Interview schedule

This paper examines how street-level bureaucrats (SLBs) interpret and exercise discretion when implementing healthcare and immigration policies for migrants in the City of Johannesburg (CoJ), Gauteng, South Africa. Using interviews with thirty frontline workers and guided by Street-Level Bureaucracy theory and the 7-C policy implementation model, the study identifies a persistent gap between progressive legal provisions and actual practice. While most SLBs understood core health policies, limited knowledge of migration legislation, conflicting prescripts, and resource shortages shaped highly variable decision-making. Discretion produced mixed outcomes: some staff used flexibility to ensure access for vulnerable migrants, whereas others engaged in discriminatory behaviours, including overcharging, delays, and refusal of care. Analysis across the 7-C model shows that context, capacity, communication, and coordination exert the strongest influence on discretionary choices. Implementation gaps stem from policy ambiguity, inadequate oversight, socio-political pressures, and uneven institutional support, underscoring the need for clearer guidance, training, and intergovernmental collaboration.

本研究探讨南非豪登省约翰内斯堡市（City of Johannesburg, CoJ）街头官僚（street-level bureaucrats, SLBs）在针对移民群体执行医疗与移民政策时，如何解读政策并行使自由裁量权。本研究通过对三十名一线工作人员的访谈，以街头官僚理论（Street-Level Bureaucracy theory）与7-C政策执行模型（7-C policy implementation model）为分析框架，发现前瞻性法律条款与实际执行情况之间始终存在显著差距。尽管多数街头官僚能够理解核心医疗政策，但对移民立法的认知不足、相互冲突的行政指令以及资源匮乏，共同导致了决策高度差异化。自由裁量权的行使产生了混合性结果：部分工作人员通过灵活处置保障了弱势移民的服务获取渠道，而另一些则存在歧视性行为，包括超额收费、办事拖延以及拒绝提供服务。基于7-C政策执行模型的分析显示，情境、能力、沟通与协调对自由裁量选择的影响最为显著。政策执行差距源于政策模糊性、监管不足、社会政治压力以及不均衡的制度支持，这凸显了制定更清晰的政策指引、开展针对性培训以及加强政府间协作的必要性。