Social policy case study 4: Reform of the NHS

Abstract

This chapter focuses on a further area of contemporary and topical social policy that, like Free Schools, has been aligned with the ‘Big Society’ agenda, has aspired to address the ‘broken society’ and sought to consolidate levels of social mobility and social justice across the wider population. It deals with attempts by the Conservative-led coalition government to effectively manage and, simultaneously, reform the key institution of the National Health Service. Like educational policy, this area of welfare provision is an important aspect of modern British governance in the 21st century, and as an integral high-profile component of the British welfare state it has been said to have ‘no parallel in terms of its resilience, its longevity and its abiding appeal to the citizens of the United Kingdom’.¹ The sheer size and complexity of the NHS as an organisation² provides a significant political challenge to any administration in terms of making it function efficiently and effectively along the organisational or functional lines that it desires. As a pivotal feature of British welfare policy provision, it therefore provides a clear opportunity for the modern Conservative Party to demonstrate just how original and innovative its approach is in dealing with a significant and increasingly expensive area of social policy. Parallels can be drawn with education policy: both are high-profile aspects of governance with a ‘compassionate’ policy edge that affect large numbers of people, and so both are potent electoral issues. We should also hope to find out if the party’s proposals in this area of social policy present any evidence of a revised attitude since its last period in government during the 1980s and 1990s.