ABSTRACT
This chapter focuses an exploration of the tension between public commitments to the preservation of the National Health Service (NHS) contrasted against political will to neoliberal informed reform of the NHS in England. In the decentred approach, any and all action is regarded as a contingent individual choice, which Bevir defines as situated agency. In terms of situated agency, if sufficient numbers responded negatively to the tax increase, and rejected the dilemma in neoliberal traditions, then the government would have faced a crisis of legitimacy. Legitimacy and accountability are determined through the measured degree of stakeholder satisfaction with outputs. The fact that demand for healthcare always tends to outstrip supply is a problematic dynamic for a state trying to fund a healthcare system purportedly predicated upon principles of free, universal care based on need. The decision that the situated agent makes is only as good as the information they are privy to, in making their decision.
