Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales

Hughes, David; Mullen, Caroline; Vincent-Jones, Peter

doi:10.1111/j.1369-7625.2009.00559.x

Journal article 1274 views

Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales

David Hughes, Caroline Mullen, Peter Vincent-Jones

Health Expectations, Volume: 12, Issue: 3, Pages: 237 - 250

Swansea University Author: David Hughes

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DOI (Published version): 10.1111/j.1369-7625.2009.00559.x

Abstract

Changing patient and public involvement (PPI) policies in England and Wales are analysed against the background of wider National Health Service (NHS) reforms and regulatory frameworks. We argue that the growing divergence of health policies is accompanied by a re-positioning of the state vis-à-vis...

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Published in:	Health Expectations
ISSN:	1369-6513 1369-7625
Published:	2009
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa6769
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first_indexed	2013-07-23T11:55:26Z
last_indexed	2018-02-09T04:34:18Z
id	cronfa6769
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spelling	2015-05-11T09:32:52.2839869 v2 6769 2012-01-24 Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 2012-01-24 FGMHL Changing patient and public involvement (PPI) policies in England and Wales are analysed against the background of wider National Health Service (NHS) reforms and regulatory frameworks. We argue that the growing divergence of health policies is accompanied by a re-positioning of the state vis-à-vis PPI, characterized by different mixes of centralized and decentralized regulatory instruments. In England, continued hierarchical control is combined with the delegation of responsibilities for the oversight and organization of PPI to external institutions such as the Care Quality Commission and local involvement networks, in support of the government’s policy agenda of increasing marketization. In Wales, which has rejected market reforms and economic regulation, decentralization is occurring through the use of mixed regulatory approaches and networks suited to the small-country governance model, and seeks to benefit from the close proximity of central and local actors by creating new forms of engagement while maintaining central steering of service planning. Whereas English PPI policies have emerged in tandem with a pluralistic supply-side market and combine new institutional arrangements for patient ‘choice’ with other forms of involvement, the Welsh policies focus on ‘voice’ within a largely publicly-delivered service.The English reforms draw on theories of economic regulation and the experience of independent regulation in the utilities sector, while the Welsh model of local service integration has been more influenced by reforms in local government. Such transfers of governance instruments from other public service sectors to the NHS may be problematic. Journal Article Health Expectations 12 3 237 250 1369-6513 1369-7625 Patient Choice, PPI, England, Wales 31 12 2009 2009-12-31 10.1111/j.1369-7625.2009.00559.x a. The author made a substantial contribution either to all aspects of the study and (b) took the lead in writing the paper. IF 2.110, 5 year IF 2.659. of 136 Public, Environ. & Occup. Health. 15 Google scholar citations. Paper based on EU F6 REFGOV project and featuring a comparison of English and Welsh health policy. COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2015-05-11T09:32:52.2839869 2012-01-24T00:03:50.6570000 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health David Hughes 1 Caroline Mullen 2 Peter Vincent-Jones 3
title	Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales
spellingShingle	Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales David Hughes
title_short	Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales
title_full	Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales
title_fullStr	Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales
title_full_unstemmed	Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales
title_sort	Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales
author_id_str_mv	f1fbd458e3c75d8b597c0ac8036f2b88
author_id_fullname_str_mv	f1fbd458e3c75d8b597c0ac8036f2b88_***_David Hughes
author	David Hughes
author2	David Hughes Caroline Mullen Peter Vincent-Jones
format	Journal article
container_title	Health Expectations
container_volume	12
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container_start_page	237
publishDate	2009
institution	Swansea University
issn	1369-6513 1369-7625
doi_str_mv	10.1111/j.1369-7625.2009.00559.x
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description	Changing patient and public involvement (PPI) policies in England and Wales are analysed against the background of wider National Health Service (NHS) reforms and regulatory frameworks. We argue that the growing divergence of health policies is accompanied by a re-positioning of the state vis-à-vis PPI, characterized by different mixes of centralized and decentralized regulatory instruments. In England, continued hierarchical control is combined with the delegation of responsibilities for the oversight and organization of PPI to external institutions such as the Care Quality Commission and local involvement networks, in support of the government’s policy agenda of increasing marketization. In Wales, which has rejected market reforms and economic regulation, decentralization is occurring through the use of mixed regulatory approaches and networks suited to the small-country governance model, and seeks to benefit from the close proximity of central and local actors by creating new forms of engagement while maintaining central steering of service planning. Whereas English PPI policies have emerged in tandem with a pluralistic supply-side market and combine new institutional arrangements for patient ‘choice’ with other forms of involvement, the Welsh policies focus on ‘voice’ within a largely publicly-delivered service.The English reforms draw on theories of economic regulation and the experience of independent regulation in the utilities sector, while the Welsh model of local service integration has been more influenced by reforms in local government. Such transfers of governance instruments from other public service sectors to the NHS may be problematic.
published_date	2009-12-31T03:08:20Z
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Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales

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