Reforming a Health Care System in a Big Way? The Case of Change in the British NHS
Bibliographic Data
| ID | 11196644 |
|---|---|
| Authors | Martin Powell (0000-0002-9148-5087, Health Services Management Centre University of Birmingham Birmingham UK, corresponding author) |
| Year | 2016 |
| Volume | 50 |
| Issue | 2 |
| Pages | 183-200 |
| Publication date | 2016-03-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Policy and Administration (JOURNAL) |
| Journal identifiers | ISSN: 0144-5596 • E-ISSN: 1467-9515 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/spol.12210 |
| OpenAlex | W2541179093 |
| Language | EN |
| Citations received | 5 |
| References cited | 53 |
There is a significant literature on change in health care systems, but much of this has little explicit discussion of conceptual approaches, measures or explanations of change. This article examines studies of the British National Health Service (NHS) focusing on the what, how much and why of change. It sets out the main approaches to studying continuity and change: institutional continuity and path dependency (PD); incremental change; punctuated equilibrium; gradual institutional change; ideational analysis; paradigm change; and institutional logics. It briefly critically discusses each of these approaches, and then examines the main studies in chronological order. With reference to the three main questions of this article, the ‘what’ of change suggests that, in terms of the number of studies, PD and ideational approaches appear to be dominant. The ‘how much’ of change question remains problematic due to unclear dependent variables and conflicting conclusions. Lastly, the ‘why’ of change remains unresolved. In short, studies of change in the British NHS tend to be overly descriptive and under‐theorized, and do not fully address issues of theories and concepts, measures and explanations; or the what, how much and why of change
Economic system · Economics · Institutional change · Order (exchange · Path dependency · Political science · Positive economics · Punctuated equilibrium · Sociology · Theory of change · Employment and Welfare Studies · Healthcare innovation and challenges · Public Administration · Social Policy and Reform Studies
Budgeting
Public Policy
Accidental Logics
The Recomposition of an Organizational Field
Politics in Time
Punctuated Equilibrium and Path Dependency in Coexistence
Dismantling Public Policy
Dismantling the Welfare State?
Small, Slow, and Gradual Reform
Drift and conversion
Policy Change and Health Care Research
Programmatic Actors and the Transformation of European Health Care States
The New Politics of the Welfare State
Health Care System Change and the Cross-Border Transfer of Ideas
Explaining Institutional Change
Institutional Layering
Path Dependence, Realism and the NHS
Charles Lindblom is alive and well and living in punctuated equilibrium land
The Dependent Variable Problem in the Study of Policy Change
The Historical Logic of National Health Insurance
Health Care Policy for Better or for Worse? Examining NHS Reforms During Times of Economic Crisis versus Relative Stability
Explaining Different Paths in Social Health Insurance Countries – Health System Change and Cross‐border Lesson‐drawing between G ermany, A ustria and the N etherlands
Towards Neo‐Bismarckian Health Care States? Comparing Health Insurance Reforms in Bismarckian Welfare Systems
The Organization of Decision‐making and the Dynamics of Policy Drift
Privatization Through Centralization in the Israeli Health Care System
A Reform Less Ordinary? Historical Institutionalism, Punctuated Equilibrium, and Mental Health Care Privatization
Realignments in the Welfare State
The responsiveness of social policies. Explaining institutional change in three policy domains
A short history of studying incremental institutional change
"The Science of "Muddling Through
Still Muddling, Not Yet Through
What Are Policy Punctuations? Large Changes in the Legislative Agenda of the UK Government, 1911–2008
Questioning path dependence theory
From metaphors to measures
The Long Road to Long-Term Care Insurance in Germany
Path Dependency, or Why History Makes It Difficult but Not Impossible to Reform Health Care Systems in a Big Way
Policy Punctuations in Mature Welfare States
Understanding institutional conversion
Reassessing the concept of policy paradigm
Ideas, paradigms and confusions
Understanding NHS Reform
Ideas and Policy Change
Social Rights, Civil Rights, and Health Reform in Canada
Adapting the Welfare State
Taking ideas and discourse seriously
Ideas, institutions, and policy change
Policy Paradigms, Social Learning, and the State
Increasing Returns, Path Dependence, and the Study of Politics
Privatizing Risk without Privatizing the Welfare State
Commissioning in the English National Health Service
| Unique citing works | 5 |
|---|---|
| Citations per year | 0,63 |
| Citation span | 2018 - 2024 (7) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 5 |