The Health Debate

Second Edition

David J. Hunter

The Health Debate

David J. Hunter

Distributed for Policy Press at the University of Bristol

240 pages | 5 x 7 3/4 | © 2016
Paper $26.00 ISBN: 9781447326977 Published March 2016 For sale in North and South America only
Health care systems across the world are in a state of permanent revolution as they struggle to cope with multiple pressures arising from changing demography, the rise of noncommunicable disease, the growing demand for health services, and limited resources in a time of austerity. Focusing on reforms of the British National Health Service, this book offers a fresh look at how it is coping with such pressures. By exploring the complexity and interconnectedness of health policy and health services concerns, David J. Hunter offers a critical perspective on such issues as integrated care and the return of public health to local government. Crucially, he critiques the market-style changes introduced by the Coalition Government between 2010 and 2015. Lively, accessible, and with implications for global health care policy debates, this new edition of The Health Debate will be vital reading for students of health care and health policy, policy makers, and public health and health care professionals.
Contents
List of boxes
About the author
Acknowledgements
Foreword to second edition by Michael Hill, Series Editor

1. Key challenges facing health systems
Introductions
Defining a health system
Health systems: convergence or divergence?
A framework for understanding the policies of health 
Plan of book

2. Meeting the health system challenges
Introduction
Types of health system
The ‘cult of managerialism’
Back to the future?
Conclusion

3. Models of health system reform
Introduction
Health care before health
The problem: the dominance of medical model
Shifting the paradigm
Towards a health strategy for Europe
Conclusion

4. Choice and competition in health systems
Introduction
Health system reform in England
Reviewing health system reform over the New Labour years
Enter the coalition government
Twenty years of continuous change: a triumph of hope over experience
Policy incoherence
Intra-UK health system divergence
Conclusion

5. Priority setting in health systems
Introduction
Approaches to rationing health care
Rational rationing: the limits economic approaches
Involving the public in priority setting
Implicit versus explicit rationing
Finding a middle way
Conclusion

6. Choice and competition in health systemsIntroduction
The appeal of markets
The limits to markets
Conclusion

7. The health debate: what and where next?
Introduction
A structural perspective on health system reform: revisiting Alford
Is there another way?
Last word
Postscript 

References
Index
Review Quotes
Health Service Journal, on the first edition
“This book is ideal for anyone with an interest in health policy, health systems development, and the wider health agenda. . . . A useful resource for all students of health, health professionals, policy makers, and strategy developers.”
Critical Social Policy, on the first edition
“A thoughtful assessment of recent National Health Service reforms that is more balanced and insightful than many of those produced by New Labour’s critics.”
Sociology of Health & Illness, on the first edition
“This book’s strength lies in the clarity of the argument and the presentation of evidence within a clear analytic framework.”
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