Local authority health strategies

Abstract

This chapter reviewing the local authority contribution to the ‘national health’ is in itself symbolic of the changes which have occurred in the health policy environment in Britain. At the level of service delivery, local authority action is also a reaction to a situation in which current community-based health initiatives represent a patchwork of provision, including many examples of experimentation, but with areas left uncovered. Some current thinking on the nature of central/local relations still seems to be tending towards the notion of local government as the agent of central government; for example, Chandler’s assessment that most national political actors seek to ensure local government’s implementation of policies, determined centrally, to suit local circumstances (Chandler, 1988). This model does not, however, fit easily with a number of examples of local authorities’ developing seemingly high profile health strategies. This might be interpreted as a means of making public statements about the value and credibility of local government as such, and as evidence of a local government concern for public well-being which goes well beyond a narrow focus on statutorily-defined duties.