A National Health Service? : The Restructuring of Health Care in Britain Since 1979

This book contrasts the proposals of the Royal Commission of the late 1970s with the very different set of priorities enshrined in the 1989 White Paper and describes how the changes between the two documents came about. It argues that the NHS reforms should be seen not as the inevitable product of technical developments nor as a consensus response to narrowly managerial difficulties within the NHS, but rather as part of a wider political strategy towards state provision of welfare. The book strongly emphasises the uneven geographical impacts of post-1979 changes, a topic usually underplayed by analysts of social policy, and draws heavily on previously unpublished material. 1. From The Royal Commission To The Nhs Reforms: A Review Of Policies And Statistics -- 2. Explaining Change In The Welfare State And In Health Care Policy -- 3. Conservatism, Health Policy And Health Care Policy -- 4. Spatial Resource Allocation: Local Difficulties, Technical Adjustments And Political Solutions -- 5. Imagined And Imaginary Communities: Rhetoric And Reality In Community Care Policy -- 6. Producing Health Care: Management, Labour And The State In The Nhs -- 7. Blurring The Boundaries: Health Care Outside The Nhs -- 8. The Entrepreneurial State: Commercial And Charitable Activities By Health Authorities -- 9. Powers, Responsibilities And Accountability: Organisational Reform And Local Autonomy -- 10. Conclusions: In What Sense A National Health Service? -- Appendix: Chronology Of Major Developments In Health And Health Care Policy Since 1979. John Mohan. Requested Title: Restructuring Healthcare. Includes Bibliographical References (p. 258-276) And Index. Front Matter....Pages i-xx From the Royal Commission to the NHS Reforms: A Review of Policies and Statistics....Pages 1-24 Explaining Change in the Welfare State and in Health Care Policy....Pages 25-43 Conservatism, Health Policy and Health Care Policy: From the Royal Commission to the White Paper....Pages 44-72 Spatial Resource Allocation: Local Difficulties, Technical Adjustments and Political Solutions....Pages 73-100 Imagined and Imaginary Communities: Rhetoric and Reality in Community Care Policy....Pages 101-128 Producing Health Care: Management, Labour and the State in the NHS....Pages 129-153 Blurring the Boundaries: Health Care Outside the NHS....Pages 154-173 The Entrepreneurial State: Commercial and Charitable Activities by Health Authorities....Pages 174-195 Powers, Responsibilities and Accountability: Organisational Reform and Local Autonomy....Pages 196-218 Conclusions: In What Sense a National Health Service?....Pages 219-233 Back Matter....Pages 234-286 This text contrasts the proposals of the Royal Commission of the late 1970s with those enshrined in the 1989 White Paper and describes how the changes came about. It asserts that the NHS reforms should be seen as part of a wider political strategy towards state provision of welfare