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This book contends that attempts to reform the NHS can only be understood by reference to both the wider social and political contexts, and to the organisational and ideational legacies present within the NHS itself. It aims to take students beyond a basic understanding of the historical development of health policy in the UK, to one that demonstrates an appreciation of the interactions between health policy, organisation and society

This article explores the relationship between inequality and social harm, revisiting the original "Spirit Level" data from Wilkinson and Pickett, updating it for a later time period, and considering what difference it makes to their results by addressing criticisms made of their original research by using an alternative measure of inequality and expanding the range of possible causal factors. To achieve this, it makes use of both the original method used by Wilkinson and Pickett and that of a different approach, Qualitative Comparative Analysis. It finds that a measure of the kind of democracy (lower "integrative democracy"), along with higher inequality, are the key factors at the root of solutions for explaining higher social harm in both periods, which both follow up the suggestions by Wilkinson and Pickett about the role of democracy in explaining social problems, as well as making the extent and means of that relationship clearer.

AbstractThis paper takes an overview of the barriers to social progress 80 years on from the original Beveridge report (Beveridge, 1942). It argues we can identify and conceptualise five alternative 'Giants', relating these to social theory and social debates in the 21st century, and considering the prospects for progress against these new challenges. After considering Beveridge's original Giants in their context, it considers large‐scale theories of social change after 1942 and reviews what other 'Giants' writers have suggested in calls for a 'new Beveridge' and proposes inequality, preventable mortality, job quality, fragmenting democracy and environmental degradation as the most significant challenges we face, linking each to one of Beveridge's original Giants.

This paper explores the contextual and government response factors to the first-wave of the COVID-19 pandemic for 25 the Organisation for Economic Co-operation and Development nations using fuzzy-set qualitative comparative analysis. It considers configurations of: obesity rates; proportions of elderly people; inequality rates; country travel openness and COVID-19 testing regimes, against outcomes of COVID-19 mortality and case rates. It finds COVID-19 testing per case to be at the root of sufficient solutions for successful country responses, combined, in the most robust solutions, with either high proportions of elderly people or low international travel levels at the start of pandemic. The paper then locates its sample countries in relation to existing welfare typologies across two dimensions based on total social expenditure and proportional differences between the GINI coefficient before and after taxes and transfers. It finds that countries generally categorised as liberal in most existing typologies did the most poorly in their first-wave COVID-19 response.

This article examines Organisation for Economic Co-operation and Development (OECD) and Commonwealth Funding data to explore the relationship between the level and means of funding of 11 different healthcare systems, on the one hand, and overall equity and health outcome measures, on the other. It utilises qualitative comparative analysis (QCA) and the idea of 'fitness landscapes' for the clusters of funding combinations and outcomes they present. It finds that health systems with relatively high levels of voluntary health insurance tend to be associated with poor outcomes almost across the board, but healthcare systems with higher overall expenditures combined with low voluntary insurance levels offer combinatory possibilities for achieving both high equity and high outcomes. The article also explores how 'contradictory cases' can be used to explore how systems falling short of the outcomes of others with the same funding patterns, might find improvements.

AbstractOne of the central features of public governance in the 2000s was an extension in the use of performance management (PM), but research has suggested that the "gaming" of PM systems became commonplace and that measured performance data was often unreliable. However, PM is necessary in some form, and has fared better in some settings than others. This article presents a systematic comparison based on two case studies where success has been claimed, from English local government and the Quality and Outcomes Framework in the National Health Service, as a means to generating insights into how PM systems can be made to work better. It links its analysis to Frey's and Deci's work on intrinsic motivation in order to theoretically explain its findings before exploring how the insights generated can be applied to other service settings.