Policy entrepreneurs play a pivotal role in policy changes in both electoral democracies and authoritarian systems. By investigating the case of healthcare reform in Sanming City, this article illustrates how the fragmented bureaucracy in China enables and constrains local policy entrepreneurs, and how entrepreneurial manoeuvring succeeds in realigning the old institutional structures while attacking the vested interests. Both structural conditions and individual attributes are of critical importance to the success of policy entrepreneurship. Four factors and their dynamic interactions are central to local policy entrepreneurship: behavioural traits, political capital, network position and institutional framework. This study furthers theoretical discussion on policy entrepreneurship by elucidating the fluidity of interactional patterns between agent and structure in authoritarian China. The malleability of rigid institutions can be considerably increased by the active manoeuvring of entrepreneurial agents.
