Health Policy in Britain

by Ham, Christopher

• ISBN13: 9780230507579
• ISBN10: 0230507573
• Edition: 6th
• Format: Paperback
• Copyright: 2009-08-15
• Publisher: Red Globe Pr

Summary

The National Health Service is forever in the headlines. Critics Claim that it is in terminal decline, while advocates maintain that it is on the road to recovery following a decade of investment and reform.

Author Biography

CHRISTOPHER HAM is Professor of Health Policy and Management at the University of Birmingham, UK. He was Director of the Strategy Unit in the Department of Health between 2000 and 2004 and was awarded a CBE in 2004.

Table of Contents

List of Figures and Tables	p. xi
Acknowledgements	p. xii
Preface to the Sixth Edition	p. xiii
Abbreviations	p. xv
Introduction	p. 1
The structure of the analysis	p. 2
The Development of Health Services and Health Policy	p. 5
The origins of hospitals and medicine	p. 6
Public health Services	p. 8
Mothers and young children	p. 9
Health insurance	p. 10
Hospital services	p. 11
The establishment of the National Health Service	p. 13
The structure of the National Health Service	p. 15
The NHS between 1948 and 1974	p. 16
The reorganisation of the NHS	p. 23
The reorganised National Health Service	p. 25
Conclusion	p. 28
Health Policy under Thatcher and Major	p. 30
Increasing NHS efficiency	p. 30
Making the NHS businesslike	p. 32
Dealing with the funding crisis	p. 34
Working for Patients	p. 37
The reform of primary care and community care	p. 38
Implementing the reforms	p. 39
The Impact of the reforms	p. 43
Streamlining the structure	p. 45
Conclusion	p. 47
Health Policy under Blair and Brown	p. 49
The inheritance	p. 49
The New NHS	p. 51
The new structure	p. 53
Implementation	p. 55
The comprehensive Spending review	p. 57
The NHS Plan	p. 59
Shifting the Balance of Power	p. 61
Delivering the NHS Plan	p. 63
A return to the market?	p. 64
The NHS Improvement Plan	p. 66
The health reform programme	p. 69
Gordon Brown and the NHS Next Stage Review	p. 71
The impact of the reforms	p. 72
Conclusion	p. 75
Financing Health Services and the Rediscovery of Public Health	p. 77
The growth of NHS expenditure	p. 77
The Wanless review of the long-term funding needs of the NHS	p. 82
Raising and spending money in the NHS	p. 85
Public health and health improvement	p. 89
What has been achieved?	p. 95
Conclusion	p. 96
Policy and Priorities in the NHS	p. 98
The context	p. 98
Access and standards	p. 99
Primary care	p. 103
Pharmacy and dentistry	p. 108
Acute hospital services	p. 109
Cancer	p. 112
Heart disease and stroke	p. 114
Mental health	p. 116
Learning disabilities	p. 118
Older people	p. 119
Children's services and maternity care	p. 123
Health and social care integration	p. 124
Priority-setting	p. 126
Conclusion	p. 130
Policy-making in Westminster and Whitehall	p. 131
What is policy?	p. 131
British central government	p. 133
Parliament	p. 135
The Prime Minister and Cabinet	p. 137
Ministers, civil servants and special advisers	p. 142
Relationships between departments	p. 144
Outside interests	p. 147
Pluralism or corporatism?	p. 148
Conclusion	p. 152
Policy-making in Scotland, Wales and Northern Ireland	p. 154
Differences before devolution	p. 154
Differences after devolution: 1999-2003	p. 156
Devolution after 2004	p. 161
Comparing performance	p. 168
An assessment	p. 170
Regional government in England	p. 172
The European Union	p. 173
Conclusion	p. 174
Policy-making in the Department of Health	p. 176
The Department of Health	p. 176
The policy community	p. 180
Pressure groups	p. 183
Parliament and the mass media	p. 185
NHS bodies	p. 187
The Consultative machinery	p. 189
Ministers and civil servants	p. 190
Special advisers and the core executive	p. 193
Industrial and commercial interests	p. 195
The role of ideas	p. 198
Changes in the Department	p. 199
Conclusion	p. 205
Implementing Health Policy	p. 207
The organisation of the NHS	p. 207
The regional tier and strategic health authorities	p. 208
NHS trusts and NHS foundation trusts	p. 210
Primary care trusts	p. 212
Arm's-length bodies	p. 214
The role of the DH	p. 214
Professional influences on policy implementation	p. 221
Policy-making in NHS bodies	p. 224
The NHS today	p. 229
Conclusion	p. 231
Auditing and Evaluating Health Policy and the NHS	p. 233
The context	p. 233
Performance indicators and performance ratings	p. 235
The audit explosion and the rise of the regulators	p. 240
Evaluation by independent organisations and government	p. 246
Health improvement	p. 248
Access to health care	p. 256
Conclusion	p. 264
Power in Health Services	p. 266
Pluralist theories	p. 266
Structuralist approaches	p. 267
Marxist theories	p. 268
Concepts of health	p. 270
Power, interests and ideology	p. 273
Theories and practices	p. 275
Conclusion	p. 280
Looking Back and Looking Ahead	p. 283
How good is the NHS?	p. 283
The organisation and management of the NHS	p. 291
Hierarchies, markets and networks	p. 294
The role of politicians	p. 297
The future demand for health care	p. 299
Increasing efficiency in the NHS	p. 303
Priority-setting or rationing	p. 305
Political futures	p. 309
Conclusion	p. 312
Reflections on the Reform of the NHS: 11 Lessons for Policy-makers	p. 315
Taking stock	p. 315
Moving forward	p. 324
Guide to Further Reading	p. 327
Bibliography	p. 331
Index	p. 347
Table of Contents provided by Ingram. All Rights Reserved.

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