Health Policy In England Research Articles

Devolution and Health Policy in England

This article looks at the possible implications of English regional government for the promotion and provision of healthcare. Elected assemblies may allow more locally tailored policies aimed at reducing health inequalities, which vary substantially between regions. They may also increase the democratic accountability of health services and help to 'join-up' health and other policy domains. The obstacles to devolved control over health care include the inherently centralized nature of health care provision in Britain and strong public support for a National Health Service. Given these potentials and constraints, this article attempts to identify those areas of health policy that feasibly could be devolved to English regional assemblies.

Evaluating mental health policy in England. Care Programme Approach and supervision registers.

The Care Programme Approach (CPA) and supervision register policies in England are intended to prioritize patients to receive specialist mental health care. To describe and evaluate the practical application of the policies. A questionnaire survey of key informants in mental health provider trusts and an analysis of aggregated data collected by health authorities using the Mental Illness Needs Index as a measure of population need. On average, 1175 per 100,000 total population are subject to the CPA (95% CI = 1055-1309) and 8.6 per 100,000 (95% CI = 7.5-9.9) are on supervision registers. Wide local variations in the number of people subject to the CPA and supervision registers are not explained by variations in population need. Prioritization to receive specialist mental health services is carried out inconsistently, and inequitable use of resources may result.

The impact of health economics on health policy in England, and the impact of health policy on health economics, 1972-1997.

This paper contains a review of the impact of health economics on health policy in England during the past 25 years. Some health economists have expressed disappointment with the scale of the impact that health economics has had on policy but the record set out below suggests that there is modest cause for celebration. That is not to say that there is cause for complacency. There is still a long way to go before all important health policies are based on sound economics reasoning and evidence. The paper begins with some definitions and background; it covers nine areas of health policy, and health policy making, where past impacts of health economics have been postulated; it covers briefly the reciprocal impact of health policy on health economics; and it concludes with a discussion about the findings.

Coronary heart disease: Trends in spatial inequalities and implications for health care planning in England

The idea of health gain has recently received particular emphasis in health policy in England. One of the areas where there is considerable scope for health gain is in the reduction of mortality due to Coronary Heart Disease. Some reduction in mortality rates due to this cause have already been achieved in England in the 1980s. However, the change in standardised mortality rates varies around the country. A review of studies of geographies of declining CHD mortality shows that such geographical variation is typical of other countries which have recently experienced a reduction in the CHD epidemic. The paper presents the results of an analysis of change in spatial inequality in coronary heart disease mortality among the population aged 35–74 for the 190 District Health Authorities in England over the period 1982–1989. Data were derived from counts of cause-specific deaths and population estimates published by the Office of Population Censuses and Surveys. Various approaches were used to assess the change in spatial disparity which has accompanied the average overall reduction in mortality rates over the study period. The results show that the trends vary between age and sex groups in the population and that, particularly for older people, overall health gain across the country is being achieved at the cost of greater inequality in health between areas. The implications for local health strategies with respect to coronary heart disease reduction are discussed.