The Politics of the National Health Service

(In January 1989 the Conservative Government of Mrs Thatcher published far-ranging plans for reorganising the National Health Service. Events in 1989. like events in 1948 the year of the NHS's creation, must be seen in the context of the social, economic and political environment of the time. Just as the creation of the NHS reflected faith in rational planning, so the 1989 reorganisation reflects a belief in value for money and competition. Moreover, throughout the history of the NHS there have been a series of between the desire to control budgets through centralisation and the wish to promote responsiveness through decentralisation, between bureaucratic and professional power, between expert paternalism and con-Using Cabinet papers and interviews with the political and professional actors in the health policy arena, this book analyses the way in which these tensions have worked themselves out through the forty years history of the NHS upto and including the 1989 Government White Paper. It concludes that with the transformation of society in the 1980s - the result of technological, social and economic changes - the transformation of health care in Britain is inevitable, even though the precise nature of what will eventually emerge is still an open question.The future of the NHS has dominated the political agenda in the second half of the 1980s. Politicians trade a bewildering array of statistics in order to prove or disprove that the NHS is 'safe in the hands' of the government. The second edition of this enormously popular book cuts through the political rhetoric to provide a cool analysis of the fundamental issues at stake in one of the key debates in British politics)