A new book examined recent healthcare policy, locating the National Health Service in the context of the welfare state. It considered the successes and failures of the NHS since its inception, and recent responses to its apparent failures. It concluded that the NHS had successfully met the challenges facing it, and was likely to continue to meet the changing health needs of the population.
Source: John Carrier and Ian Kendall, Health and the National Health Service, Routledge
Links: Summary
Date: 2012-Dec
A think-tank report said that the National Health Service was entering a period of significant risk that could jeopardize progress made over the previous decade. As unprecedented financial pressures started to bite, 'cracks were beginning to appear', with accident and emergency waiting times rising and more hospitals in financial difficulty. Major organizational changes and the loss of experienced managers left the service in a 'precarious' position.
Source: Sarah Gregory, Anna Dixon, and Chris Ham (eds), Health Policy under the Coalition Government: A mid-term assessment , King s Fund
Links: Report | Kings Fund press release | Labour Party press release | NHS Confederation press release | BBC report | Guardian report | Public Finance report
Date: 2012-Nov
The Department of Health published its annual report for 2011-12. At the same time the coalition government published updated figures for the costs and savings arising from National Health Service reorganization: it said that the costs were likely to be £300 million higher than previously thought, but that the savings over the transition period (2010-11 to 2014-15) would be £1 billion higher.
Source: Annual Report and Accounts 2011-12, HC 66, Department of Health, TSO
Date: 2012-Oct
A report examined health policy responses in Europe to the financial crisis. Some countries had introduced no new policies, while others had introduced many. Some health systems were better prepared than others due to fiscal measures they had taken before the crisis, such as accumulating financial reserves. There were many instances in which policies planned before 2008 had been implemented with greater intensity or speed as they became more urgent or politically feasible as a result of the crisis. There had also been cases where planned reforms were slowed down or abandoned in response to the crisis. The breadth and scope of statutory coverage had been largely unaffected, and in some cases benefits had been expanded for low-income groups. However, some countries had reduced the depth of coverage by increasing user charges for essential services, which was a cause for concern.
Source: Philipa Mladovsky, Divya Srivastava, Jonathan Cylus, Marina Karanikolos, Tamas Evetovits, Sarah Thomson, and Martin McKee, Health Policy Responses to the Financial Crisis in Europe, World Health Organisation (Regional Office for Europe)
Links: Report
Date: 2012-Sep
The World Health Organisation adopted a policy framework for Europe. The strategy targeted the main health challenges, such as: increasing health inequalities within and between countries; shrinking public service expenditures due to the financial crisis; and a growing burden of ill-health from non-communicable diseases, including obesity, cancer, and heart disease.
Source: Health 2020: A European policy framework supporting action across government and society for health and well-being, World Health Organisation (Regional Office for Europe)
Links: Framework | WHO press release
Date: 2012-Sep
An article examined welfare state retrenchment under the coalition government, focusing on the English National Health Service. It located the coalition's reforms of public services and public sector employment relations in the long trajectory of public sector restructuring that began in the 1980s.
Source: Stephanie Tailby, 'Public service restructuring in the UK: the case of the English National Health Service', Industrial Relations Journal, Volume 43 Issue 5
Links: Abstract
Date: 2012-Sep
A chapter in the 2012 British Social Attitudes Survey report examined public attitudes to the National Health Service. Public satisfaction with the NHS had fallen sharply since a record high in 2010, although most people thought that the standard of healthcare had improved or stayed the same in the previous five years. People tended to think that the healthcare system needed to change: but there was little appetite for fundamental reform of the NHS.
Source: John Appleby and Lucy Lee, 'Health care in Britain: is there a problem and what needs to change?' (in Alison Park, Elizabeth Clery John Curtice, Miranda Phillips, and David Utting (eds), British Social Attitudes: The 29th Report), National Centre for Social Research
Links: Report | NatCen press release | Guardian report | Nursing Times report | Telegraph report
Date: 2012-Sep
An article said that research on health policy actors and healthcare systems in developed (OECD) countries needed to be separated more thoroughly. There was also a need to put greater emphasis on extending the understanding of the outcomes of different national healthcare arrangements and whether policy reforms actually delivered their promised results. To do this, more attention to the measurement of success was required.
Source: Theodore Marmor and Claus Wendt, 'Conceptual frameworks for comparing healthcare politics and policy', Health Policy, Volume 107 Issue 1
Links: Article
Date: 2012-Aug
A new book examined a wide range of conceptual and practical issues relating to health policy across the world. Individual chapters explored ways of measuring access to health care in Europe; the health and social care divide in the United Kingdom; barriers and opportunities for private long-term care insurance in England; and the implications of historical trends in mortality for health policies in England and Wales.
Source: Alistair McGuire and Joan Costa-Font (eds), The LSE Companion to Health Policy, Edward Elgar Publishing
Links: Summary
Date: 2012-Aug
A report compared different payment systems for healthcare used across Europe, and examined their role in improving the efficiency and quality of care. Rather than a single payment system such as 'pay for performance' or diagnosis-related groups, blended payment systems had repeatedly been found to contribute to the delivery of high-quality, affordable care.
Source: Anita Charlesworth, Alisha Davies, and Jennifer Dixon, Reforming Payment for Health Care in Europe to Achieve Better Value, Nuffield Trust
Date: 2012-Aug
A think-tank report examined why and how the Health and Social Care Act 2012 became law. It said that the Act was widely seen as a 'car crash' in terms of both policy and politics.
Source: Nicholas Timmins, Never Again? The story of the Health and Social Care Act 2012 – A study in coalition government and policy making, Institute for Government/King s Fund
Links: Report | Kings Fund press release
Date: 2012-Jul
A new book examined social policy developments under the coalition government across a range of key policy areas. It included chapters dealing with health, housing, family support, and the proposed new universal credit.
Source: Majella Kilkey, Gaby Ramia, and Kevin Farnsworth (eds.), Social Policy Review 24: Analysis and debate in social policy, 2012, Policy Press
Links: Summary
Date: 2012-Jun
An article examined whether the way in which health systems were financed in high-income countries influenced whether health policy-makers were more or less interested in accessible and equitable health services. The key findings were:
Improving population health outcomes was more likely to be on the agenda under tax-based systems and when centre-left parties were dominant in government.
Health systems funded through social insurance were more preoccupied with efficiency and cost containment than tax-funded systems.
The political complexion of governments was not a major factor shaping health policy agendas.
Since 2003 there had been an increasing interest in initiatives that addressed public health concerns, access, and equity, and population health outcomes.
Source: Tim Tenbensel, Samantha Eagle, and Toni Ashton, 'Comparing health policy agendas across eleven high income countries: islands of difference in a sea of similarity', Health Policy, Volume 106 Issue 1
Links: Abstract
Date: 2012-May
The coalition government announced that it would not publish an internal risk assessment of its plans to reform the National Health Service in England – contrary to a ruling by an information tribunal. It published instead a heavily edited version of the assessment that did not make clear the potential impact on patients.
Source: Debate 10 May 2012, columns 153-163, House of Commons Hansard, TSO | Transition Programme Risks: Review of November 2010 risk register, Department of Health
Links: Hansard | DH press release | Edited report | BMA press release | Labour Party press release | BBC report (1) | BBC report (2) | Guardian report
Date: 2012-May
A think-tank report called for the National Health Service in Wales to take a radically different course from that in prospect in England. Consultant private practice and family doctors' role as independent contractors should both be ended, as these arrangements put private profit ahead of patients' interests. The NHS needed to became a comprehensive service, fulfilling the original vision of a service from 'cradle to grave' rather than being limited to demand-led clinical medicine.
Source: Julian Tudor Hart, A New Path Entirely: How NHS Wales could lead the world, Bevan Foundation
Links: Report | Bevan Foundation press release | BBC report
Date: 2012-Apr
An article examined and assessed empirical studies that explicitly used a welfare regime typology in comparative health research. Just under one-half of studies comparing outcomes by regime found at least some evidence that health inequalities were lowest, or population health was the best, in social democratic countries. Studies analyzing the relationship between health (mortality) and the political determinants or policies of welfare states were more likely to report results consistent with welfare regime theory. But health differences by regime were not always consistent with welfare regime theory: measurement of policy instruments or outcomes of welfare regimes might be more promising for public health research than the use of typologies alone.
Source: Sarah Brennenstuhl, Amelie Quesnel-Vallee, and Peggy McDonough, 'Welfare regimes, population health and health inequalities: a research synthesis', Journal of Epidemiology and Community Health, Volume 66 Number 5
Links: Abstract
Date: 2012-Apr
A paper examined whether choice and competition reforms in healthcare in European countries were only a route to improving economic efficiency, or whether other goals buttressed the so-called choice agenda. Although competition and choice reforms had primarily been driven by the attainment of micro-efficiency and modernization goals, 'middle-class politics' and (to a some extent) provider interests had also appeared to prompt choice reforms.
Source: Joan Costa-Font and Valentina Zigante, Are Health Care "Choice-and-Competition" Reforms Really Efficiency Driven?, Working Paper 26/2012, LSE Health (London School of Economics)
Links: Paper
See also: Valentina Zigante, Assessing Welfare Effects of the European Choice Agenda: The case of health care in the United Kingdom, LEQS Paper 35, European Institute (London School of Economics)
Date: 2012-Mar
An article examined the reform under which more autonomy was given to better-performing National Health Service hospitals in England. Despite being enmeshed in a politicized culture of regulations and guidance, autonomy was increasingly perceived positively, and appeared to depend on the extent to which organizations had the incentives and the capacity to respond.
Source: Paul Anand, Mark Exworthy, Francesca Frosini, and Lorelei Jones, 'Autonomy and improved performance: lessons from an NHS policy reform', Public Money and Management, Volume 32 Issue 3
Links: Abstract
Date: 2012-Mar
The Health and Social Care Act 2012 was given Royal assent. The Act provided for measures to:
• Give new consortiums of family doctors across England the task of commissioning healthcare services, and control over the budget to pay for them.
Abolish primary care trusts and strategic health authorities by 2013.
• Compel all hospitals in England to become foundation trust hospitals (semi-independent of central control) with the freedom to earn money by treating private patients.
• Establish 'Healthwatch', a new independent body that could look into complaints and scrutinize the performance of local health providers.
• Establishing 'Public Health England', a new body to improve public health and reduce health inequalities.
• Abolish many arm's-length bodies, including the Health Protection Agency and Human Fertilisation and Embryology Authority.
Source: Health and Social Care Act 2012, Department of Health, TSO
Links: Act | Explanatory notes | DH press release
Date: 2012-Mar
A new book examined the relationship between sociology, medicine, and medical sociology. Issues considered included health inequalities, gender, ethnicity, mental health, consumerism in medicine, and biotechnology.
Source: Hannah Bradby, Medicine, Health and Society, SAGE Publications
Links: Summary
Date: 2012-Mar
An article examined how narrative analysis might be used to evaluate policy documents in the field of healthcare, based on a comparative study of documents produced by the governments of England, Scotland, Wales, and Northern Ireland. 'Text-mining' strategies, allied with features of semantic and network analysis, could be used to unravel the basic elements of policy stories and help to verify the strengths (and weaknesses) of any given analysis.
Source: Lindsay Prior, David Hughes, and Stephen Peckham, 'The discursive turn in policy analysis and the validation of policy stories', Journal of Social Policy, Volume 41 Issue 2
Links: Abstract
Date: 2012-Mar
A report said that the Health and Social Care Bill would lead to a disorganized National Health Service with increased health inequalities, more bureaucracy, and wasted public funds. It called for the Bill to be withdrawn in its entirety.
Source: Health and Social Care Bill: Risk Assessment Summary, Faculty of Public Health
Links: Report | FPH press release | Guardian report
Date: 2012-Mar
A report by a committee of MPs said that care services for older people in England were still highly fragmented, despite successive governments' commitment to integration. At the same time levels of adult social care funding were inadequate, with a rising funding gap between need and resource, and there was a need to rebalance public spending on older people away from acute hospital care towards preventive health and social care in the community. The report called on the government to place a duty on local councils and the proposed new National Health Service clinical commissioning groups to create a single commissioning process for older people's health, care, and housing, pooling all public resources, with a single accountable officer.
Source: Social Care, Fourteenth Report (Session 2010-12), HC 1583, House of Commons Health Select Committee, TSO
Links: Report | Oral and written evidence | ADASS press release | Alzheimers Society press release | Carers UK press release | CSJ press release | JRF press release | Kings Fund press release | LGA press release | NHS Confederation press release | NPC press release | RCN press release | RCP press release | Turning Point press release | UKHCA press release | BBC report | Community Care report | Guardian report | Inside Housing report | Public Finance report | Telegraph report
Date: 2012-Feb
An article examined post-devolution developments in health policy. Despite some noticeable differences in policy rhetoric, approaches to both healthcare provision and tackling public health problems remained similar in all four countries of the United Kingdom.
Source: Katherine Smith and Mark Hellowell, 'Beyond rhetorical differences: a cohesive account of post-devolution developments in UK health policy', Social Policy and Administration, Volume 46 Number 2
Links: Abstract
Date: 2012-Feb
A campaign group report highlighted the risks to the health of people in England as a result of proposals in the coalition government's Health and Social Care Bill. It said that the reforms would lead to a fragmented system, where accountability would be patchy and quality would suffer. Patients would be subject to longer waiting times for those treatments that clinical commissioning groups (CCGs) were prepared to pay for. CCGs would have the power to ration healthcare: in some areas of England, treatments that were currently available on the National Health Service would be denied – leading to a 'postcode lottery' on a scale never seen before, and increased inequalities in access to healthcare.
Source: Breaking the NHS: Stealing England's health through reckless reform, SOS NHS
Links: Report
Date: 2012-Feb
A report by a cross-party group of MPs said that although there were advantages in moving towards a more clinician-led commissioning system, there was 'no real need' for the coalition government to engage in wholesale restructuring of the National Health Service. It also expressed concern over the accountability of clinical commissioning groups, and variation in performance between them.
Source: Were Massive Reforms Necessary to Save the NHS? Inquiry into the NHS health reforms, All-Party Parliamentary Group on Primary Care and Public Health
Links: Report | Unite press release
Date: 2012-Jan
