Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-25T21:09:37.237Z Has data issue: false hasContentIssue false
  • English
  • Français

Seventy years of the British National Health Service: problem, politics and policy streams

Published online by Cambridge University Press:  15 April 2018

Martin Powell
Martin Powell*
Affiliation:
Health Services Management Centre, University of Birmingham, Birmingham, UK
*
*Correspondence to: Martin Powell, Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Birmingham B15 2RT, UK. Email: m.powell@bham.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

The British National Health Service (NHS) celebrates its 70th birthday on 5 July 2018. This paper examines this anniversary through the lens of previous anniversaries, exploring two strands of political debates and NHS documents. It draws on the basic ‘multiple streams model’ of Kingdon that argues that an issue reaches the agenda when the policy window opens to allow the coupling of three independent streams – policy, problem and politics. It is found that there appears to be some discontinuity in the problem stream; some periods of relative consensus and sharp political differences in the politics stream; and sharp variations over time in the policy stream. While it is clear that there have been both continuities and discontinuities in the problem, politics and policy streams over the past 70 years, they have rarely come together to result in a policy that has taken it off the agenda.

Type
Perspective
Information
Health Economics, Policy and Law , Volume 14 , Issue 1 , January 2019 , pp. 29 - 39
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Department of Health (DH) (2008), ‘High Quality Care For All, Next Stage Review Final Report (Darzi Review)’, Cm 7432, London: TSO.Google Scholar
Drisko, J. and Maschi, T. (2016), Content Analysis, Oxford: Oxford University Press.Google Scholar
Guillebaud (1956), ‘Report of the Committee of Enquiry into the Cost of the National Health Service’, Chair: C. W. Guillebaud, Cmd 9663, London: HMSO.Google Scholar
Hansard House of Commons (1958), ‘National Health Service, 30 July, vol 592, cols 1382-1506’, http://hansard.millbanksystems.com/commons/1958/jul/30/national-health-service [11 December 2017].Google Scholar
Hansard House of Commons (1969), ‘National Health Service (Financing), 1 July, vol 786, cols 242-313’, http://hansard.millbanksystems.com/commons/1969/jul/01/national-health-service-financing#S5CV0786P0_19690701_HOC_280 [12 December 2017].Google Scholar
Hansard House of Commons (1979), ‘National Health Service, 15 March, c707–830’, http://hansard.millbanksystems.com/commons/1979/mar/15/national-health-service#S5CV0964P0_19790315_HOC_293 [13 December 2017].Google Scholar
Hansard House of Commons (1988), ‘National Health Service, 5 July, c907-996’, http://hansard.millbanksystems.com/commons/1988/jul/05/national-health-service [14 December 2017].Google Scholar
Hansard House of Commons (1997), ‘National Health Service, 9 December, c796-810’, http://hansard.millbanksystems.com/commons/1997/dec/09/national-health-service#S6CV0302P0_19971209_HOC_128 [15 December 2017].Google Scholar
Hansard House of Commons (2008), ‘Opposition Day. NHS (60th Anniversary), 24 June, c216-259’, https://publications.parliament.uk/pa/cm200708/cmhansrd/cm080624/debtext/80624-0013.htm#080624123000001 [18 December 2017].Google Scholar
House of Lords Select Committee on the Long-term Sustainability of the NHS (2017), The Long-term Sustainability of the NHS and Adult Social Care, HL Paper No. 151, London.Google Scholar
Kingdon, J. (1984), Agendas, Alternatives and Public Policy, Boston, MA: Longman.Google Scholar
Klein, R. (2013), The New Politics of the NHS, 7th edn, Abingdon: Radcliffe Medical.Google Scholar
Jones, M., Peterson, H., Pierce, J., Herweg, N., Bernal, A., Raney, H. and Zahariadis, N. (2016), ‘A river runs through it: a multiple streams meta-review’, The Policy Studies Journal, 44(1): 13–36.Google Scholar
Ministry of Health (1968), National Health Service: The Administrative Structure of the Medical and Related Services in England and Wales, London: HMSO.Google Scholar
Powell, M. and Exworthy, M. (2016), ‘Never Again? A Retrospective and Prospective View of English Health Reforms’, in M. Exworthy, R. Mannion and M. Powell (eds), Dismantling the NHS? Bristol: Policy Press, 365–380.Google Scholar
Royal Commission on the National Health Service (NHS) (1979), ‘Report’, Chairman: Sir Alec Merrison, Cmnd 7615, London: HMSO.Google Scholar
Secretary of State for Health (1989), ‘Working for Patients’, Cm 555, London: HSMO.Google Scholar
Secretary of State for Health (1997), ‘The new NHS. Modern. Dependable’, Cm 3807, London: TSO.Google Scholar
Secretary of State for Health (2009), ‘NHS 2010–2015: From Good to Great. Preventative, People-Centred, Productive’, Cm 7775, London: TSO.Google Scholar
Timmins, N. (ed.) (2008), Rejuvenate or Retire? Views of the NHS at 60, London: Nuffield Trust.Google Scholar