Policy and ideology: the politics of post-reform health policy in the United Kingdom

Abstract

While it is commonly accepted that the broader political and economic climate directly influences the nature of any major changes in the provision of health care (witness the 1991 National Health Service reforms in the United Kingdom), there is less consideration of the effect of paradigm changes in health care and health care management themselves on wider political and ideological strategies. This article examines the recent health policy initiatives presented by Britain's Labour Party. The author argues that while the Conservatives' market-oriented reforms reflected the perceived political and economic realities of the 1980s, the rapidly increasing credibility of strategies of prevention within the health care sector (including an emphasis on the social determinants of ill-health, the need to plan a shift from acute to community care, and the desire for greater lay participation in policy-making) allows Labour to highlight the limitations of a strongly market-oriented system in the health care sector more so than in any other policy area.