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.
209 nine Health policy under labour introduction This chapter brings together the analysis from other chapters of this book to consider health policy since 1997, when Tony Blair’s Labour government was elected. It takes the account of health policy and organisation through to the end of 2007, shortly after Blair retired as Prime Minister and Gordon Brown took over. the context of health policy 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 significant problem
Analysing health policy Overview This chapter clarifies the meaning of health policy. It also reviews conceptual frameworks that are useful in the study of health policy. Health policy The task of defining health policy 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 disrupted by
Parliament and health policy Overview This chapter looks at the impact of Parliament on health policy. 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 health policy. 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 health policy. They argued that Parliament was largely powerless when faced with a majority government, and that the House of
Partnerships and health policy Overview This chapter explores the role of other organisations and stakeholders involved in the implementation of health policy. 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. Health policy is not a matter for the NHS alone. The implementation of health policies depends heavily on other organisations that provide health
Policy & Politics vol 31 no 4 303 Key words: discourse • New Labour • health policy © The Policy Press, 2004 • ISSN 0305 5736 Policy & Politics v 32 n 3 303–16 The three moments of New Labour’s health policy discourse Ian Greener English This article examines the three ‘moments’ of health policy discourse under New Labour. It contends that, since 1997, there have been two significant changes: the first from an initially very Fabian rhetoric to one based instead around performance measurement and investment, and the second adding a new version ‘internal
333 Are there bases for evidence-based health policy in Switzerland? Factors influencing the extent of evaluation activity in health policy in the Swiss cantons Andreas Balthasar This paper aims at explaining the extent of evaluation activity in Swiss cantonal health policy. It is a quantitative analysis of determinants that promote evaluation. For the first time, it draws together data on the frequency of health policy evaluations in the Swiss cantons, shows the results of bi- and multivariate analysis and interprets them based on policy analysis
two Party politics and health policy Overview This chapter explores the role of political parties in relation to health policy, 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 health policy 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 health policy Overview The health policy 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 health policy networks, their strategies and tactics, and discusses those factors that enable them to exert influence over health policy
