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Policy Success and Public Health: The Case of Public Health in England

Published online by Cambridge University Press:  10 January 2012

ROB BAGGOTT
ROB BAGGOTT*
Affiliation:
Health Policy Research Unit, De Montfort University, Leicester, LE1 9BH email: [email protected]
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Abstract

Like many countries, England has introduced a range of policies and strategies on public health since the early 1990s. Using concepts drawn from the policy success and failure literature, this article concludes that recent governments in England achieved only ‘precarious success’ in McConnell's typology. It demonstrates, with wider significance, that success or failure is not merely about policy achievement in programme terms, but that policy processes and the political dimensions of policy must be included in any evaluation. It also highlights the adversarial nature of public health policy, the subjectivity of judgments about effectiveness and the political problems this creates for government. The article pinpoints the relevance of public health policies for judgements about government competence, trustworthiness and accountability. It argues that failures of public health policy, including poor evaluation and failures to learn from experience, may be more comprehensible by adopting a political analysis of public policy making in this field.

Type
Articles
Information
Journal of Social Policy , Volume 41 , Issue 2 , April 2012 , pp. 391 - 408
Copyright
Copyright © Cambridge University Press 2012

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References

Acheson, D. (1998), The Report of the Independent Inquiry into Inequalities in Health, London: The Stationery Office.Google Scholar
Audit Commission (2010), A Healthy Balance, London: Audit Commission.Google Scholar
Australian National Government (2010), Taking Preventative Action: A Response to Australia − the Healthiest Country by 2020, the Report of the National Preventative Task Force, Canberra: Commonwealth of Australia.Google Scholar
Baggott, R. (2010), Public Health Policy and Politics, 2nd edn, Basingstoke: Palgrave.Google Scholar
Bonell, C., McKee, M., Fletcher, A., Wilkinson, P. and Haines, A. (2011), ‘One nudge forward, two steps back’, British Medical Journal, 342, d401 (accessed 14.9.11).Google Scholar
Bovens, M. and t'Hart, P. (1996), Understanding Policy Fiascoes, London: Transaction.Google Scholar
Bovens, M., t'Hart, P. and Peters, B. G. (eds.) (2001), Success and Failure in Public Governance: A Comparative Analysis, Cheltenham: Edward Elgar.CrossRefGoogle Scholar
Cabinet Office (2007), Capability Review of the Department of Health, London: Cabinet Office.Google Scholar
Clarke, M. and Stewart, J. (1997), ‘Handling the wicked issues − a challenge for government’, School of Public Policy, University of Birmingham.Google Scholar
Department for Communities and Local Government (2006), Strong and Prosperous Communities, Cm 6939, London: The Stationery Office.Google Scholar
Department of Health (DH) (1992), The Health of the Nation: A Strategy for Health in England, Cm 1986, London: The Stationery Office.Google Scholar
Department of Health (DH) (1998a), Smoking Kills, Cm 4177, London: The Stationery Office.Google Scholar
Department of Health (DH) (1998b), The Health of the Nation: A Policy Assessed, London: The Stationery Office.Google Scholar
Department of Health (DH) (1999), Saving Lives: Our Healthier Nation, Cm 4386, London: The Stationery Office.Google Scholar
Department of Health (DH) (2000), The NHS Plan: A Plan for Investment – A Plan for Reform, Cm 4818, London: The Stationery Office.Google Scholar
Department of Health (DH) (2003), Tackling Health Inequalities: Programme for Action, London: The Stationery Office.Google Scholar
Department of Health (DH) (2006), Our Health, Our Care, Our Say: A New Direction for Community Services, Cm 6737, London: The Stationery Office.Google Scholar
Department of Health (DH) (2008), High Quality Healthcare for All, Cm 7432, London: The Stationery Office.Google Scholar
Department of Health (DH) (2010a), Equity and Excellence: Liberating the NHS, Cm 7881, London: The Stationery Office.Google Scholar
Department of Health (DH) (2010b), Monitoring Mortality Bulletin (Infant Mortality, Inequalities), London: The Stationery Office.Google Scholar
Department of Health (DH) (2010c), Healthy Lives, Healthy People: Our Strategy for Public Health in England, Cm 7985, London: The Stationery Office.Google Scholar
Department of Health (DH) (2011a), Healthy Lives, Healthy People: Update and Way Forward, London: The Stationery Office.Google Scholar
Department of Health (DH) (2011b), Monitoring Mortality Bulletin, London: The Stationery Office.Google Scholar
Edelman, M. (1977), Political Language: Words that Succeed and Policies that Fail, New York: Institute for the Study of Poverty.Google Scholar
Evans, C., Cleghorn, C., Greenwood, D. and Cade, J. (2010), ‘A comparison of British school meals and packed lunches from 1990 to 2007’, British Journal of Nutrition, 104: 4, 474–87.Google Scholar
Evans, D. (2004), ‘Shifting the balance of power? UK public health policy and capacity-building’, Critical Public Health, 14: 1, 63–75.Google Scholar
Faculty of Public Health (2008), Specialist Public Health Workforce in the UK, London: Faculty of Public Health.Google Scholar
Gray, P. and t'Hart, P. (eds.) (1998), Public Policy Disasters in Western Europe, London: Routledge.Google Scholar
Haroun, D., Harper, C., Wood, L. and Nelson, M. (2011), ‘The impact of the food based and nutrient based standards on lunchtime food and drink provision and consumption in primary schools in England’, Public Health Nutrition, 14: 2, 209–18.Google Scholar
Healthcare Commission and Audit Commission (2008), Are We Choosing Health? The Impact of Policy on the Delivery of Health Improvement Programmes and Services, London: Healthcare Commission.Google Scholar
Health Committee (2001), 2nd Report 2000–1: Public Health, London: The Stationery Office.Google Scholar
Health Committee (2006), 2nd Report 2005–6: Changes to Primary Care Trusts, London: The Stationery Office.Google Scholar
Health Committee (2009), 3rd Report 2008–9: Health Inequalities, London: The Stationery Office.Google Scholar
Health Committee (2011), 12th Report 2010–11: Public Health, London, The Stationery Office.Google Scholar
Health Protection Agency (2011), Statistics on Sexually Transmitted Infections, www.hpa.org.uk (accessed 8.3.11).Google Scholar
HM Government (2007), Safe, Sensible, Social: Next Steps in the National Alcohol Strategy, London: HM Government.Google Scholar
HM Government (2008), Healthy Weight, Healthy Lives: A Cross-Government Strategy for England, London: Cross-Government Obesity Unit, DH and DCSF.Google Scholar
HM Government/Department of Health (2004), Choosing Health: Making Healthy Choices Easier, Cm 6374, London: The Stationery Office.Google Scholar
Hughes, D. (2009), Joint Strategic Needs Assessment: Progress so Far, London: Improvement and Development Agency.Google Scholar
Hunter, D., Marks, L. and Smith, K. (2010), The Public Health System in England, Bristol: Policy Press.Google Scholar
Hunter, D., Perkins, N., Bambra, C., Marks, L., Hopkins, T. and Blackman, T. (2011), ‘Partnership working and the implications for governance: issues affecting public health partnerships (NHS SDO), http://www.sdo.nihr.ac.uk/projdetails.php?ref=08-1716-204 (accessed 1.6.11).Google Scholar
Kmietowicz, Z. (2010), ‘NICE told to halt work on 19 public health topics’, British Medical Journal, 341: c7306 (accessed 3.3.11)Google Scholar
Local Government Information Unit (LGIU) (2010), All's Well that Ends Well? Local Government Leading on Health Improvement, London: LGIU.Google Scholar
Limb, M. (2011), ‘Experts warn public health reforms will lead to job losses and service fragmentation’, British Medical Journal, 342: d417 (accessed 9.2.11)Google Scholar
McConnell, A. (2010), Understanding Policy Success: Rethinking Public Policy, Basingstoke: Palgrave.Google Scholar
McKee, M., Hurst, L., Aldridge, R., Raine, R., Mindell, J., Wolfe, I. and Holland, W. (2011), ‘Public health in England: an option for the way forward?’, The Lancet, 378: 536–49.Google Scholar
Mackenzie, M., O'Donnell, C., Halliday, E., Sridharan, S. and Platt, S. (2010), ‘Evaluating complex interventions: one size does not fit all’, British Medical Journal, 340: 20 February, 401–3.Google Scholar
Milburn, A. (2000), ‘A healthier nation and a healthier economy: the contribution of a modern NHS’, LSE Health annual lecture, London School of Economics.Google Scholar
National Audit Office (NAO) (1996), Health of the Nation: A Progress Report, London: HMSO.Google Scholar
NHS Information Centre (NHSIC) (2011a), Statistics on Obesity, Physical Activity and Diet 2010, Leeds: NHSIC.Google Scholar
NHS Information Centre (NHSIC) (2011b), Statistics on Alcohol, 2010, Leeds: NHSIC.Google Scholar
NHS Information Centre (NHSIC) (2011c), Statistics on Smoking, 2011, Leeds: NHSIC.Google Scholar
Nuffield Council on Bioethics (2007), Public Health: Ethical Issues, London: Nuffield Council on Bioethics.Google Scholar
Office for National Statistics (ONS) (2011), Statistical Bulletin: Conceptions in England and Wales, London: ONS.Google Scholar
Perkins, N., Smith, K., Hunter, D., Bambra, C. and Joyce, C. (2010), ‘What counts is what works? New labour and partnerships in public health’, Policy and Politics, 38: 1, 101–17.Google Scholar
Prime Ministers’ Strategy Unit (PMSU) (2004), Alcohol Harm Reduction Strategy for England: Final Report, London: Cabinet Office.Google Scholar
Public Accounts Committee (2010), Tackling Inequalities in Life Expectancy in Areas with the Worst Health and Deprivation, London: TSO.Google Scholar
Rawnsley, A. (2010), The End of the Party, London: Penguin.Google Scholar
Snape, S. (2004), ‘Partnerships between health and local government: the local government policy context’, in Snape, S. and Taylor, P. (eds.), Partnerships between Health and Local Government, London: Frank Cass, pp. 73–98.Google Scholar
Strategic Review of Health Inequalities in England (2010), Fair Society Healthy Lives (The Marmot Review), London: Department of Health.Google Scholar
Taylor, P. (1984), Smoke Ring: Tobacco, Money and Multi-National Politics, London: Bodley Head.Google Scholar
Thaler, R. and Sunstein, C. (2009), Nudge, London: Penguin.Google Scholar
Triggle, N. (2011), ‘More groups reject health deal as pledges are unveiled’, BBC News, 15 March 2011, http://www.bbc.co.uk/news/health-12737200 (accessed 22.9.11).Google Scholar
USDHHS (2011), USA Healthy People 2020, http://www.healthypeople.gov/2020/Consortium/HP2020Framework.pdf.Google Scholar
Wanless, D. (2004), Securing Good Health for the Whole Population, London: HM Treasury.Google Scholar
Wanless, D. (2007), Our Future Health Secured?, London: King's Fund.Google Scholar