This book explains the politics of thirty years of ‘market reform’ in the English NHS, with the rest of the UK a counter-factual. Paton shows how each subsequent reform has been shaped by the confusion left by the previous reform. The long-term ideology has been anti-statist but policy-making at each stage of ‘reform’ has been driven by short-term politics. The outcome in England has been ever-increasing complexity in the NHS, with significantly increased management costs and no commensurate benefit.
This book provides an original analysis of the trajectory of health policy reform in the United Kingdom from the beginning of the ‘Thatcher reforms’ in the 1980s right up to the latest changes in England in 2022. Rooted in political science and health policy analysis, it tackles key arguments around the ‘new integration’ of the NHS since 2015, what the new and emerging NHS structure represents, the UK’s poor response to the Covid-19 crisis, and the future threat to a comprehensive public NHS. It includes significant new material on what has happened since 2015, such as the politics of the Covid-19 pandemic, the effects of Brexit, and the conundrum of ‘social care’. The book is a scholarly and polemical analysis from an expert who has studied the politics of health services for more than forty years. It will be a key resource for students, academics and policy makers.
Systematically updated throughout, the 6th edition of this leading text takes the story of health policy to the end of the Blair era and into the early years of the Brown premiership. It offers a clear and thorough introduction to the history of the NHS, its funding and priorities, and to the process of policy making.
'Christopher Ham's book provides an historical and theoretical introduction to the making, implementation and evaluation of health policy in Britain. It has been completely revised throughout for this third edition with new chapters added on the current health service reforms and key issues for the future of health policy setting the British situation in an international context. 'It is hard to find a better basic textbook about health policy in Britain for students with little existing knowledge. However, it can also be highly recommended for readers who work in the NHS, but want to make more sense of the often confusing web of policies and imperatives. This book manages to synthesise a mass of material in a readable form, and enlightens as well as informs.' Public Health.
In this timely and unique work, Calum Paton assesses the political economy and politics of current health policy in order to explain the underlying causes of problems in the National Health Service. Debates from political theory, political economy and public administration are used to examine health policy made and implemented by New Labour since their election victory in 1997. The author argues that the fundamental nature of health policy is dependent upon the prevailing regime in political economy and also that 'policy overload', contradictions and confusion have rendered the task of coherent implementation very difficult. Although there is implicit comparison, the primary focus is England within the UK (post-devolution), and the book provides a detailed examination of contemporary health policy. Written by an established scholar in the field, it will particularly interest academics, post-graduate students and professionals in health policy, social policy and politics.
This book provides an in-depth analysis of the NHS reforms ushered in by UK Coalition Government under the 2012 Health and Social Care Act, arguably the most extensive reforms ever introduced in the NHS. Contributions from leading researchers from the UK, the US and New Zealand examine the reforms in the contexts of national health policy, commissioning and service provision, governance and others. Collectively, the chapters presents a broader assessment of the trajectory of health reforms in the context of marketisation, the rise of health consumerism and the revelation of medical scandals. This is essential reading for those studying the NHS, those who work in it, and those who seek to gain a better understanding of this key public service.
Focusing on the British NHS, this book reviews some of the key contemporary debates concerning health systems and how they have shaped the way that health care has, and is, evolving.
'The New Politics of the NHS' is not a history of the NHS. It concentrates on those issues that seem best to illuminate the analytic themes and to provide the most insight into political processes.
Politicians have talked endlessly about the seismic economic and social impacts of the recent financial crisis, but many continue to ignore its disastrous effects on human health—and have even exacerbated them, by adopting harsh austerity measures and cutting key social programs at a time when constituents need them most. The result, as pioneering public health experts David Stuckler and Sanjay Basu reveal in this provocative book, is that many countries have turned their recessions into veritable epidemics, ruining or extinguishing thousands of lives in a misguided attempt to balance budgets and shore up financial markets. Yet sound alternative policies could instead help improve economies and protect public health at the same time. In The Body Economic, Stuckler and Basu mine data from around the globe and throughout history to show how government policy becomes a matter of life and death during financial crises. In a series of historical case studies stretching from 1930s America, to Russia and Indonesia in the 1990s, to present-day Greece, Britain, Spain, and the U.S., Stuckler and Basu reveal that governmental mismanagement of financial strife has resulted in a grim array of human tragedies, from suicides to HIV infections. Yet people can and do stay healthy, and even get healthier, during downturns. During the Great Depression, U.S. deaths actually plummeted, and today Iceland, Norway, and Japan are happier and healthier than ever, proof that public wellbeing need not be sacrificed for fiscal health. Full of shocking and counterintuitive revelations and bold policy recommendations, The Body Economic offers an alternative to austerity—one that will prevent widespread suffering, both now and in the future.
This book represents the first comparative study of how health policy is made in leading industrial nations. Using detailed case histories of the UK, the US and Germany, it shows that health care systems and modern states are indissolubly bound together. The author explains how the health care state originated before the rise of democracy, and demonstrates that it has had to confront the twin pressures of democratic politics and competitive capitalism. It focuses on three important arenas of health care politics--the government of consumption, the government of doctors, and the government of medical technology--and illustrates how these three arenas intersect.
