Regulatory Capitalism and the UK Labour Government's Reregulation of Commissioning in the English National Health Service

Today, policy analysts and regulatory governance scholars are sceptical about the capacity of the regulatory state hypothesis to describe change at the institutional level. For many, the hypothesis is a convenient oversimplification that fails to account for the hybridity of institutional arrangements within individual policy sectors and also for the divergence of reform trajectories across different national and sector‐based policy contexts. This article assesses the influence of the key themes of the regulatory state on the UK Labour government's reregulation of National Health Service (NHS) commissioning organizations. Following the critics, it argues that these themes are only partially evident in the programme. While the government has codified previously informal relationships with policies like Patient Choice and has also subjected commissioning organizations to metaregulatory techniques, its reforms have neither displaced public ownership and the direct supply of commissioning services with markets and new mechanisms for rule making and standard setting, nor have the reforms divided labour within the state by creating an independent agency to regulate NHS commissioning organizations via technocratic means. Under the reforms, NHS commissioning continues to take place within a structure of bureaucratic relationships. However, the article suggests that the hybridity of regulatory techniques at work within the UK Labour government's reregulation of NHS commissioning lends weight to the claim that the current era is one of regulatory capitalism. It concludes with a discussion of the consequences of this finding for the public policy and regulatory governance literatures.     

Does Institutional Structure Effect Public Health Expenditures?

This paper explores supply‐side costs and institutional structure in a shared authority state public health system. It is found that in a shared governance public health system, intermediary district structure influences the movement of limited resources to serve populations and persons most in need. This early empirical test suggests that policy making and public administration concerning public health expenditures in a shared governance system are in a practical sense local, but decisions made at the intermediary level by regional district administration are an important influence on local public health expenditures.     

Reassessing Power

<正>Fukushima accident increases global concern over nuclear safety The accident at the Fukushima Daiichi Nuclear Power Plant in Japan has had an immediate impact on resurgent interest in nuclear power worldwide.Numerous governments have announced plans to re-examine nuclear energy policy and review the safety of their reactors and the adequacy of their regulatory frameworks.     

The ‘Too Difficult Box’: Its Temptations and How to Avoid Them

Within our democratic political system too many of the pressing and serious political, economic and social challenges of our times are delayed or put off, deposited in the ‘Too Difficult Box’. This happens for a variety of reasons which include failure correctly to identify the best solution, failure to understand obstructions in implementing the proposed solution, difficulties in placating or overcoming a range of vested interests, glitches in circumnavigating a range of legal constraints, lack of appreciation of the international dimension of the issue, succumbing to the vicissitudes of the political process and evaporation of the necessary political creativity and energy. It is a responsibility of democratic politics to find ways of dealing with these problems, through more collaborative or consensual politics if necessary. Otherwise citizens will lose confidence in the ability of democracy to solve the problems which concern them.