MAKING REFORM LOCALLY: GENERAL PRACTITIONERS, HEALTH CARE MANAGERS AND THE "NEW" BRITISH NATIONAL HEALTH SERVICE

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The National Health Service is key to Britain's welfare state, and has been subject to repeated reform initiatives. Such reforms rarely "fix" the problems for which they are introduced, but evaluations have neglected the significance of local action. Reform implementation involves local translation of politically contextualized ideas into workable practice. I focus on implementation processes and the role of professions. Ethnographic data reveal local actors engaging with policy objectives to protect existing structures within the boundaries of official reform rhetoric. Actors employ multiple strategies to maintain existing systems. Rather than "failing," policy is made through localized collaboration.

Original languageEnglish (US)
Title of host publicationReorganizing Health Care Delivery Systems
Subtitle of host publicationProblems of Managed
Pages143-162
Number of pages20
DOIs
StatePublished - Dec 1 2003
Externally publishedYes

Publication series

NameResearch in the Sociology of Health Care
Volume21
ISSN (Print)0275-4959

ASJC Scopus subject areas

  • Sociology and Political Science
  • Public Health, Environmental and Occupational Health
  • Nursing (miscellaneous)

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