ABSTRACT
Politics are normally heavily implicated in most health systems, and this is especially so where public funding of health is involved. This applies to the UK and many other countries. Political leadership is typically concerned with the size and allocation of resources, patient access, public health, the design of services and the organizational forms through which health and care services are offered. Chris Ham, former CEO of The King’s Fund, summarises the politics of healthcare as ‘who decides, who benefits and who controls health services’ (Ham 2004: 1). Moreover, the politics of healthcare includes, but goes beyond, healthcare policy. Engagement with healthcare involves attempts to shore up legitimacy and involves interaction with a range of social actors (Harrison and McDonald 2008). Accordingly, one can expect to see ideology and opportunism playing a part in developments and decisions. The ideological dimension is most evident in the debates about the ‘privatisation’ of the NHS and related concepts such as challenge, choice and competition (Pollock 2004; Davis and Tallis 2013). Clear examples of political activity here include, most notably, the Private Finance Initiatives, the Public Private Partnerships and the whole purchaser-provider division of health service organizations.
