Efficiency Criteria for Nationalised Industries (Routledge Revivals): Volume 3

The Economics of Feasible Socialism Revisited

Contents:

  • The British National Health Service 1948–2008: A Review of the Historiography
  • Product details
  • Collected Works, 1st Edition
  • Foundation
  • Stalinism and After by Alec Nove
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    • The British National Health Service 1948–2008: A Review of the Historiography

    Political Economy and Soviet Socialism 5. Socialism, Economics and Development 6. If you are interested in Revivals in the Behavioral Sciences, please visit https: Learn More about VitalSource Bookshelf. An eBook version of this title already exists in your shopping cart. If you would like to replace it with a different purchasing option please remove the current eBook option from your cart. Add to Wish List. Description Contents Series Subjects. Description From the early s until his death in , Alec Nove was one of the world's leading authorities on Russian and Soviet economic history.

    The Bookshelf application offers access: The official history details the long deliberative phase which preceded this reform. Analysis of its gestation points to ministerial frustration at the slow development of community care facilities and the unresponsiveness of the RHBs to central policy goals for psychiatric hospitals.

    Mays and Bevan explain the RAWP's origins in terms of a favourable political juncture the reorganisation, coupled with the advocacy of David Owen and increasing academic interest in inequalities and refining indicators of need; Welshman by contrast stresses the influence of academic health economists. The technocratic state was unsuccessful in appeasing the NHS's workforce, as spending curbs provoked industrial action by nurses, junior doctors and ancillary workers.

    Klein ascribes the growth of labour militancy to competition between the unions for members, and the disruptive effect of incomes policies on traditional pay differentials.

    Though the survey texts treat the Thatcher and Major years separately, the Conservative hegemony of —97 arguably forms a discrete period in the NHS's political history. General accounts of the welfare state view this as a watershed, marked by restrained public spending, confrontation with corporate interests and the imposition of market disciplines. Particularly intriguing is the debate over the genesis of this change, for Thatcher's ideological commitment had hitherto been tempered by concern over the political combustibility of NHS reform.

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    Summary This article surveys historical writing on the British National Health Service since its inception in Steven rated it really liked it Sep 05, Klein ascribes the growth of labour militancy to competition between the unions for members, and the disruptive effect of incomes policies on traditional pay differentials. Open Preview See a Problem? Albert rated it really liked it Jul 10,

    Butler's study is a first draft of this history, emphasising the combination of media pressures, Enthoven's ideas, and continuity with existing management reforms which fed into her review. Given the confrontational rhetoric of Thatcherism, it is unsurprising that commentaries on the Conservative policies are also oppositional. Klein is broadly sympathetic, viewing Thatcherism as a product of the societal changes of deindustrialisation and emergent consumerism: To the extent that it can yet be historicised, the Blair era divides into two phases.

    The first saw a softening rather than rejection of the internal market, with purchasing replaced by commissioning and GP fundholders by Primary Care Groups, and the acceleration of the Private Finance Initiative PFI building programme. Hitherto demographic data had persuaded government economists that NHS funding levels were broadly correct, and an annual inflator was calculated based on population change, new technology costs and relative price effects.

    Armed by the state with National Institute for Health and Clinical Excellence NICE guidelines and the National Service Frameworks standards, health service executives now wielded unprecedented power over clinical practice.

    Collected Works, 1st Edition

    Efficiency Criteria for Nationalised Industries (Routledge Revivals): Economics Books @ www.farmersmarketmusic.com Efficiency Criteria for Nationalised Industries (Routledge Revivals): Volume 3 1st . hand-picked children's books every 1, 2, or 3 months — at 40% off List Price.

    Whether or not this policy mix is a new trajectory is uncertain. Webster's history ends in with cautious praise that at least a substantial rise in expenditure has occurred. Opinion is more divided on individual aspects. PPI's recent history has attracted particular interest, with scholars tracking the changing forms, from the Community Health Councils CHCs set up in and abolished by Milburn in , to the use from of focus groups, citizens' juries and opinion polling, and finally to New Labour prescriptions of Patients' Forums and hospital membership communities.

    She argues that the founding principles of the NHS are already lost: Before turning to historical evaluations of the NHS, we should briefly note three significant areas of the health service which stand somewhat apart from the grand narrative outlined above. The others are the long-term care of psychiatric and elderly patients, where the issue of deinstitutionalisation looms large. The declinist analysis of public health was established by Lewis in the s, tracing the marginalisation of Medical Officers of Health MOsH , who were victims of restructuring in and , but also authors of their own downfall, failing to forge a new philosophy of preventive medicine relevant to the post-war environment.

    A central theme of psychiatry in the NHS is the shift since the s from institutional to community care. This is not a process which scholars have viewed as liberating or humane, nor is there consensus on the cause. Some, such as Freeman and Jones, regard the old asylums as essentially benign institutions whose demise was due to the unhappy conjunction of Conservative cost-cutting and wrong-headed anti-psychiatry doctrines.

    A third subaltern history is that of long-term care for the elderly. Here too there is a trajectory of decarceration and community care, and a theoretical framework which emphasises the productionist features of welfare states, with their tendency to allocate fewer resources to economically inactive groups. Before examining evaluations of the NHS in its different phases, we should first consider a central theme in Webster's analysis: One approach to this is to take population health as an indicator.

    On these terms it was initially argued that the NHS was very good value for money, achieving similar mortality rates at a cheaper cost than other countries, notably the United States. Appleby speculates with his eye on the recent past that managerial reform and new incentive structures were generating improvement even in the absence of more cash. Throughput is a blunt instrument with which to measure total NHS output, revealing nothing of quality and subject to other influences, such as technological advance.

    Nor is the causal link between rising throughput and post managerialism straightforward, since major productivity growth also occurred in the parsimonious and statist s. Thus the jury remains out on the under-funding thesis, though en passant we should note that Appleby buttresses Webster's view of the Left's greater financial commitment: Turning now to evaluations of the early period NHS, it is striking that despite the dismissals of contemporary politicians, historians have been generally kind to the Bevan model. Klein denies the possibility of impartial evaluation, as in the pluralist polity the NHS serves there are multiple and competing criteria.

    A surprising aspect of evaluations of the post reforms is just how little evidence there is of beneficial change from all the upheavals. Academic evaluation suggests not. Where do such findings from recent policy analysis leave the historian, groping towards an assessment of the reform era? The achievement was to shift power to primary care providers, to introduce incentives to enhance responsiveness and to make the activities of the service more transparent and measurable than ever before.

    The one is pessimistic, viewing the market-infused NHS as fundamentally inimical to the service's core ethic. How will these readings look at the seventy-fifth anniversary? Or will the trajectory of fragmentation and privatisation continue until it entirely overturns the post-war social democratic project?

    For now, in summer , with the worm turning again in the political and economic cycle, all this is uncertain. With this in mind, which research areas might future historians of the NHS prioritise? While their predecessors may have recounted its national political history, much remains to be learned of how policy translated into practice. Here the regional study offers rich possibilities for interrogating some of the themes discussed above, such as the balance of power between clinicians and managers, the resourcing struggles between teaching, general and psychiatric hospitals, the changing fortunes of public health, and so on.

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    The pre period, now so prone to either idealisation or condemnation, particularly deserves attention. Another promising area, not touched on hitherto, is the cultural history of the NHS. Media representations of medicine and health have until recently been a peripheral theme, though a strong case can be made for their centrality in shaping public perceptions and, by extension, political expectations of health services.

    Much statistical data gathered at regional level await collection and analysis, particularly for the early period. The shifting boundary between the public and private sector in the NHS, now so prominent and controversial in the policy literature, also cries out for a full historical survey. The questions of equity and efficiency which such studies might address are, as indicated above, central to the appraisal of the service. This prompts a final observation, and exhortation. With several of the NHS's leading historians now in the latter stages of distinguished careers, it is imperative that others come forward to engage with this subject.

    If not, institutional memory will remain weak and the tendency to glib caricature will surely intensify.

    Foundation

    Social expenditure comprises the NHS, education, social services, social security and housing. Such findings challenge McKeown's famously sceptical position on this issue, see Nolte and McKee , p. Specifically the throughput measure is hospital discharges and deaths; he argues that his expenditure series is more robust than either Webster's or the Office of Health Economics' series, in that it shows government spending net of other inputs, pp.

    For a psychoanalytic reading of this process, see Fotaki National Center for Biotechnology Information , U. Published online Oct Author information Copyright and License information Disclaimer. Summary This article surveys historical writing on the British National Health Service since its inception in National Health Service, historiography, primary care, hospitals, welfare state, policy, financing. Foundation The founding of the NHS is marked by debate over whether a broad consensus existed in favour of reform, or whether change was the outcome of conflict between progressive and reactionary forces.

    The First Phase, — The survey texts then delineate an initial phase of consolidation encompassing most of the s Webster until , Rivett and Klein to Three Subaltern Narratives Before turning to historical evaluations of the NHS, we should briefly note three significant areas of the health service which stand somewhat apart from the grand narrative outlined above. Evaluations and Historical Trajectories Before examining evaluations of the NHS in its different phases, we should first consider a central theme in Webster's analysis: Footnotes 1 Major ; Blair a , p.

    Can There Be Equity? The United States, Sweden and England. John Wiley and Sons; What Does the Historical Record Reveal? Journal of Health Services Research and Policy. Smoking and the Discourse of Public Health in Britain, — Oxford University Press; History's Role in Health Policy Making. Smoking and the New Health Education in Britain s—s.

    American Journal of Public Health. Public Health in the s and s: From Cradle to Grave: Fifty Years of the NHS. King's Fund, ix; New Politics for a New Century. The NHS at Accessed 1 October General Practice under the National Health Service — Evaluating Public Management Reforms: Open University Press; Social History of Medicine. Changing Ideas and Practice. Patients, Policies and Politics: Before and After Working for Patients. Nye Bevan and the Mirage of British Socialism. Weidenfeld and Nicolson; Ending Paternalism in Medical Care.

    Stationery Office for the Nuffield Trust ; Is a Government Health Warning Required? The British Experience Since Sociology of Health and Illness. The British National Health Service: A Tarnished Moral Vision? University of Birmingham; The English Health Service. Harvard University Press; The Case of the British Medical Association. Allen and Unwin; International Journal of Health Services. Asian Doctors in the NHS: British Journal of General Practice. Blood, Politics, and Social Science: Richard Titmuss and the Institute of Economic Affairs, —; pp.

    A Biography Volume Two: From Quasi-Market and Back to Market? A Comparative Analysis of Failure in Unlearning. Health Policies, Health Politics: The British and American Experience, — Princeton University Press; A Century of Psychiatry. Psychiatry in the National Health Service — British Journal of Psychiatry.

    Love, Hate and Welfare: Psychosocial Approaches to Policy and Practice. General Practice and Primary Health Care ss. Nuffield Provincial Hospitals Trust; Over to You, Mr Brown: How Labour Can Win Again. London's Voluntary Hospitals in the Interwar Period: Growth, Transformation or Crisis?

    Stalinism and After by Alec Nove

    Nonprofit and Voluntary Sector Quarterly. Twentieth Century British History. Policy-Making in the National Health Service: The Medical Profession, the Public, and the Government. Journal of Social Policy. Medical Autonomy and the UK State to The Frontier of Control: Doctors and Managers in the NHS to Which Champions, Which People?

    What is Nationalization?

    Social Policy and Administration. The Business of Medicine: Private Health Care in Britain. The Business-Social Policy Nexus: Health, Happiness and Security: The Creation of the National Health Service. Mental Health and Mental Handicap. Aspects of Scottish Health Services — Edinburgh University Press; Interest and Institutions in Western Europe.

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    Cambridge University Press; The Health of Nations: Cornell University Press; Accessed 8 June From the Early 18th Century to the s. Kathleen Jones in Conversation with Peter Kennedy. The Reporting of Health and Medicine. A Study in Professional Accountability. The Politics of the NHS.