Coalition health policy: a game of two halves or the final whistle for the NHS?
Bibliographic record
Abstract
Introduction The King's Fund audit of coalition health policy (Ham et al, 2015: 1) claims that the first half of the 2010–15 parliament was taken up with debate on the Health and Social Care Bill (HSCB), while the second half was devoted to limiting the damage caused by the Bill and subsequent Act and dealing with the effects of growing financial and service pressures in the NHS (see also, Seldon and Snowdon, 2015: 540). While previous Social Policy Reviews have focused on the first half (Ruane, 2010; 2012; Mays, 2011; Heins, 2013), there has been little coverage of the second half. However, was it a case of a game of two halves or did the coalition reforms bring about the final whistle, signalling the end of the NHS? This chapter examines both halves of the coalition government's health policy (see, for example, Burchardt, 2015 and Glasby, 2016, on social care). After a brief ‘extra time’ exploring the early period of the Conservative government elected in May 2015, it provides a ‘match report’ of temporal, intrinsic and comparative evaluation templates. ‘The final whistle?’ explores the debate on the ‘end of the NHS’ in terms of the issues of privatisation and financial crisis/sustainability. First half: the Health and Social Care Act Many commentators regard the reorganisation of the White Paper, Equity and Excellence: Liberating the NHS (Department of Health, 2010a) and the subsequent Health and Social Care Act (HSCA) of 2012 as the biggest change in the history of the NHS (for example, Ruane, 2010; 2012; Mays, 2011; Heins, 2013). For example, according to Hunter (2013b), the changes ushered in by the HSCA are different in both scope and intent from anything to which the NHS has previously been subjected. According to Seldon and Snowdon (2015: 181), this ‘NHS debacle’ was ‘the biggest cock-up of Cameron's premiership’. Widely regarded as a ‘car crash’ of both politics and policy making, it was, in the words of Sir David Nicholson, then NHS chief executive, ‘the only change management system you can actually see from space’ (quoted in Timmins, 2012). Timmins (2012) relates the story that before the 2010 election, David Cameron promised ‘no top-down reorganisations’ of the NHS (see also, Seldon and Snowdon, 2015).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".