmatic action framework (Hornung, Hassenteufel, 2024), which can be analyzed through the role of programmatic actors in new implementation positions created by the policy change process itself. These two extensions of the programmatic action framework in order to better grasp the role of policy actors in policy change dynamics will be developed not only on a theoretical perspective, but also on two empirical cases. The first one is the transformation of primary care in France, based on the construction of an instrument constituency (Beland et Howlett 2015; Voss et Simon 2014) between an organization of general practitioners, promoting and developing new multi-professional and coordinated organizations of ambulatory care, and the French administrative programmatic elite (the “Welfare elite”). Analyzing the transaction process between these different policy actors provides key explanations of the policy change dynamics based on the reframing and the reorganization of primary care. The second, related case, is the analysis of the institutionalization of the “welfare elite”, based on the creation of new steering, expert and implementation institutions, and of the circulation of its members within an 'iron triangle', from positions in advisory institutions to implementation positions. It provides clues for the understanding of the continuity of a policy change path over time.