DOCSLIB.ORG

Redalyc.British Social Policy: the Case of Health Policy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Redalyc.British Social Policy: the Case of Health Policy Argumentum E-ISSN: 2176-9575 [email protected] Universidade Federal do Espírito Santo Brasil BYWATERS, Paul British social policy: the case of health policy Argumentum, vol. 3, núm. 2, julio-diciembre, 2011, pp. 190-210 Universidade Federal do Espírito Santo Vitória, Brasil Available in: http://www.redalyc.org/articulo.oa?id=475547533012 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Paul Bywaters ARTIGO British social policy: the case of health policy1 A política social britânica: o caso da política de saúde Paul BYWATERS2 Abstract: This paper is about the targeting of the UK health service by private international health care corporations who want to get their hands on the £200b annual budget and the collusion in that project by successive governments, including the present administration led by David Cameron which is the most ideologically driven government that we have had in the UK in my lifetime – more radical in their dismantling of our welfare state than Margaret Thatcher in the 1980s but building upon her legacy. It is a tale about neo-liberalism, about the power of global business interests, about privatisation, about reducing the role of the state, and about a weak democracy. And so it is a cautionary tale about progress – even when affordable universal health care has been secured, it is not immune from attack and from being reversed. Keywords: Health policy. UK. Social policy. RESUMO: Este trabalho aborda as medidas direcionadas ao serviço de saúde do Reino Unido por empresas internacionais de saúde, que querem colocar as mãos no orçamento anual de £200 bilhões e na conspiração desse projeto que vem de sucessivos governos. Isso inclui a atual administração de David Cameron, que é o governo mais ideologicamente impulsionado que tivemos em toda minha vida — mais radical em desmantelar nosso estado de bem-estar social que Margaret Thatcher na década de 1980, mas que é baseado no legado desta última. Trata-se de um texto sobre o neoliberalismo; sobre o poder dos interesses empresariais globais; sobre a privatização; sobre a redução do papel do Estado e sobre uma democracia fraca. Trata-se também de uma advertência sobre o progresso — mesmo quando cuidados de saúde universais e acessíveis são garantidos, eles não são imunes à reversão. Palavras-chave: Política de Saúde. Reino Unido. Política Social. Submetido: 21/7/2011 Aceito: 2/9/2011 1 Partes dessas reflexões foram apresentadas no 6° Encontro Nacional de Política Social em Vitória (ES) entre os dias 28 e 30 de setembro de 2011. 2 Emeritus Professor of Social Work, Coventry University, and Honorary Professor, University of Warwick (UK) E-mail: <[email protected]>. 190 Argumentum, Vitória (ES), v. 3, n.2,p. 190-210, jul./dez. 2011 British social policy: the case of health policy Introduction the world is trying to move towards universal health coverage, in England our government is pushing through he WHO World Health Report policy changes which will end universal for 2010, published last equality of access, increase costs and December, was entitled ‘Health reduce the quality of our health care Systems Financing: The Path to system. How can this be? Universal Coverage’. T So this paper is about the targeting of the It acknowledged what the Commission UK health service by private on the Social Determinants of Health international health care corporations had said in 2008, that the circumstances who want to get their hands on the in which people grow, live, work, and £200b annual budget and the collusion in age - education, housing, food and that project by successive governments, employment and the distribution of including the present administration led power in societies - are the most by David Cameron which is the most significant influences on how people live ideologically driven government that we and die. But timely access to health have had in the UK in my lifetime – services a mix of promotion, prevention, more radical in their dismantling of our treatment and rehabilitation – is also welfare state than Margaret Thatcher in critical. the 1980s but building upon her legacy. ‘Recognizing this, Member States of the It is a tale about neo-liberalism, about World Health Organization (WHO) the power of global business interests, committed in 2005 to develop their about privatisation, about reducing the health financing systems so that all role of the state, and about a weak people have access to services and do democracy. And so it is a cautionary tale not suffer financial hardship paying for about progress – even when affordable them.’ (Executive Summary 2010) universal health care has been secured, it is not immune from attack and from But as I started to write this paper in late being reversed. July I received an email. It was a report of a newspaper article in the Daily How does the NHS Work? Telegraph, a leading serious, right wing national newspaper in the UK, under the Let me go back a step or two to explain headline. ‘The day they signed the death to you what has been happening in the warrant for the NHS’ - the English UK. In a sense the English National National Health Service. I suspect that Health Service is the story of my life. The you will have heard much more about birth of the NHS came in 1948, the year President Obama’s struggle to improve before I was born. And the NHS was health coverage in the USA, but there is founded on two key pillars. It gives also a profound fight in the UK to try to everyone access to comprehensive health save our national health service. While 191 Argumentum, Vitória (ES), v. 3, n.2,p. 190-210, jul./dez. 2011 Paul Bywaters care that is ‘free at the point of delivery’ an expert in the aspect of medicine that – when you go to see a doctor or a nurse is relevant. or go to hospital you do not have to pay You cannot usually go directly to a anything. And the second pillar is that hospital to see a specialist doctor unless health care is paid for out of general you have an accident or are suddenly taxation. The UK does not have an taken seriously ill. In that case you can insurance based scheme, we pay our go directly to an Accident and national taxes, and some of the money is Emergency Department in a hospital and used to pay for the NHS. And with tiny get emergency treatment. exceptions, there are no co-payments. All of this is free – no money changes When a doctor recommends that you hands between you as a patient and any take medicine or drugs you have to pay of these services and effectively the a prescription charge but this is less than doctors prescribing treatment have no £10 per go and many groups – personal interest in the cost of the pensioners, the unemployed, pregnant treatments they prescribe – they cannot women – are exempt. make more money be prescribing one form of treatment, one drug rather than At the moment, the English health another, although there are some general service works like this from the patients’ controls on this to prevent waste. And so perspective. Virtually everyone is patients can trust their doctors not to be registered with a small group of primary acting out of personal gain. care doctors, what we call General Practitioners, GPs. If you are feeling ill, There is a relatively small market in or need a vaccination or other preventive private health insurance in the UK which treatment, you simply make an is complementary to the state provision, appointment with your GP and usually buying faster access to specialist care, or see them the same day. GPs are based choice of private care provider. locally – mine is about half a mile away from where I live – and grouped in However, by 2006 only 1% of total health surgeries or clinics, usually half a dozen expenditure went on private health or so doctors with some nurses and insurance with only 10% of the other health professionals and population having some complementary administrative staff. Numerically, the private health insurance (Thomson and vast majority of health concerns for Mossialos 2009). And a larger group of which the health service is consulted are people will sometimes use private health dealt with by GPs. Some investigations – care services, paying for the care blood tests, for example – will also be themselves without insurance. done through the GP. But if you need more specialist care the GP will refer you By contrast social care – care services for to an NHS hospital where you will see adults who are disabled or with learning disabilities, and care services for older 192 Argumentum, Vitória (ES), v. 3, n.2,p. 190-210, jul./dez. 2011 British social policy: the case of health policy people who are no longer able to look developed countries. It was particularly after themselves without help because effective at making access to health care they are frail or suffering from dementia, independent of how wealthy you are for example – including services (Schoen et al 2010). As Table 1 shows, provided through social workers, are this is reflected in exceptionally high mostly not free in England and are run levels of adult confidence in the NHS. in through a completely different system The UK was the only country in which to the NHS. These services are heavily more than 90% of the adults surveyed rationed in two main ways: first you said that they were conifdent that if they have to be assessed as sufficiently in were seriously ill they would receive the need to be eligible for a service, and most effective health care including secondly, any services that are provided drugs and diagnostic tests and that they through the state are means tested.
Load more

Recommended publications
  • A National Health Service: the British White Paper
    posals were not carried into effect. A National Health Service: The British Sixteen years later similar proposals were made by a Voluntary Hospitals White Paper* Commission established by the Brit• ish Hospitals Association under the THE BRITISH WHITE PAPER on a Na• Health Insurance was enacted in chairmanship of Lord Sankey. tional Health Service was made pub• 1911; shortly after medical benefits lic on February 17. In it the Minister became payable it was recognized One of the most complete official of Health and the Secretary of State that there was a strong case for add• surveys of Scottish health services for Scotland recommend the estab• ing consultant services to the general and health problems ever attempted lishment of a National Health Service practitioner services provided. In was published in 1936 in the Cathcart "which will provide for everyone all 1920, a Consultative Council on Med• report of the Committee on Scottish the medical advice, treatment and ical and Allied Services, appointed by Health Services. Their recommenda• care they may require." The pro• the Minister of Health, with Lord tions assume throughout that the posals are offered at this time for dis• Dawson of Penn as chairman, re• separate medical services must be cussion in Parliament and in the ported and recommended a compre• integrated and that the coordinated country but not as fixed decisions. hensive scheme under which all forms medical service should be based, as "The Government will welcome con• of medical service would be made far as possible, on the family doctor. structive criticism and they hope that available, under suitable conditions, The latest official report on hospital the next stage—the stage of consul• to the population at large.
    [Show full text]
  • Devolution V2.3
    Is Devolution Creating Diversity in Education and Health? A report on Health and Education Policy and Performance in Wales and Scotland. Prof Colin Talbot, Dr Carole Johnson and Mark Freestone Commissioned by the BBC (World This Weekend, Radio 4) 1 of 29 Is Devolution Creating Diversity in Education and Health? A report on Health and Education Policy and Performance in Wales and Scotland. Prof. Colin Talbot, Dr Carole Johnson and Mark Freestone Nottingham Policy Centre University of Nottingham August 2004 Commissioned by the BBC (World This Weekend, Radio 4) 2 of 29 1 Summary This research was carried out in August 2004 for the BBC. We have simply collated and analysed existing information about the new devolved governments of Wales and Scotland in the fields of health and education. We have focussed on inputs (what is being spent), policies and results. This is not meant to be a comprehensive analysis but has focussed on noteworthy issues of difference and divergence. A surprising amount of change is taking place (especially in health), given initial scepticism about just how ‘devolved’ the new institutions would be. But also a great deal remains the same – the underlying educational and especially health problems in Wales and Scotland have not (yet) dramatically improved and in some areas have gotten markedly worse (e.g. waiting list problems in Wales). Here we provide a simple summary of what we have found so far in gathering and analysing what evidence is available on the policies and performance of the new devolved administrations in the field of health and education.
    [Show full text]
  • The Four Health Systems of the United Kingdom: How Do They Compare?
    The four health systems of the United Kingdom: how do they compare? Gwyn Bevan, Marina Karanikolos, Jo Exley, Ellen Nolte, Sheelah Connolly and Nicholas Mays Source report April 2014 About this research This report is the fourth in a series dating back to 1999 which looks at how the publicly financed health care systems in the four countries of the UK have fared before and after devolution. The report was commissioned jointly by The Health Foundation and the Nuffield Trust. The research team was led by Nicholas Mays at the London School of Hygiene and Tropical Medicine. The research looks at how the four national health systems compare and how they have performed in terms of quality and productivity before and after devolution. The research also examines performance in North East England, which is acknowledged to be the region that is most comparable to Wales, Scotland and Northern Ireland in terms of socioeconomic and other indicators. This report, along with an accompanying summary report, data appendices, digital outputs and a short report on the history of devolution (to be published later in 2014), are available to download free of charge at www.nuffieldtrust.org.uk/compare-uk-health www.health.org.uk/compareUKhealth. Acknowledgements We are grateful: to government statisticians in the four countries for guidance on sources of data, highlighting problems of comparability and for checking the data we have used; for comments on the draft report from anonymous referees and from Vernon Bogdanor, Alec Morton and Laura Schang; and for guidance on national clinical audits from Nick Black and on nursing data from Jim Buchan.
    [Show full text]
  • Lack of Transparency Puts Health Service at Risk
    May 2012 Lack of transparency puts health service at risk By Roger Kline Some politicians appear more concerned with risks to their own power and careers than with the risks faced by the users of public services for which Public World associate they are responsible. How else to explain the British government’s refusal to Roger Kline is a prominent advocate of comply with a demand from the official Information Commissioner to publish transparency in public the risk assessment prepared by its own civil servants about its National services, an advisor to the Health Service (NHS) reforms? chief executive of Public The Conservative government under Prime Minister David Cameron came to Concern at Work and co- author of an important power two years ago promising no fundamental reforms of the NHS. But new book on the Cameron appointed as Secretary of State for Health a politician, Andrew professional public Lansley, who had long been planning to introduce market reforms, and so he servant’s ‘duty of care’. did. Here he challenges the Those plans have now become law amid widespread fears -- and growing British government to evidence -- that the result will be NHS privatisation and poorer health comply with the demand outcomes for many patients. If the outcome of the risk assessment carried of the country’s official out by civil servants suggests otherwise the government could allay those Information Commissioner fears by publishing their report, as Britain’s Information Commissioner has and publish the risk said it should. An independent tribunal confirmed the demand last month assessment carried out by after the government said it would not publish the ‘Risk Register’, as the civil servants about its assessment it is obliged to conduct is officially termed.
    [Show full text]
  • The Middlesex Hospital Orthopaedic Department 1920 – 2005 the 85
    The Middlesex Hospital Orthopaedic Department 1920 – 2005 The 85 years 1 Contents 1. Charles Bell (1774-1842) The Middlesex Hospital Sean Hughes Medical School 2. A Brief Overview of The Middlesex Hospital 1745 – Michael Edgar 2005 3. Blundell Bankart (1879 –1951) Roger Emery 4. Phillip Wiles (1899 – 1967) A. Total Hip Replacement James Scott B. Contribution to Scoliosis Surgery Michael Edgar 5. Phillip Newman (1912 – 1994) A. Sir Winston Churchill’s Hip Fracture: Liam Mcloughlin The Middlesex Hospital June 1962 B. Spinal Surgery Michael Edgar 6. Rodney Sweetnam (1927 – 2013) Michael Benson 7. Nursing in The Middlesex Orthopaedic Department Fiona Hamblin 8. The Athletes’ Clinic Fares Haddad Michael Edgar Reflections on being a Registrar in the Patrick Boland Athletes’ Clinic 9. The Last Fifteen years of The Middlesex Orthopaedic Department 1991 – 1996 Michael Edgar 1995 – 2005 Justin Cobb 10. The Middlesex in Africa Chris Lavy 11. The Contributions of The Middlesex Orthopaedic Steve Cannon Department to the National and International Scene 2 The Middlesex Hospital 2000, (taken after a fire drill). 3 Chapter 1 Sir Charles Bell (1774 – 1842) and The Middlesex Hospital Medical School Sean Hughes Charles Bell (1774 – 1842), a surgeon and anatomist, was also an artist and philosopher. He was born in Fountainbridge, an area of Edinburgh, the youngest of four sons of the Reverend William Bell (1704 –1779), who died when Charles was five years old. His mother, Margaret Morris, was William Bell’s second wife and was the elder daughter of an Episcopalian clergyman in St Andrews, a seaside town north-east of Edinburgh. Her father was the head of the Episcopalian Church of Scotland, the Primus, in his time, reflecting the strong religious upbringing in Charles’s early development.
    [Show full text]
  • Life Sciences Vision Contents
    Build Back Better: our plan for growth Build Back Better: our plan for growth Life Sciences Vision © Crown copyright 2021 This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open- government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected]. Where we have identified any third-party copyright information you will need to obtain permission from the copyright holders concerned. Any enquiries regarding this publication should be sent to us at: [email protected] ii Life Sciences Vision Contents Foreword – Prime Minister Rt Hon Boris Johnson, MP 3 Foreword – Professor Sir John Bell, Rt Hon Sajid Javid MP, Rt Hon Kwasi Kwarteng MP, Lord David Prior, Sir Jonathan Symonds 4 Introduction 6 The Vision 9 Healthcare Missions 9 Preconditions for Success 10 UK Competitiveness in Life Sciences 12 Science & Research 12 Operating/Business Environment 13 Access to New Medicines and Technologies 15 Building on the UK’s Science and Research Infrastructure and harnessing the UK’s unique Genomic and Health Data 17 Clinical Research 18 Genomics at Scale 21 Health Data 23 Access and Uptake 27 Create an Outstanding Environment for Life Sciences Businesses to Start, Grow and Invest 32 Access to Finance 33 Regulation 35 Skills 38 Manufacturing 40 Trade and Investment 42 Addressing the Great Healthcare Challenges 45 Improving translational capabilities
    [Show full text]
  • 2014 Cabinet Reshuffle
    2014 Cabinet Reshuffle Overview A War Cabinet? Speculation and rumours have been rife over Liberal Democrat frontbench team at the the previous few months with talk that the present time. The question remains if the Prime Minister may undertake a wide scale Prime Minister wishes to use his new look Conservative reshuffle in the lead up to the Cabinet to promote the Government’s record General Election. Today that speculation was in this past Parliament and use the new talent confirmed. as frontline campaigners in the next few months. Surprisingly this reshuffle was far more extensive than many would have guessed with "This is very much a reshuffle based on the Michael Gove MP becoming Chief Whip and upcoming election. Out with the old, in William Hague MP standing down as Foreign with the new; an attempt to emphasise Secretary to become Leader of the House of diversity and put a few more Eurosceptic Commons. Women have also been promoted faces to the fore.” to the new Cameron Cabinet, although not to the extent that the media suggested. Liz Truss Dr Matthew Ashton, politics lecturer- MP and Nicky Morgan MP have both been Nottingham Trent University promoted to Secretary of State for Environment and Education respectively, whilst Esther McVey MP will now attend Europe Cabinet in her current role as Minister for Employment. Many other women have been Surprisingly Lord Hill, Leader for the promoted to junior ministry roles including Conservatives in the House of Lords, has been Priti Patel MP to the Treasury, Amber Rudd chosen as the Prime Minister’s nomination for MP to DECC and Claire Perry MP to European Commissioner in the new Junker led Transport, amongst others.
    [Show full text]
  • National Health Service
    NATIONAL HEALTH SERVICE Guidance on the allocation of organs for the purposes of transplantation 1. This guidance is issued to NHS Blood and Transplant (Gwaed a Thrawsblaniadau’r GIG) (“NHSBT”) to assist with the interpretation and implementation of paragraph 4 of the NHS Blood and Transplant (Gwaed a Thrawsblaniadau’r GIG) (England) Directions 2005 which came into force on 1st October 2005 (“the Directions”) (attached as Annex 3). 2. This guidance is intended to be read in conjunction with the Directions Paragraph 4(2) 3. Paragraph 4(2) of the Directions provides that when NHSBT allocates organs for transplantation, the people in Group 1 are to be given priority. All the people in Group 1 are to be given equal priority. 4. A person in Group 2 will only receive a UK donor organ if there is no person in Group 1 for whom the organ is clinically suitable. Paragraph 4(3)(a) – Persons ordinarily resident in the United Kingdom 5. Paragraph 4(3)(a) applies irrespective of nationality. 6. A person should be accepted as “ordinarily resident” if lawfully living in the United Kingdom voluntarily and for settled purposes as part of the regular order of his or her life whether of long or short duration. The person should be resident in the United Kingdom with some degree of continuity and apart from accidental or temporary absences. Paragraph 4(3)(c) – Persons covered by Regulations (EEC) No 1408/71 and 574/72 7. The European Community Social Security Regulations (Regulations (EEC) 1408/71, 574/72 and 883/2004) (“the Regulations”) co-ordinate the healthcare schemes of the member states of the European Economic Area (“the EEA”) and Switzerland.
    [Show full text]
  • 130225 117 El Compromiso Del Gobierno Con La
    InfoGibraltar Servicio de Información de Gibraltar Comunicado Gobierno de Gibraltar: Ministerio de Salud y Medio Ambiente El compromiso del Gobierno con la salud va más allá de Servicio Nacional de 1 Salud (NHS) Gibraltar, 25 de febrero de 2013 Al Gobierno le asombra la insistencia de la oposición en criticar su intención de considerar el ofrecimiento de la tecnología NaPro (Procreación Natural)2 a aquellas parejas que la consideren como su mejor opción. Esta fue la posición adoptada por el portavoz de la oposición en materia de salud, Isobel Ellul-Hammond, durante la sesión parlamentaria de la semana pasada, y que más tarde ella misma confirmó en Twitter3. El Gobierno no se disculpa por haber introducido la fecundación in vitro, tal y como prometió en su programa electoral. Sin embargo, reconoce el hecho de que algunas parejas no aceptan este método por diversas razones y desea, por tanto, proporcionar una alternativa, siempre y cuando se lleve a cabo bajo supervisión médica adecuada. A pesar de que la Autoridad Sanitaria de Gibraltar (Gibraltar Health Authority) adopta los principios del NHS4 [británico] y sigue las directrices establecidas por el Instituto Nacional para la Salud y la Excelencia Sanitaria y Clínica (National Institute for Health and Clinical Excelence, NICE5), no se ve limitada por ello, y el Gobierno apoyará la introducción de iniciativas cuidadosamente estudiadas que puedan extender el servicio de salud de Gibraltar más allá de lo que se ofrece en otros países. Los términos bajo los que se proporcionará la tecnología NaPro están siendo estudiados en estos momentos, al igual que se estudia la ampliación de los criterios para la fertilización in vitro según la modificación de NICE hace dos semanas.
    [Show full text]
  • This Document Contains Written Evidence Submitted to the Procedure Committee for the Inquiry Into Explanatory Statements on Amendments
    This document contains written evidence submitted to the Procedure Committee for the inquiry into explanatory statements on amendments. Contents Evidence list Date reported for publication Written evidence submitted by the Leader of the 30 January 2013 House, The Rt Hon Andrew Lansley MP (P 96, 2012-13) Written evidence submitted by the Clerk of Legislation, House of Commons (P 97, 2012-13) Written evidence submitted by The Rt Hon Andrew Lansley MP, Leader of the House of Commons (P 96, 2012-13) As you will be aware, I wrote to the Clerk of Legislation on 29 November 2012, seeking a factual evaluation of the pilots of explanatory statements to amendments to legislation. I enclose the Clerk of Legislation's response of 8 January. I am pleased that the House Authorities have found that anecdotal evidence shows feedback from Members and their staff to be positive and that explanatory statements are felt to be helpful. The statistics provided by the Clerks also highlight the high level of participation in the pilot, with the notable exception of the opposition in the case of the Electoral Registration and Administration Bill. Our respective predecessors agreed in May 2012 that the Procedure Committee would report on the outcome of the pilots. I hope that the Committee will be able to undertake this as part of its work programme in the near future. I remain strongly of the view that for explanatory statements to be a useful part of the legislative process, it is necessary for there to be full participation across the House, from Government, the Opposition front bench and from backbench members.
    [Show full text]
  • A Healthier Wales: Our Plan for Health and Social Care Contents
    A Healthier Wales: our Plan for Health and Social Care Contents Foreword 1 Introduction 2 Executive summary 3 Our vision for the future 4 Values 4 Delivering our Vision 5 How we will drive transformation 15 The Quadruple Aim 15 Design Principles 15 New Models of Seamless Local Health and Social Care 18 Transformation Programme 21 Making our health system fit for the future 22 Improving Quality and Value 22 Digital and Data 24 Sustainable health and social care funding 26 Continuous Engagement 28 The Health and Social Care Workforce 30 National Leadership and Direction 32 Mae’r ddogfen yma hefyd ar gael yn Gymraeg. This document is also available in Welsh. © Crown copyright 2019 WG39129 Digital ISBN 978-1-83933-278-4 Print ISBN 978-1-83933-277-7 Foreword With cross-party support, the Welsh Government seamless whole system approach to health and recently commissioned a Parliamentary Review social care. Services from different providers of the Long Term Future of Health and Social should be seamlessly co-ordinated, and we should Care. An international panel of experts, chaired by go beyond services to make a difference to the Dr Ruth Hussey, called for a “revolution from within”, social and economic factors which influence health, to drive the changes we need to see in our health wellbeing and life chances. and social care system, so that it is able to meet the This is not a challenge which the Welsh Government, needs of current and future generations in Wales. NHS Wales, or local government can meet on their This plan is a response to the Parliamentary Review own.
    [Show full text]
  • Looking Back on New Labour Health Policy
    LOOKING BACK ON NEW LABOUR HEALTH POLICY Michael Traynor* THE CONTEXT The UK National Health Service has been described as the closest that Britain has come to a national religion. Despite many reforms it is still largely free at the point of service and its personnel widely seen as dedicated to an ethic of public service. Its popularity is matched by its significance for British political parties. For the left the NHS is probably the most important public service institution upon which the whole of its reputation can depend. For the right, it has been, sometimes despite rhetoric to the contrary, an outmoded and self-serving machine too much a product of collectivist politics and antithetical a market economy. The NHS represents both vulnerability and opportunity and for this reason is highly politicised. Healthcare scandals are the stuff of national and local news alike. Add the (possibly waning) power of one of the few remaining traditional professions, medicine, and there is a rich and complex environment for policy makers to act upon. Some say that those providing the service – doctors, nurses and very many others – benefit from this political prominence but if you ask them they are likely to crave less interference, fewer targets, less change. The British NHS was set up in the years following World War II as a part of the new welfare state which aimed to slay the three giants of ignorance, poverty and ill-health. In fact, so optimistic were policy makers that the expectation was that the health service would largely be a temporary measure.
    [Show full text]