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.
'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.
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.
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.
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. He 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.
Taking a ‘decentred’ approach to the analysis of health policy means being attentive to the historical contingencies and circumstances within which reforms are located, the influence of dominant or elite narratives in the shaping of policy, the local traditions and customary practices through which policies are mobilised, and the way local actors contest, negotiate and co-construct policy. This book offers a unique analysis of the changing landscape of healthcare reform in Britain, as an example of decentralized reforms across the developed world. The collection is framed by the recognition that healthcare reform has resulted in variegated and decentralized forms of governance. The chapters look at distinct aspects of reform within the British NHS to bring to light the influence of local histories, traditions, coalitions, and values, in the remaking of a national healthcare system. Each chapter focuses on a different aspects of reform, and in others developing cross-national and comparative analysis. However, each offers a unique contribution and analysis of contemporary theories of healthcare governance. This book will be of key interest to scholars, students and practitioners in healthcare, health and social policy, political science, and public management and governance.
This book provides the first in-depth study of healthcare reforms in post-communist Eastern Europe. Combining insights from comparative politics and public policy analysis, it examines health reforms in Slovenia, the Czech Republic, and Poland between 1989 and 2019. The book argues that the post-communist transformation of healthcare policy has entailed a process of policy learning, and that the countries' reform pathways were shaped by a series of initiatives aimed at applying market-oriented policy ideas in healthcare. The success of these initiatives has been influenced by three factors: policy legacies, political competition, and institutional configurations. The book offers a novel comparison of health reform in the region and policy changes more generally. It will appeal to scholars and students of public policy, health policy, and European politics.
This text offers an account of health reform struggles in developed democracies. It explores the ambitions and realities of health care regulation, financing and delivery across countries.
This book explores the transformation in the healthcare system in Turkey since 2003, which has been portrayed as a benchmark for building universal healthcare systems in emerging market economies. Focussing on healthcare politics in an under-researched developing country context, it fills a significant lacuna in existing scholarship. This study answers these questions: What were the political dynamics that enabled the introduction of healthcare reform in Turkey? What political conflicts did the reform generate? How and to whose benefit have these conflicts been resolved? Drawing on qualitative interviews with a diverse set of actors, Yılmaz explores the actors’ subjective interpretations of the reform, the discourses and strategies they used to influence the reform, and the changing healthcare politics scene. He demonstrates that the reform has been a complex political process within which actors negotiated whether and to what extent healthcare remains a citizenship right or a commodity. This book will appeal to students and scholars of social policy, politics, health policy, public health and sociology.
