ABSTRACT

This conclusion presents some closing thoughts on concepts discussed in this book. The National Health Service (NHS) survives to its sixtieth year despite the General Election in 1979, which was won by a Government whose ideological position involved a commitment to reduce burdensome public expenditure on welfare. Whilst the Government may have abandoned any notion of significantly diminishing a major social policy programme of public expenditure on health care, it did appear to have a growing commitment to replacing the traditional modes of public service administration and professionalism with a form of private sector managerialism. The traditional ideal of 'rational' coherent planning to meet needs, for example the Priorities documents, seemed to be displaced by a new idea of strong managerial control to remain within cash limits. The Government's reaction to the Black Report and The Health Divide could be seen as essentially ideological, an unwillingness to accept explanations that called for more Government expenditure and more Government intervention.