The Politics of Health Policy Reform in the UK : England’s Permanent Revolution

'Calum Paton has long been one of our most insightful health academics. Rigorous in his approach, he has never been afraid to swim against the ever shifting tides of received opinion. His latest book which is the culmination of decades of analysis of the impact of politics on evolving health policy is a tour de force. Beautifully written, it exposes the fragility of much of the thinking behind the endless re-organisations and re-structurings endured by the NHS. He castigates both the right and the left who for widely opposing reasons have subjected the NHS to an overbearing audit and tick box oversight that chokes off the altruism of staff and gets in the way of improving services. At a time when the NHS is so much under the cosh both politically and financially, his book is a timely warning to all sides of the debate that pre conceived political ideologies are not the basis for progress; nor too, a woolly consensual approach seeking in vain to take the NHS out of politics. He acknowledges no magical solution but argues that awareness of the problems caused by market solutions or so called public service reforms is at least a start. Calum's book is a must read for all concerned about the NHS and its future.'- The Rt Hon. the Lord Hunt of Kings Heath OB, President of the Royal Society for Public Health 'Calum Paton's book traces 25 years of NHS re-organisations (or re-disorganisations). He offers a detailed and insightful examination of the twists and turns of policy and the effects that this has had, and indeed the causes of the current state of affairs. The author argues that underlying and persistent political beliefs concerning such things as the role of the market reveal both arational and irrational aspects of policy making, which need to be seen in the broader context of the British political scene. Calum Paton writes, as always, with wit and aplomb together with a keen theoretical perspective and a wry sense of humour. It's a fascinating journey through the history of NHS policy, and anyone who wants to understand how and why the NHS ended up in another fine mess, should read this book.'- Dr Alison Hann, Senior Lecturer in Public Health and Policy Studies, Swansea University, UK This book explains the politics of thirty years of 'market reform' in the English NHS, with the rest of the UK a counter-factual. Paton shows how each subsequent reform has been shaped by the confusion left by the previous reform. The long-term ideology has been anti-statist but policy-making at each stage of 'reform' has been driven by short-term politics. The outcome in England has been ever-increasing complexity in the NHS, with significantly increased management costs and no commensurate benefit. Calum Paton is Emeritus Professor of Public Policy at Keele University, UK. His books include seminal analyses of the Thatcher and Blair reforms to the NHS. He is Editor-in-Chief of the International Journal of Health Planning and Management. He was Chair of the University Hospital of North Staffordshire NHS Trust from 2000 to 2006, and has advised politicians in the UK, governments abroad and agencies such as WHO, World Bank, UNDP, and the EU. 'Calum Paton has long been one of our most insightful health academics. Rigorous in his approach, he has never been afraid to swim against the ever shifting tides of received opinion. His latest book which is the culmination of decades of analysis of the impact of politics on evolving health policy is a tour de force. Beautifully written, it exposes the fragility of much of the thinking behind the endless re-organisations and re-structurings endured by the NHS. He castigates both the right and the left who for widely opposing reasons have subjected the NHS to an overbearing audit and tick box oversight that chokes off the altruism of staff and gets in the way of improving services. At a time when the NHS is so much under the cosh both politically and financially, his book is a timely warning to all sides of the debate that pre conceived political ideologies are not the basis for progress; nor too, a woolly consensual approach seeking in vain to take the NHS out of politics. He acknowledges no magical solution but argues that awareness of the problems caused by market solutions or so called public service reforms is at least a start. Calum's book is a must read for all concerned about the NHS and its future.- The Rt Hon. the Lord Hunt of Kings Heath OB, President of the Royal Society for Public Health 'Calum Paton's book traces 25 years of NHS re-organisations (or re-disorganisations). He offers a detailed and insightful examination of the twists and turns of policy and the effects that this has had, and indeed the causes of the current state of affairs. The author argues that underlying and persistent political beliefs concerning such things as the role of the market reveal both arational and irrational aspects of policy making, which need to be seen in the broader context of the British political scene. Calum Paton writes, as always, with wit and aplomb together with a keen theoretical perspective and a wry sense of humour. It's a fascinating journey throu gh the history of NHS policy, and anyone who wants to understand how and why the NHS ended up in another fine mess, should read this book.- Dr Alison Hann, Senior Lecturer in Public Health and Policy Studies, Swansea University, UK This book explains the politics of thirty years of 'market reform in the English NHS, with the rest of the UK a counter-factual. Paton shows how each subsequent reform has been shaped by the confusion left by the previous reform. The long-term ideology has been anti-statist but policy-making at each stage of 'reform has been driven by short-term politics. The outcome in England has been ever-increasing complexity in the NHS, with significantly increased management costs and no commensurate benefit. Calum Paton is Emeritus Professor of Public Policy at Keele University, UK. His books include seminal analyses of the Thatcher and Blair reforms to the NHS. He is Editor-in-Chief of the International Journal of Health Planning and Management. He was Chair of the University Hospital of North Staffordshire NHS Trust from 2000 to 2006, and has advised politicians in the UK, governments abroad and agencies such as WHO, World Bank, UNDP, and the EU Front Matter....Pages i-xiv The Politics Behind the Conservative ‘Internal Market’ in the 1990s....Pages 1-18 The Changing Politics of New Labour: From ‘Reintegration Without Reorganisation’ to Retreading the Market Road....Pages 19-36 Political Explanation of Labour’s Initiative-itis....Pages 37-51 England in a UK Context: Diversity of Governance....Pages 53-64 From New Labour’s End-Game to Coalition Re-invention of the Wheel....Pages 65-83 From the 2010 White Paper to the 2012 Health and Social Care Act....Pages 85-99 Summative Political Explanation: NHS ‘Reform’ over 30 Years....Pages 101-119 Garbage-Can Politics Yet Neo-Liberal Ideology....Pages 121-155 The Cost of the Market: The Price of Ideology....Pages 157-175 Diagnosis, Prognosis, and Prescription: Will England Join the UK?....Pages 177-206 Back Matter....Pages 207-214