A report outlined the views of local authority chief executives and senior managers on the shape of future health and social care reform. It called for a 'transformative' approach that placed people at the heart of the system. There should be one person overseeing all of an individual's health and care needs, and working with them to co-ordinate these; better co-operation and information sharing among the people involved in their care; and one accountable, local body to go to if they had concerns. The preferred goal was shared commissioning, shared budgets, and shared management teams, with local health and wellbeing boards providing local strategic leadership across the whole system. But local areas also needed to move beyond treating ill-health and supporting people with care needs, and to think about how to improve the health of their whole population through prevention.
Source: Principles for Health and Social Care Reform, Society of Local Authority Chief Executives and Senior Managers
Links: Report | SOLACE press release
Date: 2013-Sep
A collection of essays examined the impact of austerity on health policy. It looked at the public health impact of economic decline – higher unemployment, job insecurity, fuel poverty, homelessness, and other social ills – that had a direct effect on the National Health Service. Although existing budget restrictions might be tough for those working at the frontline, it was the longer-term trend of an ageing population that would prove to be the NHS's biggest challenge. The question was whether health policy-makers would make the necessary response to demographic change.
Source: Claudia Wood (ed.), Health in Austerity, Demos
Date: 2013-Sep
A collection of essays examined whether the health and social care policies of the coalition were irreversible. They highlighted the complexity of issues throughout the system, ranging from the measurement of National Health Service performance to the creation of a robust incentive system for prevention of illness.
Source: Dan Wilson Craw and Martin Edobor (eds), Irreversible? Health and social care policy in a post-coalition landscape, Fabian Society
Links: Report
Date: 2013-Sep
A series of articles examined issues of religious faith in relation to healthcare provision.
Source: Health Care Analysis, Volume 21 Number 3
Links to abstracts:
Jagbir Jhutti-Johal, 'Understanding and coping with diversity in healthcare'
Jean McHale, 'Faith, belief, fundamental rights and delivering health care in a modern NHS: An unrealistic aspiration?'
Chris Swift, 'A state health service and funded religious care'
Stephen Pattison, 'Religion, spirituality and health care: confusions, tensions, opportunities'
Date: 2013-Aug
An article examined the coalition's programme of reform for the National Health Service in England. The programme was characterized by its wide scope and the organizational upheavals involved, and by the fact that it was being introduced at a time when the NHS faced unprecedented financial pressures. The legislation faced strong political, public, and professional hostility – both from those who saw it as a crime against the founding principles of the NHS and from those who saw it as a disruptive blunder that created more problems than it solved. The essential, defining characteristics of the NHS were not in fact under threat: it would continue as a publicly funded service, freely available to all, and was not being privatized. But it was moving toward a more pluralistic system.
Source: Rudolf Klein, 'The twenty-year war over England's National Health Service: a report from the battlefield', Journal of Health Politics, Policy and Law, Volume 38 Number 4
Links: Abstract
Date: 2013-Aug
The Department of Health published its annual report for 2012-13.
Source: Annual Report and Accounts 2012-13, HC 46, Department of Health, TSO
Links: Report
Date: 2013-Aug
An article examined the widening involvement of the European Union in healthcare, focusing on the issue of quality of care. The depth of EU 'interference' had increased from sharing information to standardization and even to the first signs of enforcement.
Source: Hans Vollaard, Hester van de Bovenkamp, and Karsten Vrangbaek, 'The emerging EU quality of care policy: from sharing information to enforcement', Health Policy, Volume 111 Issue 3
Links: Abstract
Date: 2013-Aug
The coalition government published the first six reports arising from a review of the 'balance of competences' between the United Kingdom and European Union. The reports included those relating to health issues and taxation.
Source: Review of the Balance of Competences between the United Kingdom and the European Union: Health, Department of Health | Review of the Balance of Competences between the United Kingdom and the European Union: Taxation, HM Treasury
Links: Health report | Taxation report | Cabinet Office press release | HMT press release | CBI press release | Civitas blog post | BBC report | Daily Mail report | Guardian report | Telegraph report
Date: 2013-Jul
A report by a committee of the National Assembly for Wales examined a Bill designed to promote greater integration in health and social services in Wales. It welcomed the general principles underlying the Bill and the need for legislation: but it expressed concern that the policy objectives of the Bill might not be realized in practice.
Source: Social Services and Well-being (Wales) Bill: Stage 1 Committee Report, Health and Social Care Committee, National Assembly for Wales
Links: Report | NAW press release | OPCW press release
Date: 2013-Jul
A think-tank report examined the future of the National Health Service in the wake of the Francis report into care standards. Parts of the NHS seemed to have lost their focus on patients' needs, and a fundamental reappraisal was needed. There was a growing recognition of the distortions caused by central targets: but new outcome frameworks would need to be paired with strengthened information availability and patient choice. There was also a growing evidence base on the positive effects of competition in provision. The inherent lack of clear accountability in the existing model meant that it was time to seriously examine decentralization of health services, together with a continental-style universal social health insurance system.
Source: Elliot Bidgood, After Francis: Standards & care quality in the NHS, Civitas
Links: Report | Civitas press release
Date: 2013-Jul
A collection of essays (edited by the Labour party's shadow spokesperson on health and social care) examined the policy implications of integrated health and social care services.
Source: Andy Burnham MP (ed.), Together: A vision of whole person care for a 21st century health and care service, Fabian Society
Date: 2013-Jul
An article said that the 2012 Health and Social Care Act did not represent, as some had suggested, a radical break with the past: instead it was an extension of the previous Labour government's neo-liberal reforms of the public sector. In particular, the Act invoked the principles of 'new professionalism' to undermine professional dominance, and attract private providers into statutory healthcare at the expense of public providers. In turn, this extension of new professionalism might encourage public distrust in the medical profession and absolve the state of much of its statutory healthcare obligation.
Source: Ewen Speed and Jonathan Gabe, 'The Health and Social Care Act for England 2012: the extension of "new professionalism"', Critical Social Policy, Volume 33 Issue 3
Links: Abstract
Date: 2013-Jul
A new book examined coalition government plans for reforming the National Health Service. It said that the NHS had been betrayed by doctors, unions, the media, and politicians – all of whom claimed to be stalwart defenders of the service, but who had failed to protect it. In theory, the reforms meant that family doctors in clinical commissioning groups would take the lead in running NHS services: in practice, the commissioning groups were a Trojan horse designed to allow the private sector to gain unprecedented access and power.
Source: Raymond Tallis and Jacky Davis (eds), NHS SOS: How the NHS was betrayed – and how we can save it, Oneworld Publications
Links: Summary | Guardian report
Date: 2013-Jun
A new book examined social policy developments under the coalition government across a range of key policy areas. It included chapters dealing with health policy, pensions, fuel poverty and climate change, unemployment and activation policies, precarious employment, and the proposed new universal credit.
Source: Gaby Ramia, Kevin Farnsworth, and Zoe Irving (eds), Social Policy Review 25: Analysis and debate in social policy, 2013, Policy Press
Links: Summary
>Date: 2013-Jun
A report summarized a set of five papers that examined the policies of the former Labour government (1997-2010), charting their impact on the distribution of outcomes, and on poverty and inequality. Labour had set out an ambitious agenda to improve outcomes overall, narrow socio-economic gaps, and modernize public services:
• Public spending went up from 39.5 to 47.4 per cent of national income. This was a large rise: but until the 2008 global crisis, spending levels were unexceptional by historic standards.
• The extra spending went mainly on services. Health and education both increased as a proportion of all public spending.
• Nearly all the extra cash spent on benefits went on children and pensioners. Benefits for working-age people unrelated to having children fell as a proportion of national income.
• Access and quality in public services improved, including waiting times for health services and pupil-teacher ratios.
• Outcomes improved and gaps closed on virtually all the socio-economic indicators targeted, such as poverty for children and pensioners, and school attainment.
• But there was no progress in some areas that were not subject to explicit targets: poverty for working-age people without children rose; there was no real change in levels of income inequality; and disparities in regional economic performance persisted.
Source: Ruth Lupton (with John Hills, Kitty Stewart, and Polly Vizard), Labour s Social Policy Record: Policy, spending and outcomes 1997-2010, Social Policy in a Cold Climate Research Report 1, Centre for Analysis of Social Exclusion (London School of Economics)
Links: Report | Supplementary paper | Nuffield Foundation press release | Guardian report
Notes: Details of individual papers:
Polly Vizard and Polina Obolenskaya, Labour s Record on Health (1997-2010), Social Policy in a Cold Climate Working Paper 2
Ruth Lupton and Polina Obolenskaya, Labour s Record on Education: Policy, Spending and Outcomes 1997-2010, Social Policy in a Cold Climate Working Paper 3
Kitty Stewart, Labour s Record on the Under Fives: Policy, Spending and Outcomes 1997-2010, Social Policy in a Cold Climate Working Paper 4
John Hills, Labour s Record on Cash Transfers, Poverty, Inequality and the Lifecycle 1997-2010, Social Policy in a Cold Climate Working Paper 5
Ruth Lupton, Alex Fenton, and Amanda Fitzgerald, Labour s Record on Neighbourhood Renewal in England: Policy, Spending and Outcomes 1997-2010, Social Policy in a Cold Climate Working Paper 6
Date: 2013-Jun
A think-tank report examined the differences between the United Kingdom's four separate health systems. England's adherence to and extension of market-like mechanisms in managing health differentiated it most dramatically from the other three services. But lack of timely and genuinely comparable data meant that it was hard to say which country was getting better value for money from its health service. The four health departments should therefore agree specific indicators, establish which data was needed to make comparisons, and identify how best to collect that data.
Source: Nicholas Timmins, The Four UK Health Systems: Learning from each other, King s Fund
Links: Report
Date: 2013-Jun
An article examined the record of the 1997-2010 Labour governments on health and healthcare.
Source: Carol Propper and Mary-Anne Venables, 'An assessment of Labour s record on health and healthcare', Oxford Review of Economic Policy, Volume 29 Number 1
Links: Abstract
Date: 2013-Jun
An article examined the popular legitimacy of European healthcare systems. Universally high support was found for state responsibility: but satisfaction levels varied considerably, with particularly low levels found in eastern Europe.
Source: Sarah Missinne, Bart Meuleman, and Piet Bracke, 'The popular legitimacy of European healthcare systems: a multilevel analysis of 24 countries', Journal of European Social Policy, Volume 23 Number 3
Links: Abstract
Date: 2013-Jun
A think-tank report examined the argument that tax-financed or 'free' healthcare was a privilege that could no longer be afforded. The National Health Service had been created at a time when the country had been literally bankrupt, and there was no economic reason why it could not be sustained: the case against doing so was political, not financial. Coalition government legislation in 2012 abolishing the duty to provide universal healthcare services had made it easier to transform the English NHS from a nationally mandated public service into a number of fragmented and competing services based on commercial contracting and providers with limited accountability.
Source: Allyson Pollock and David Price, Duty to Care: In defence of universal health care, Centre for Labour and Social Studies
Date: 2013-May
A think-tank paper said that income and wealth inequalities were directly correlated with health inequalities. Providing a good health service was much harder in a more economically unequal country. In more unequal countries the richest groups were more likely to opt out of national health services, and had less interest in their quality, exacerbating health inequalities further. Success in defending and improving the health service needed to be linked to a wider attack on social inequalities.
Source: Danny Dorling, In Place of Fear: Narrowing Health Inequalities, Centre for Labour and Social Studies
Links: Paper | Summary | Left Foot Forward blog post
Date: 2013-May
A report called for a radical shift away from reactive, hospital-based care towards greater use of preventative services to keep people healthy and allow them to manage their conditions at home and in the community.
Source: The Prevention Revolution: Transforming health and social care, Association of Chief Executives of Voluntary Organisations
Links: Report
Date: 2013-Mar
An article examined the extent to which European countries varied in the implementation of health policies in ten different areas, and exploited these variations to investigate the role of political, economic, and social determinants of health policy. 'Striking variations' were found between countries in process and outcome indicators of health policies.
Source: Johan Mackenbach and Martin McKee, 'A comparative analysis of health policy performance in 43 European countries', European Journal of Public Health, Volume 23 Number 2
Links: Abstract
Date: 2013-Mar
The opposition Labour Party said that the National Health Service and social care budgets in England should be combined. It said that the money – £119 billion in 2012-13 – could be used to provide more joined-up care across the hospital, mental health, and social care sectors.
Source: Speech by Andy Burnham MP (Shadow Health Secretary), 24 January 2013
Links: Speech | Paper | ADASS press release | Kings Fund press release | Progress blog post | BBC report | Community Care report | Guardian report | Telegraph report
Date: 2013-Jan
