The New Politics of the NHS has become established over 30 years as the key overview of the NHS, its processes and paths of influence. The seventh edition remains a clear, easy-to-read guide to often complex debates. It encompasses both the background of the evolution of the NHS since its foundation, and a completely up-to-date picture of its present and future in a more pluralistic - and possibly more financially austere - era in which deference to medical expertise is eroding and information on health and care is far more widely available. It includes entirely new material on events since the turn of the millennium, the Blair administration, the 2010 General Election, the impact of the Coalition Government and strategies for coping with a new, much harsher economic environment. Assuming no prior knowledge of NHS politics and systems, The New Politics of the NHS focuses on management, structure, centralisation, funding, economic performance, challenges, current party political debates, interest groups and rationing, and also on the NHS's institutional and cultural continuity as a tax-funded service providing comprehensive, universal health care free at the point of delivery. It is a vital update for all health care professionals, NHS managers, policy-makers and shapers, and those in special interest groups including patient advocacy organisations. It is essential reading for anyone interested in understanding current controversies. 'Edition-by-edition, the perspective shaping the analysis has shifted somewhat as new questions have come to the surface. However, the book remains structured around themes and preoccupations that have organised the text from the beginning and continue to do so. It is shaped, above all, by the assumption that the NHS (and the wider health care policy arena) can be seen as a laboratory for a whole range of social, institutional and organisational experiments with implications for other areas of policy and perhaps other countries as well.' Rudolf Klein, in the Preface
Table of Contents
Preface. Acknowledgements. The politics of creation. The emerging consensus. The curtain goes up. Coalition compromises. Private negotiation into public controversy. Whose victory was it? References. The politics of consolidation. Infinite demands, finite means. Whatever is best administered is best. Centre-periphery relations: the circle refuses to be squared. The pattern of inequalities. Professional influence and public power. Agenda for the future. References. The politics of technocratic change. Growing scarcity in an era of growth. Planning and rationing. National policy and medical decisions. In search of an organisational fix. References. The politics of disillusionment. The politics of economic crisis: the NHS in a new environment. The exploding health care policy arena. The politics of ideological confrontation: a case study. The politics of organisational stasis. Back to the drawing board: the consensus under challenge. References. The politics of value for money. The changing environment. Political v. financial constraints. The return to centralisation. The new managerialism. A drift to privatisation? Controlling the gatekeepers. References. The politics of the big bang. A dialogue of the deaf. Reviewing the options. An explosion of opposition. General practitioners on the rampage. Implementation as learning. New themes in the health policy arena. A new hierarchy of command. The Conservative legacy. References. The politics of The Third Way. The Third Way. New Labour in office. Strategy for the NHS. Regulating the medical profession. Resources, rationing and crisis. Commanding but not controlling? References. The politics of reinvention. Economic success, political victory. The great transformation. Present needs, future demands. Managing the performance of the NHS. The implementation gap. Enter the regulators. Changing the money flows. Balancing voice and choice. The private sector to the rescue. The State and the profession. Reorganising yet again. Beyond the Department of Health. The Blair legacy. References. The politics of transition. Interpreting the Brown oracle. A pandemic of visions. Towards the fiscal ice age? A new management and a new agenda. The NHS and the people. Scarcity among plenty. Dropped bedpans - yet again. Performance, perceptions and expectations. Conflict within consensus - yet again. References. The politics of confrontation. From church to garage. Policy making in an international context. The future: unfinished business. References. Index.