S. Asthana and J. Halliday
Milbank Quarterly, vol.84, 2006, p.577-603
The reduction of health inequalities has been an important part of the political agenda in the UK since the election of the New Labour government in 1997. An associated imperative has been that policies designed to address health inequalities should be based on reliable evidence. Systematic reviews of the available evidence have identified few interventions that appear to work. Public health interventions to address health inequalities, however well designed, operate within complex social systems. Not all the variables that could affect the impact of an intervention can be controlled. Acknowledging that the effectiveness of similar interventions varies according to context, researchers need to distinguish between potentially generalisable and conditionally successful interventions, and, for the latter, to find those contextual features that turn potential into successful outcomes. The authors suggest that international comparison of policies and interventions adopted by different public health regimes can be a useful analytical framework to this end. This approach could differentiate between policies and interventions that are effective in different contexts and therefore potentially generalisable and those that depend on particular conditions for success.
Public Management Review, vol.8, 2006, p.463-482
This analysis shows that under both the Blair and Thatcher governments public expenditure increased in monetary terms from around £4bn in 1979 to around £400bn in 2002. However, as a ratio of GDP it has declined from a peak of around 47% in 1974 to 40% in 2002. Under both governments public expenditure cuts have impacted mainly on infrastructure programmes, such as building roads, schools and hospitals, and on public service pay. However, two decades of pay restraint led to shortages of doctors, nurses and teachers. At the micro level, the Thatcher government constrained spending on social programmes, health and education, while investing in defence and law and order. In contrast, Blair has prioritised spending on health, education, social security and housing.
T.P. Larsen, P. Taylor-Gooby and J. Kananen
Journal of Social Policy, vol.35, 2006, p.629-649
New Labour has relied on a mix of policy making styles since gaining power in 1997. This article reviews the policy processes behind the recent welfare reforms and considers the policy styles used in the areas of long term care, family policy, labour market policy and pensions. It argues that a mix of policy-making methods is currently being used, ranging from the classic top-down approach, through the use of external commissions to a more bottom-up approach, where external groups substantially design policy. The policy-making style employed depends on the type of policy and the power relations between key actors and the government. External commissions and bottom-up approaches are primarily used when New Labour attempts to intervene in the private or voluntary sector, when reforms are service-oriented or extend government authority in terms of developing new policy directions, and when cross-departmental collaboration or changes in current administration are required. By contrast, the classic top-down approach is more prevalent when new policies involve dramatic increases in public expenditure, are more politically or ideologically driven, and affect relatively weaker groups.
Community Care, Sept.28th-Oct.4th 2006, p.28-29
This article evaluates ideas put forward in the government’s latest plan for tackling social exclusion. It looks at plans for: 1) the development of intensive home-based interventions to tackle childhood mental health and conduct disorders; 2) the encouragement of paid employment for those suffering from more severe mental health problems; and 3) the piloting of a budget-holding lead professional model to improve and co-ordinate access to services for children with additional needs.
Journal of Social Policy, vol.35, 2006, p.671-688
In the context of population ageing, the UK government hopes to improve labour supply by securing higher levels of economic activity, particularly among women. It aims to encourage women with children to re-enter the labour market by improving childcare provision and extending parental leave. The author concludes that, while they may increase the labour supply in the short term, these measures are unlikely to be sufficient to reverse the trend towards smaller families. Thus they will not reverse population ageing by encouraging women to have larger families.