Health Policy in Britain; The Politics and Organisation of the National Health Service; Fifth Edition

by Christopher Ham

• ISBN13: 9780333961759
• ISBN10: 0333961757
• Edition: 5th
• Format: Trade Book
• Copyright: 2004-10-15
• Publisher: Palgrave Macmillan

Summary

Systematically updated throughout, the fifth edition of this leading text provides the most up- to-date and comprehensive account available of health policy in the United Kingdom. It offers a clear and thorough introduction to the history of the NHS, its funding and priorities, and to the process of policy making. Written by a leading authority it provides a systematic assessment of changes under the Blair administration and includes two entirely new chapters on policy in Scotland, Wales and Northern Ireland after devolution and on key current issues and international comparisons.

Author Biography

Christopher Ham is Professor of Health Policy and Management, Health Services Management Centre, University of Birmingham.

Table of Contents

List of Figures and Tables	xi
Acknowledgements	xii
Preface to the Fifth Edition	xiii
Abbreviations	xiv
Introduction	1	(213)
The structure of the analysis	2	(3)
1 The Development of Health Services and Health Policy	5	(25)
The origins of hospitals and medicine	6	(1)
Public health services	7	(1)
Mothers and young children	8	(2)
Health insurance	10	(1)
Hospital services	10	(3)
The establishment of the National Health Service	13	(2)
The structure of the National Health Service	15	(1)
The NHS between 1948 and 1974	16	(6)
The reorganisation of the NHS	22	(2)
The reorganised National Health Service	24	(4)
Conclusion	28	(2)
2 Health Policy under Thatcher and Major	30	(20)
Increasing NHS efficiency	30	(2)
Making the NHS businesslike	32	(2)
Dealing with the funding crisis	34	(3)
Working for Patients	37	(1)
The reform of primary care and community care	38	(2)
Implementing the reforms	40	(4)
The impact of the reforms	44	(3)
Streamlining the structure	47	(1)
Conclusion	48	(2)
3 New Labour and the NHS	50	(23)
The inheritance	50	(3)
The new NHS	53	(2)
The new structure	55	(3)
Implementation	58	(2)
Integrated care	60	(1)
The comprehensive spending review	61	(2)
The NHS Plan	63	(2)
Shifting the Balance of Power	65	(1)
Delivering the NHS plan	66	(1)
A return to the market?	67	(3)
The impact of the reforms	70	(1)
Conclusion	71	(2)
4 Funding Health Services and Setting Priorities	73	(29)
The growth of NHS expenditure	73	(4)
The Wanless Review	77	(3)
Raising and spending money in the NHS	80	(2)
Public health and health improvement	82	(3)
Health care services	85	(8)
Health and social care integration	93	(6)
Priority-setting	99	(2)
Conclusion	101	(1)
5 Scotland, Wales and Northern Ireland	102	(11)
Differences before devolution	102	(2)
Differences after devolution	104	(5)
An assessment	109	(1)
Regional government in England	110	(1)
Conclusion	111	(2)
6 The Policy-making Process in Central Government	113	(23)
What is policy?	113	(2)
British central government	115	(1)
Parliament	116	(3)
The Prime Minister and Cabinet	119	(4)
Ministers and civil servants	123	(2)
Relationships between departments	125	(3)
Outside interests	128	(2)
Pluralism or corporatism?	130	(4)
Conclusion	134	(2)
7 Making and Changing Health Policy	136	(27)
The Department of Health	136	(4)
The policy community	140	(3)
The sources of policy inputs	143	(14)
Policy analysis in the Department	157	(1)
Back to management	158	(3)
Conclusion	161	(2)
8 Implementing Health Policy	163	(23)
The management of the NHS	163	(1)
The regional tier	164	(1)
Health authorities	165	(2)
NHS trusts	167	(1)
Primary care trusts	168	(1)
Special health authorities and other bodies	169	(1)
The role of the DH	170	(5)
Professional influences on policy implementation	175	(4)
Policy-making in NHS bodies	179	(5)
Conclusion	184	(2)
9 Auditing and Evaluating Health Policy	186	(28)
The context	186	(4)
The audit explosion	190	(9)
Health improvement	199	(6)
Access to health care	205	(8)
Conclusion	213	(1)
10 Power in Health Services	214	(15)
Pluralism	214	(1)
Structuralist approaches	215	(1)
Marxist approaches	216	(1)
Concepts of health	217	(3)
Power, interests and ideology	220	(3)
Theories and practice	223	(4)
Conclusion	227	(2)
11 Looking to the Future	229	(33)
Britain in the international context	229	(6)
Convergence in health care reform?	235	(3)
The private sector	238	(6)
Hierarchies, networks and markets	244	(3)
Changing social attitudes	247	(4)
Changing demographic patterns	251	(2)
Medical advances	253	(2)
Rationing	255	(3)
Political futures	258	(3)
Conclusion	261	(1)
Guide to Further Reading	262	(4)
Bibliography	266	(16)
Index	282