Healthcare in Transition : Understanding Key Ideas and Tensions in Contemporary Health Policy

A call for change in healthcare thinking, this book explores the fundamental currents and tensions behind recent trends in policy, such as shared decision making, coproduction, and personalization. While these trends are often discussed in connection with a transition in epidemiological thought, this book argues that they instead embody a philosophical shift—a change in our conception of healthcare and of appropriate forms of knowledge and analysis. As clinical concerns are increasingly nested within social concerns, policy analysis must engage with the multiple philosophical tensions that are now at the heart of the healthcare debate. The book's focus on these key, underlying ideas could not be more timely. Accessibly written and with international relevance, the book will help fuel a shift from a delivery model of healthcare to a deliberative one. HEALTHCARE IN TRANSITION Contents Acknowledgements Preface 1. Building blocks The philosophical transition in healthcare Health-related ideas: shaping the practices and climates of health systems Trends, reforms and ‘trade-offs’ What should we do? Comparing futures Conclusion 2. Taking less medicine What’s wrong with medicine? Medicine beyond medicalisation Health policy out of kilter and medicine out of control? Re-balancing health policy: introducing person-centredness Conclusion 3. Choosing care Shared decision making and evidence-based patient choice Sharing decisions: obstacles, complications and dilemmas Broader controversies about choice Providing choice is not caring Patient agency – correcting, reinforcing or revising biomedicine? Conclusion 4. Systems and lives Whole systems or whole persons? The threats of depersonalisation and exclusion Health promotion: for populations, groups or individuals? Organising clinical care The costs of efficiency Conclusion 5. Especially for you All things to all people Personalised medicine: new frontiers and new challenges Personalisation as consumption: using one’s own budget Personalised care: mixing support with humanity Conclusion 6. The challenge of integration Divisions and boundaries Sam and Esther Realigning relationships: gluing and ungluing connections Integration unpacked Conclusion 7. Shaping the future Healthcare goods as social goods Person power – digitally delivered? Collective responsibility for health: asking too much? Those with special responsibilities Expansive learning for new healthcare architectures Conclusion References Index Health policy thinking must change. This book explores the fundamental currents and tensions that lie behind recent trends such as shared decision-making, co-production, and personalisation. These are often discussed in relation to an epidemiological transition but this text argues that they embody a philosophical transition – a change in our conceptions of healthcare and of appropriate forms of knowledge and analysis. As clinical concerns are increasingly nested within social concerns then policy analysis must engage with the multiple philosophical tensions that are now centre stage. This focus on key underlying ideas and tensions in healthcare couldn’t have come at a better time. With international relevance, the book’s arguments help fuel a shift away from a ‘delivery’ model towards a more deliberative model of healthcare. Health policy thinking must change. This work explores the fundamental currents and tensions that lie behind recent trends such as shared decision-making, co-production, and personalisation. These are often discussed in relation to an epidemiological transition but this text argues that they embody a philosophical transition - a change in our conceptions of healthcare and of appropriate forms of knowledge and analysis This book explores the fundamental currents and tensions that lie behind recent trends in health policy such as shared decision-making, co-production, and personalisation.