Taking a ‘decentred’ approach to the analysis of health policy means being attentive to the historical contingencies and circumstances within which reforms are located, the influence of dominant or elite narratives in the shaping of policy, the local traditions and customary practices through which policies are mobilised, and the way local actors contest, negotiate and co-construct policy. This book offers a unique analysis of the changing landscape of healthcare reform in Britain, as an example of decentralized reforms across the developed world. The collection is framed by the recognition that healthcare reform has resulted in variegated and decentralized forms of governance. The chapters look at distinct aspects of reform within the British NHS to bring to light the influence of local histories, traditions, coalitions, and values, in the remaking of a national healthcare system. Each chapter focuses on a different aspects of reform, and in others developing cross-national and comparative analysis. However, each offers a unique contribution and analysis of contemporary theories of healthcare governance. This book will be of key interest to scholars, students and practitioners in healthcare, health and social policy, political science, and public management and governance.

Networks have become a prominent template for public service governance. Often seen as an alternative to hierarchies and contracts, networks cross institutionalized organizational or sectoral boundaries to promote collaboration and the sharing of resources when addressing complex problems. Nowhere is this more the case than in the field of health services modernization and improvement. Comprising unique empirical contributions, drawn primarily from the experience of the UK National Health Service (NHS), this edited collection develops a ‘decentred’ analysis of health and care networks. Contributors look beyond particular structures or patterns of governance and focus instead on the interpretation of the meaningful practices of policy actors as they encounter and enact policy instruments and structures. The approach offers a distinct form of analysis that deepens and enriches more traditional public policy accounts of network governance. It recognizes the influence of local history, highlights the influence of dominant economic, technical and corporate narratives, and acknowledges the continued influence of biomedical knowledge and professional expertise. Offering practical insight for current and future service leaders about the challenges of implementing, managing and working within networks, this book draws out key messages for practitioners and researchers alike.

Decentring Urban Governance seeks to rethink governance not as a particular state formation, but as the diverse policies emerging associated with the impact of modernist social science on policy making, considering the diverse meanings that inspire governing practices across time, space, and policy sectors in urban context. Taking an interdisciplinary approach, the book goes beyond neoliberalism, and is interested in other webs of meaning through which actors encounter, interpret, and evaluate social science, which have received less analytical attention. All these different webs of meaning – elite narratives, social science, and local traditions – influence patterns of action. The book creates an analytical space by which to consider situated agency and localised resistance to the discourses and policies of political elites, including the myriad ways in which local actors have resisted practices of governance on the ground. This text will be of key interest to scholars, students and practitioners of urban governance, governance and more broadly to the social sciences, housing, social policy, law and welfare studies.

Healthcare managers, professionals and service users operate in an increasingly complex environment in terms of policy, regulation and governance arrangements. The policy process is becoming pluralised as competing narratives are drawn upon to influence practice. A wide range of contradictory and inconsistent policies are on offer to healthcare stakeholders, which ultimately results in a broad spectrum of responses, adaptations and improvisations throughout the process of policy implementation. The impact on managerial and professional practice is significant: Whilst some voices are suppressed or ignored, the complex nature of contemporary policy contexts can also help local actors exercise their agency and advance their agenda. This edited volume investigates how contemporary policy trends are influencing healthcare systems, organisations and professions and explores the various ways in which policy implementation could be enacted, resisted and reinvented by healthcare managers and professionals on the ground. It sheds light on the complex web of connections that exist between policy development (Part I), its translation into practice (Part II), and the activities of organisational leaders who are trying their best to make sense of – and succeed in – challenging policy contexts (Part III).

This timely comparative study assesses the role of medical doctors in reforming publicly funded health services in England and Canada. Respected authors from health and legal backgrounds on both sides of the Atlantic consider how the high status of the profession uniquely influences reforms. With summaries of developments in models of care, and the participation of doctors since the inception of publicly funded healthcare systems, they ask whether professionals might be considered allies or enemies of policy-makers. With insights for future health policy and research, the book is an important contribution to debates about the complex relationship between doctors and the systems in which they practice.

This book is the first comprehensive study of international health worker-migration and -recruitment from the perspective of global governance, policy and politics. Covering 70 years of history of the development of this global policy field, this book presents new and previously unpublished data, based on primary research, to reveal for the first time that international health worker-migration-and -recruitment have been major concerns of global policy-making going back to the foundations of post-war international cooperation. The authors analyse the policies and programmes of a wide range of international organisations, from WHO, ILO and UNESCO to the IOM, World Bank and OECD, and feature extended analysis of bilateral agreements to manage health worker migration and recruitment, critiquing the claim that they work in the interests of all countries. Yeates’ and Pillinger’s ground-breaking analysis of global governance presents an assiduously researched study showing how the interplay and intersections of several global institutional regimes – spanning labour, migration, health, social protection, trade and business, equality and human rights – shape global policy responses to this major health care issue that affects all countries worldwide. It discusses the growing challenges to public health as a result of the globalisation of health labour markets, and highlights how global and national policy can realise the health and health-related Sustainable Development Goals for all by 2030. This research monograph will be of key interest to students and scholars of Global Governance, Global Public Policy, Global Health, Global Politics, Migration Studies, Health and Social Care, Social Policy and Development Studies. Policy makers and campaign activists, nationally and globally, will appreciate the practical relevance and applications of the research findings.