Evaluating Health Care Reform: the Case of the NHS Internal Market

The NHS internal market, introduced in an atmosphere of controversy, continues to generate much disagreement. This article examines the evidence on the impact of this policy with regard to a range of criteria, including efficiency, accountability, effective planning and co-ordination, patient choice and service quality, equity, and the culture of the NHS. It explores the different ways in which this evidence is perceived and seeks to make explicit the assumptions and biases of those involved in the debate about the reforms. The article also examines the policy process behind the reforms and the extent to which it has added to the problems of evaluation. By way of conclusion, the implications for future health care reform are considered and a number of procedural changes suggested.     

Diversionary cheap talk: economic conditions and US foreign policy rhetoric, 1945-2010

ABSTRACT

This study explains how the economy affects the foreign policy rhetoric used by American presidents. When economic conditions deteriorate, presidents criticize foreign nations to boost their approval ratings. Presidents use this “diversionary cheap talk” in response to the misery index of unemployment plus inflation, which poses a unique threat to their popularity. They target historical rivals, which make intergroup distinctions most salient. Diversionary cheap talk is most influential for and most frequently used by Democratic presidents, whose non-core constituents prefer hawkish foreign policy but already expect it from Republican presidents. I test the observable implications of the theory with the American Diplomacy Dataset, an original record of 50,000 American foreign policy events between 1851 and 2010 drawn from a corpus of 1.3 million New York Times articles.     

A Funny Thing Happened on the Way to the Forum? Reforming Patient and Public Involvement in the NHS in England

This article explores the introduction of a new system of patient and public involvement (PPI) in the NHS in England. After seeking to clarify the terminology found in this field, the article explores the background to the new system, why proposals were brought forward by the government and how they were implemented. The article also examines the main criticisms of the new system, which include under-resourcing, lack of capacity, complexity and fragmentation. The article concludes by drawing out lessons for future reform in this field.