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  • Author or Editor: David J. Hunter x
  • Sociology of Health and Illness x
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This chapter highlights the need for partnership working, which has been a long-standing objective of health and social policy. For many years, the National Health Service (NHS) and local authorities have been attempting to deal with ‘wicked issues’. Issues such as homelessness, disaffection of young people, and the ageing society that have complex multiple causes require joined-up approaches by the statutory and third sectors at national and local levels. In 2012, at the time when Public Health responsibilities were transferred from the NHS to local authorities, health and wellbeing boards (HWBs) were established in England. With few exceptions, HWBs punch below their weight and are not the powerful system leaders that were hoped for. Evidence of their value and impact is negligible, with poor-performance indicators, and the difficulties in overcoming deep-seated departmentalism and a silo approach prevalent in government and public services, leaving ‘wicked issues’ as deep-seated as ever.

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It is impossible to understand the devastating impact of the COVID-19 virus across the UK involving significant loss of life, and the government’s much criticised response to it, without applying the lens of a sociopolitical perspective.

A substantial body of evidence exists to show that the virus has had a disproportionate impact on poor communities, and on care homes, reflecting widening health inequalities and the effects of deep public spending cuts since 2010.

This chapter explores many of the core cleavages in health policy, reflecting political and ethical tensions over the balance to be struck, and negotiated, across personal and collective responsibility, across public and private interests, and between the rights of the community and personal freedoms.

Adopting a sociopolitical perspective allows us to identify and explore a range of factors which, taken together, help explain where the government’s handling of COVID-19 has been found wanting.

Three particular policy failures, and the political choices leading up to them, are explored. These comprise the persistence of a command and control approach to handling the crisis, the policy of austerity introduced by the Coalition government in 2010, and the heavy reliance on outsourcing activities to the private sector and management consultants. An agenda for reform going forward is presented to conclude this chapter.

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