Calum Paton, New labour's state of health: political economy, public policy and the NHS, Aldershot, Ashgate Publishing, 2006, 169 pp., ISBN 10:0 7546-4513-4

✍ Scribed by Dr Alison Hann

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 55 KB
• Volume: 22
• Category: Article
• ISSN: 0749-6753
• DOI: 10.1002/hpm.877

✦ Synopsis

This book provides a detailed and thorough analysis of New Labour's approach to health policy, and offers the reader sharp insights as to why the NHS is in such a 'sorry mess'. The book is divided into three parts, which reflect the triple reference in the title. In part one the author argues that the political economy is a major factor in explaining the development of UK health policy in the context of global capitalism. The tensions between the New Labour Project of 'tidying up the bottom of the heap' of health inequalities, while pleasing the middle classes, who increasingly want more 'bang for the buck' are ingeniously unpicked, and what is revealed is a field of policy making so fraught with contradictions that crisis seems inevitable.

Part two of the volume continues the analysis by examining the main 'causal factors' explaining role of the state, public policy making and policy implementation under New Labour. The confusing and complex interactions of causes and effects that characterise 'the policy process' are subjected to a critical and insightful analysis. What is argued is that the degree of 'rationality' required to come up with a comprehensive health policy strategy is frustrated by inadequate policy coordination, perverse outcomes and ineffective implementation coupled with 'policy hyper-activism' by the executive and a change in the structure and culture of government. Using the metaphor of the garbage can, Paton shows how the clashing of interests (or goals) and the exertion of power within the policy process leads to a 'post-modern' style of politics in a 'late modernist' world. As the author puts it: 'Thus we have the irony that a governmental structure in principle quite suitable for 'rational' policy making . . . [which has] undermined itself through post modern culture'.

The final part of the book examines New Labour's health policy in more detail, and in particular asks 'where the money has gone' and reviews some of the most salient elements of New Labour's health policy over time, identifying trends and biases, as well as questioning the ability of New Labour to win the ideological war to preserve and defend the NHS.

This volume provides a fascinating and highly detailed analysis of New Labour's project, which is persuasive in its arguments and demonstrates that any analysis of the policy process needs to be set within a much broader social and political context. It will provide inspiring reading for scholars who are engaged in research into this area, as well as students who are seeking a sharp and coherent analysis of New Labour's state of health. However, it will also be valuable eading for anyone