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While there are important differences between the public health policies of Conservative governments of the 1980s and 90s and the current British Labour government a significant element of continuity is the emphasis on government facilitating informed choice by consumers as a key public health objective. The article considers such approaches to disclosure of health risks with respect to policy on the regulation of smoking. It argues that regulation, in this area, under the Conservatives has not served to ‘empower’ consumers and that such regulatory weaknesses appear to be replicated under its successor. Defects in regulation are traced with respect to disclosure of information on tar and nicotine ‘yields’; and cigarette design with respect to tip ventilation and the use of additives to increase nicotine delivery. It is argued that lack of disclosure and insufficient controls on the industry have led to consumers being misled concerning the relative risks of different types of cigarette. Equally, it is also likely that such deficiencies have enabled manufacturers to represent some cigarette types as ‘safe’. The paper concludes by arguing that, while the weaknesses of the current regulatory regime suggest the need for measures of increased disclosure and control of product design, there is also an unresolved tension as to whether ‘empowerment’ is an intrinsic goal of policy or a means to the achievement of public health targets. [ABSTRACT FROM AUTHOR]

In 2007, the English Department of Health (DH) issued advice stating 'pregnant woman' and 'those trying to conceive' should abstain from drinking alcohol. As others have noted, this advice was issued despite their being no new evidence about the deleterious effects of low levels of alcohol consumption. In this paper, we argue this development is significant for the social construction of 'risk', since in advocating abstinence without an evidence base for this advice, policy makers formalise a connection between uncertainty and danger. We suggest this development has important implications, most obviously for pregnant women, certainly impacting on the nature of the advice they will now receive and likely more generally on their experience of the transition to motherhood. We suggest it has wider implications for individuals' experience also, as policy makers appear to be advocating the same approach to risk to non-pregnant people. Further, it suggests a noteworthy formalisation of a new definition of risk, which should be debated far more extensively, as it matters for the future development of health policy. [ABSTRACT FROM AUTHOR]

A new Labour government was elected in the UK in May 1997 with a strongly stated commitment to improving public health and tackling inequalities. This focus on public health was part of a concerted attempt to tackle poverty and social exclusion through 'joined up thinking' across central government. Thus health inequalities were to be tackled 'upstream' through wider government initiatives. Fundamental to the government's policy has been the development of public health capacity, including a more multi-disciplinary public health workforce and greater partnership working at local level. Improving public health is a long-term project, however, and politicians' decisions are often driven by short-term election cycles. Midway into its first term, the government published The NHS Plan which re-focused policy attention on the problems of the health care system. As the 2001 election approached, the government launched Shifting the Balance of Power, a major re-organization of the English NHS with the intention of improving the 'delivery' of health care, but which also had profound implications for the public health function. This paper argues that UK government policy towards public health has been characterized by continuing and fundamental tensions. Far from empowering public health practitioners, these tensions in central policy have contributed to practitioners' uncertainty about their roles, and how they can meet the centre's increasing demands for demonstrable 'delivery'. The implications are considered for building capacity in the UK and for a wider systems understanding of capacity issues. [ABSTRACT FROM AUTHOR]

Home modification or adaptation is an important global issue, especially for older people living with disabilities in ordinary housing of varying ages, and pre-dating concerns about accessibility in design. Comparisons of research from five developed nations identify common themes: variation in integrated service development; public and private financial investment; deferred health costs; workforce expansion and training; and the value of the user perspective. Further discussion identifies the importance of retrofitting alongside new build, and argues for sustainable housing that recognizes population aging but also issues of climate change and the need for more inclusive design of housing for all ages. [ABSTRACT FROM AUTHOR]

This article uses a case study of financial sector policy making in East Asia in the post 2000 period to examine and help to resolve questions surrounding the origins of the phenomenon of ‘dynamics without change’ in public policy making; that is, the appearance of policy activity and alteration without affecting the overall nature and orientation of policy outputs or outcomes. This is a phenomenon which has challenged existing notions of policy dynamics which associate enhanced policy activity with fundamental changes in outputs and outcomes and is an issue which has concerned policy studies since Robert Alford’s seminal study of British health policy dynamics first noted the phenomenon in the mid-1970s. The article develops and extends the ideas put forward by Rayneret al. (2001, Privileging the sub-sector: critical sub-sectors and sectoral relationships in forest policy-making,Forest Policy and Economics, 2 (3–4), 319–332) that ‘critical subsectors’ or subsets of actors within a subsystem which control whether or not fundamental change occurs. Evidence from recent developments in the Asian financial sector is put forward supporting the argument that the uneven structuration and non-reciprocal nature of the relationships existing between components of a policy subsystem explain that policy’s propensity for change and stability. The discussion moves the general analysis of policy change, policy subsystems and their role in policy change forward from the existing orthodoxy of ‘dynamics with change’ and provides the foundation for a new research programme analysing intra-sectoral policy dynamics in an empirically robust manner. [ABSTRACT FROM PUBLISHER]

Today, qualitative researchers are framing the relationship between qualitative case studies and quantitative evaluation research in positivist terms, seeking dialogue with quantitative researchers on the basis that qualitative case studies hold the potential to develop theory for evaluation programmes and to improve the quality of quantitative research. In the UK health policy literature, however, recent evaluations of major government programmes of reform have been conducted under largely quantitative and econometric strategies involving baskets of indicators, or routinely collected hospital statistics, set against the central stated aims of the programme: namely, to improve quality, efficiency, responsiveness, output and equity. For the wider evaluation literature, we detail the results of a qualitative case study of the impact of two key reforms, the 18 Week Patient Pathway and Payment by Results, on four English hospitals, demonstrating the value of the positivist frame to evaluation research based on its capacity to improve understandings of cause and effect and to direct quantitative researchers towards better measures and data sets. For the UK health policy literature, we demonstrate the value of qualitative case studies to the policy process in terms of their potential to reduce the risks for serious policy mistakes. [ABSTRACT FROM PUBLISHER]

This article examines Gordon Brown's promise to 'let the work of change begin', as it applies to the public services. It looks at the expectations for Brown's government at the handover from Blair, and in particular the claim that Brown is somehow to the left of his predecessor. Most of these arguments were found to be mistaken once Brown was in power. The article then looks at Brown's record on the public services during his first year in power through both his own comments and policy initiatives, and those of people close to him. In particular, the article contrasts Brown's premiership with that of his predecessor. There are two areas of focus: first, the relationship between central government and public service professionals; second, the issue of choice in the public services. The article concludes that although there are subtle differences between Brown and Blair, his project is substantially the same as that of his predecessor, although the conditions under which it has to be carried out are more difficult. If there is a difference (and it is argued this is only one of degree) it is that whilst both Blair and Brown are happy with the introduction of private money into the public services, Blair was more pro-competition than his successor. [ABSTRACT FROM AUTHOR]

This article provides a time series analysis of NHS public inquiries and inquiries related to health against the background of recent policy changes which are centralizing hazardous incident investigations within agencies such as the Healthcare Commission. [ABSTRACT FROM AUTHOR]

New Labour argues that its 'new NHS' will achieve the traditional goal of fairness using the modern NHS means of partnership and co-operation. The authors examine the issue of reducing inequalities in health using the framework of policy, process and resource streams. While the policy stream is a little muddy, the process and resource streams are more opaque. In particular, there are concerns about technical and political feasibility, and little apparent attention to issues of opportunity costs and trade-offs. The low priority given to health inequalities is reflected in the resource stream, where there are also issues of accountability and budgetary slack. The authors argue that the limited confluence of the streams is unlikely to lead to a sea-change in the level of health inequalities. [ABSTRACT FROM AUTHOR]

The article offers information on the efforts of the Centre of Excellence for Information Sharing and its associated challenges. Topics discussed include information on the Regional health information exchange for improving the health care using information sharing and policies for the education in Great Britain; discussions on the issues related to the data protection; and the discussion of information governance and big data in health.