TY - CHAP
T1 - MAKING REFORM LOCALLY
T2 - GENERAL PRACTITIONERS, HEALTH CARE MANAGERS AND THE "NEW" BRITISH NATIONAL HEALTH SERVICE
AU - Smith, Katherine Clegg
PY - 2003/12/1
Y1 - 2003/12/1
N2 - The National Health Service is key to Britain's welfare state, and has been subject to repeated reform initiatives. Such reforms rarely "fix" the problems for which they are introduced, but evaluations have neglected the significance of local action. Reform implementation involves local translation of politically contextualized ideas into workable practice. I focus on implementation processes and the role of professions. Ethnographic data reveal local actors engaging with policy objectives to protect existing structures within the boundaries of official reform rhetoric. Actors employ multiple strategies to maintain existing systems. Rather than "failing," policy is made through localized collaboration.
AB - The National Health Service is key to Britain's welfare state, and has been subject to repeated reform initiatives. Such reforms rarely "fix" the problems for which they are introduced, but evaluations have neglected the significance of local action. Reform implementation involves local translation of politically contextualized ideas into workable practice. I focus on implementation processes and the role of professions. Ethnographic data reveal local actors engaging with policy objectives to protect existing structures within the boundaries of official reform rhetoric. Actors employ multiple strategies to maintain existing systems. Rather than "failing," policy is made through localized collaboration.
UR - http://www.scopus.com/inward/record.url?scp=34247444207&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34247444207&partnerID=8YFLogxK
U2 - 10.1016/S0275-4959(03)21008-5
DO - 10.1016/S0275-4959(03)21008-5
M3 - Chapter
AN - SCOPUS:34247444207
SN - 0762310693
SN - 9780762310692
T3 - Research in the Sociology of Health Care
SP - 143
EP - 162
BT - Reorganizing Health Care Delivery Systems
ER -