In recent years the pace of reform in health policy and the NHS has been relentless. But how are policies formed and implemented? This fully updated edition of a bestselling book explores the processes and institutions that make health policy, examining what constitutes health policy, where power lies, and what changes could be made to improve the quality of health policy making. Drawing on original research by the author over many years, and a wide range of secondary sources, the book examines the role of various institutions in the formation and implementation of health policy. Unlike most standard texts, it considers the impact of devolution in the UK and the role of European and international institutions and fills a need for an up-to-date overview of this fast-moving area. It features new case studies to illustrate how policy has evolved and developed in recent years. This new edition has been fully updated to reflect policies under the later years of New Labour and the Coalition government. Although written particularly with the needs of students and tutors in mind, this accessible textbook will also appeal to policy makers and practitioners in the health policy field.
Healthpolicy under labour
This chapter brings together the analysis from other chapters of this
book to consider healthpolicy since 1997, when Tony Blair’s Labour
government was elected. It takes the account of healthpolicy and
organisation through to the end of 2007, shortly after Blair retired as
Prime Minister and Gordon Brown took over.
the context of healthpolicy in 1997
During the 1997 election, Labour campaigned to ‘save the NHS’, but
its approach to welfare policy during its first term in office faced a
This chapter clarifies the meaning of healthpolicy. It also reviews conceptual
frameworks that are useful in the study of healthpolicy.
The task of defining healthpolicy is difficult, largely because both ‘health’
and ‘policy’ are open to different interpretations.
Health can be interpreted in different ways (Aggleton, 1990; Blaxter, 2004).
In a narrow, negative sense it can mean the absence of disease or illness. This
conventional biomedical approach interprets health as a state of normality
Parliament and healthpolicy
This chapter looks at the impact of Parliament on healthpolicy. It begins with a
discussion of the health interests of MPs, and then moves on to analyse the role
and function of the House of Commons in relation to healthpolicy. This is followed
by an examination of the role of the House of Lords.
Over 30 years ago, Ingle and Tether (1981) argued that Parliament had
minimal influence over healthpolicy. They argued that Parliament was
largely powerless when faced with a majority government, and that the
Partnerships and healthpolicy
This chapter explores the role of other organisations and stakeholders involved in
the implementation of healthpolicy. It discusses key players and their involvement
in health and care provision: local government, the private sector, the voluntary
sector, and communities and citizens. It also focuses on partnership working and
efforts to improve collaboration in this field.
Healthpolicy is not a matter for the NHS alone. The implementation of
healthpolicies depends heavily on other organisations that provide health
Are there bases for evidence-based healthpolicy in Switzerland? Factors influencing the
extent of evaluation activity in healthpolicy in
the Swiss cantons
This paper aims at explaining the extent of evaluation activity in Swiss cantonal healthpolicy. It
is a quantitative analysis of determinants that promote evaluation. For the first time, it draws
together data on the frequency of healthpolicy evaluations in the Swiss cantons, shows the
results of bi- and multivariate analysis and interprets them based on policy analysis
Party politics and healthpolicy
This chapter explores the role of political parties in relation to healthpolicy, focusing
primarily on England (Chapter Nine considers party politics elsewhere in the UK in
the context of devolution). It explores the salience of health issues in party politics,
then goes on to examine the impact of party politics on healthpolicy since the
creation of the NHS.
As noted in Chapter One, parties are important political institutions that
can shape policy. However, there is disagreement about the extent of their
Policy networks and
The healthpolicy arena is host to a range of representative organisations (such
as professional groups and trade unions), campaigning organisations, think tanks,
research bodies, commercial organisations, voluntary groups and charities. It also
includes individual experts, researchers and campaigners. This chapter examines
their interaction with governing institutions within healthpolicy networks, their
strategies and tactics, and discusses those factors that enable them to exert influence