ABSTRACT
The contemporary transitions in healthcare governance bring to light broader social science narratives that have been influential across public policy and governance. The British National Health Service therefore offers something of an exemplary case, even unique ‘natural experiment’, for the decentralisation and devolution of health policy. Decentred theory is overtly historicist in its emphasis on agency, contingency, and context. A decentred approach highlights contests among diverse and contingent meanings rooted in different traditions and the dilemmas faced by actors in particular contexts. Decentred theory conceives of public policies as contingent constructions of actors, inspired by competing beliefs, which are rooted in different traditions. Subordinate actors can resist the intentions and policies of elites by consuming them in ways that draw on their local traditions and their local reasoning. The chapter also presents an overview of the key concepts discussed in this book.
