Skip to main content Accessibility help

Understanding Policy Scandals in Historical Context: A Longer-Term Lens for Policy Analysis



The emergence of and reaction to policy scandals has been usefully studied through comparative case studies. Far less attention has been devoted, however, to the study of such scandals in long-term historical context. With the aim of illuminating longer-term social processes which shape the likelihood that (health)care scandals emerge, we delineate three areas where such changes are visible: a) changing formats of social relations and emotions within and around care provision, and thereby understandings of and demands for compassionate care; b) heightened organisational and political sensitivity to failings; and c) changes in media reporting on healthcare failings, as well as in policy-makers’ responsiveness to and manipulation of media. We consider the 2013 Mid Staffordshire scandal in the English National Health Service and the extant policy literature on this scandal to help illuminate the added analytical value of our long-term approach. In the final section we explore the interconnection of the three processes and how longer-term approaches open up new vistas for policy analysis.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Understanding Policy Scandals in Historical Context: A Longer-Term Lens for Policy Analysis
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Understanding Policy Scandals in Historical Context: A Longer-Term Lens for Policy Analysis
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Understanding Policy Scandals in Historical Context: A Longer-Term Lens for Policy Analysis
      Available formats


This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.


Hide All
Alaszewski, A. and Brown, P. (2012), Making Health Policy: a critical introduction. Cambridge: Polity.
Beaussier, A., Demeritt, D., Griffiths, A. and Rothstein, H. (2016), ‘Accounting for failure: risk-based regulation and the problems of ensuring healthcare quality in the NHS’, Health, Risk & Society, 18, 3-4, 205224.
Best, J. (1990), Threatened Children: rhetoric and concern about child victims, Chicago: University of Chicago Press.
Bevan, G. and Hood, C. (2006), ‘What’s measured is what’s matters: targets and gaming in the English public health care system’, Public Administration, 84, 3, 517538.
Boin, A., t’Hart, P. and McConnell, A. (2009), ‘Crisis exploitation: political and policy impacts of framing contests’, Journal of European Public Policy, 16, 1, 81106.
Bowling, A. (2007), ‘Honour your father and mother: ageism in medicine’, British Journal of General Practice, 57, 538, 347348.
Brown, P., Elston, M.E. and Gabe, J. (2015), From patient deference towards negotiated and precarious informality: an Eliasian analysis of English general practitioners’ understandings of changing patient relations. Social Science & Medicine, 146, 164172.
Butler, I. and Drakeford, M. (2005), Scandal, Social Policy and Social Welfare, Bristol: Policy Press.
Cooter, R. (1995), ‘The resistable rise of medical ethics’, Social History of Medicine, 8, 2, 257270.
de Swaan, A. (1981), ‘The politics of agoraphobia’, Theory and Society, 10, 3, 359385.
de Swaan, A. (1995), ‘Widening circles of identification: emotional concerns in sociogenetic perspective’, Theory, Culture & Society, 12, 2, 2539.
Department of Health (1991), The Patients’ Charter, London: HMSO.
Department of Health (2013), ‘Prime Minister responds to Mid Staffs public inquiry report’, [accessed 14 April 2016].
Department of Health (2016), ‘The Government’s Mandate to NHS England for 2016-2017’, [accessed 14 May 2017].
Department of Health (2017a), ‘Compassionate care in the NHS’, [Accessed 14 May 2017].
Department of Health (2017b), ‘The Hospital Food Standards Panel’s report on standards for food and drink in NHS hospitals’, [accessed 14 May 2017].
Dixon-Woods, M., Baker, R., Charles, K., et al. (2013), ‘Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study’, BMJ Quality and Safety, 23, 106115.
Dixon-Woods, M. Yeung, K. and Bosk, C. (2011), ‘Why is UK medicine no longer a self-regulating profession? The role of scandals involving “bad apple” doctors’, Social Science and Medicine, 73, 10, 14521459.
Elias, N. (2000), The Civilising Process, Oxford: Blackwell.
Ferguson, H. (2007), ‘Abused and looked after children as “Moral Dirt”: child abuse and institutional care in historical perspective’, Journal of Social Policy, 36, 1, 123139.
Flores, R. and Brown, P. (2018), ‘The changing place of care and compassion within the English NHS: an Eliasean perspective’, Social Theory & Health, 16, 2, 156171.
Flynn, R. (2002), ‘Clinical governance and governmentality’, Health, Risk & Society, 4, 2, 155173.
Francis, R. (2013a), Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, London: The Stationary Office.
Francis, R. (2013b), ‘Culture, compassion and clinical neglect-probity in the NHS after Mid Staffordshire’, Journal of Medical Ethics, 41, 946947.
Galtung, J. and Ruge, M. (1965), ‘The structure of foreign news: the presentation of the Congo, Cuba and Cyprus Crises in Four Norwegian Newspapers’, Journal of Peace Research, 2, 1, 6490.
Giddens, A. (1990), The consequences of modernity. Cambridge: Polity.
Giddens, A. (1991), Modernity and Self-Identity: self and society in the late-modern age, Stanford: Stanford University Press.
Greenhalgh, T. (2013), ‘The compassionate organisation’, British Journal of General Practice, 63, 614, 481.
Habermas, J. (1976), Legitimation Crisis, Cambridge: Polity.
Habermas, J. (1987), Theory of Communicative Action: vol. 2, lifeworld and system, a critique of functionalist reason, Cambridge: Polity.
Habermas, J. (1989), The structural transformation of the public sphere: an inquiry into the category of bourgeois society, Cambridge: MIT Press.
Howe, G. (1969), Report of the committee of enquiry into the allegations of ill treatment of patients and other irregularities at Ely hospital, Cardiff, Cmnd3975, London: HMSO.
Hutchison, J. (2016), ‘Scandals in health-care: their impact on health policy and nursing’, Nursing Inquiry, 23, 1, 3241.
Hughes, E., Kitzinger, J. and Murdock, G. (2006), The media and risk. In: Taylor-Gooby, P. and Zinn, J. (Eds.,) Risk in Social Science (pp. 250270), Oxford University Press, Oxford.
Hunt, J. (2014), “Francis effect’ on NHS care one year on from Mid Staffs Inquiry’: press release via the Department of Health, [accessed 18 April 2016].
Jefferys, M. (2000), Recollections of the pioneers of the geriatric medicine specialty. In: Bornat, J., Perks, R., Thompson, P. and Walmsley, J. (Eds.), Oral History, Health and Welfare (pp. 7597), Routledge, London.
Jolley, J. (2004), A social history of pediatric nursing: 1920–1970. Unpublished PhD, thesis: University of Hull.
Jolley, J. and Shields, L. (2009), ‘The evolution of family-centered care’, Journal of Pediatric Nursing, 24, 2, 164170.
Jones, K. (1993), Asylums and after: a revised history of the mental health services: from the early 18th century to the 1990s, London: Athlone.
Kitzinger, J. (2000), ‘Media templates: patterns of association and the (re)construction of meaning over time’, Media, Culture & Society, 22, 1, 6184.
Lindblom, C. (1959), ‘The science of ‘muddling through’, Public Administration Review, 19, 2, 7988.
Lodge, M. and Hood, C. (2002), ‘Pavlovian policy responses to media feeding frenzies? Dangerous dogs regulation in comparative perspective’, Journal of Contingencies and Crisis Management, 10, 1, 113.
Luhmann, N. (1993), Risk: a sociological theory, New York: Aldine de Gruyter.
Lull, J. and Hinerman, S. (1997), Media Scandals: Morality and Desire in the Popular Culture Marketplace, New York: Columbia University Press.
Martin, J. and Evans, D. (1984), Hospitals in Trouble, Oxford: Blackwell.
Menzies Lyth, I. (1960), ‘Social systems as a defense against anxiety: an empirical study of a nursing service in a general hospital’, Human Relations, 13, 95121.
Mol, A. (2008), The Logic of Care: Health and the problem of patient choice. London: Routledge.
Mold, A. (2010), ‘Patient groups and the construction of the patient-consumer in Britain: an historical overview’, Journal of Social Policy, 39, 4, 505521.
Mold, A. (2015), Making the Patient Consumer: patient organisations and health consumerism in Britain, Manchester: Manchester University Press.
Moran, M. (2001), ‘The rise of the regulatory state in Britain’, Parlimentary Affairs, 54, 1, 1934.
Negrine, R. (1994), Politics and the Mass Media in Britain, 2nd edn, London: Routledge.
Newdick, C. and Danbury, C. (2013), ‘Culture, compassion and clinical neglect: probity in the NHS after Mid-Staffordshire’, Journal of Medical Ethics, 41, 956962.
Pollock, A. and Price, D. (2013), ‘Mid-Staffordshire should lead to a fundamental rethink of government policy’, British Medical Journal, 346, f2190.
Porter, R. (2005), A touch of danger: the bedside manners of the eighteenth century physician. In: Classen, C. (Ed.) The Book Of Touch (pp. 377383), Berg, New York.
Power, M. (2004), The risk management of everything: rethinking the politics of uncertainty, London: Demos.
Rader, J., Barrick, A., Hoeffer, B., et al. (2006), ‘The bathing of older adults with dementia: easing the unnecessarily unpleasant aspects of assisted bathing’, American Journal of Nursing, 106, 4048.
Raghuram, P., Bornat, J. and Henry, L. (2011), ‘The co-marking of aged bodies and migrant bodies: migrant workers’ contribution to geriatric medicine in the UK’, Sociology of Health and Illness, 33, 2, 321335.
Robb, B. (1967), Sans everything: a case to answer, Edinburgh: Nelson.
Rodger, J. (2003), ‘Social solidarity, welfare and post-emotionalism’, Journal of Social Policy, 32, 3, 403421.
Rothstein, H. (2006), ‘The institutional origins of risk: a new agenda for risk research’, Health, Risk & Society, 8, 3, 215221.
Schei, E. (2006), ‘Doctoring as leadership: the power to heal’, Perspectives in Biology and Medicine, 49, 3, 393406.
Smajdor, A. (2013), ‘Reification and compassion in medicine: a tale of two systems’, Clinical Ethics, 4, 111118.
Smith, R. (1998), ‘All changed, all changed utterly: British medicine will be transformed by the Bristol case’, British Medical Journal, 316, 19171918.
Spector, M. and Kitsuse, J. (1977), Constructing Social Problems, 4th edn, New Brunswick: Transaction.
Stimson, G. and Webb, B. (1975), Going to see the doctor, London: Routledge & Keegan Paul.
Taylor-Gooby, P. (2012), ‘Why do people stigmatise the poor at a time of rapidly increasing inequality, and what can be done about it?’, The Political Quarterly, 84, 1, 3142.
Thelen, T. (2014), Care/Sorge: Konstruktion, Reproduktion und Auflösung bedeutsamer Bindungen, Bielefeld: transcript Verlag.
Tonkens, E. (2012), ‘Working with Arlie Hochschild: connecting feelings to social change’, Social Politics, 19, 2, 194218.
Tronto, J. (2010), ‘Creating caring institutions: politics, plurality, and purpose’, Ethics and Social Welfare, 4, 2, 158171.
Turner, B.A. and Pidgeon, N.F. (1997), Man-made disasters, 2nd edn, Oxford: Butterworth-Heinemann.
Warner, J. (2006), ‘Inquiry reports as active texts and their function in relation to professional practice in mental health’, Health, Risk and Society, 8, 3, 223237.
Warner, J. (2015), The emotional politics of social work and child protection, Bristol: Policy Press.
Wilkinson, I. (2010), Risk and vulnerability in everyday life, London: Routledge.
Winnett, R. and Brogan, B. (2013) Stafford scandal: Jeremy Hunt calls for police inquiry into NHS. The Telegraph, 8 February.
Wouters, C. (2007), Informalization: Manners and emotions since 1980, London: Sage.

Understanding Policy Scandals in Historical Context: A Longer-Term Lens for Policy Analysis



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed