London School of Hygiene & Tropical Medicine

Devolution and Transformation in the NHS: What Can We Learn From History?

Organised by the Centre for History in Public Health, London School of Hygiene & Tropical Medicine, in tandem with the Institute of Public Policy Research. Sponsored by the Wellcome Trust.

This symposium will bring together historians and policy makers to  ask what we can learn from 20th century British history about the  decentralisation of health powers and the local reform agenda. Greater  devolution has been common ground in public policy in recent years, both  across the four nations of the UK, and subsequently to regions and  local authorities - with devo-Manc and STPs at the forefront of peoples  minds. See document below for more information.

AGENDA:

11.00-11.15 Opening remarks:

• Introduction: contemporary. Place and local decision-making in the NHS today – the devolution and STP agendas. (IPPR)
• Introduction: historical. Outlining chronology of the local and national in the administrative structure of the British health system; purpose of day. (Martin Gorsky)

11.15-12.15 Session 1 Before the NHS: the strengths and weaknesses of the localist, pluralist system that obtained before the NHS, and why it was abandoned in 1944-8.

• Interwar health care – the mixed economy and the ‘optimist’ and ‘pessimist’ interpretations (Barry Doyle)
• Localism versus a ‘National’ Health Service – why was the NHS created, and why not a local government NHS? (John Stewart)
• Contemporary reflections (respondent tbc)

12.15-1.15 Session 2 What has been the ‘N’ in NHS? How have policy-makers interested in devolving power balanced local and national interests? How have public attitudes towards the NHS as a national institution evolved and why do they matter?

• The Eternal Triangle: centre/periphery relations and quest for equity, efficiency and democracy in the NHS. (Rudolf Klein)
• Cultural history of public perceptions of a ‘national’ institution (Roberta Bivins/Mathew Thomson)
• Contemporary reflections (respondent tbc)

LUNCH 1.15-2.00

Session 3 Local decision-making, national issues – the long view

2.00-2.45 i The Balance of Care

• Hospital or Community Care? Activism and the politics of hospital closures since the 1970s (Jennifer Crane)
• Contemporary reflections: solutions to a recurrent problem? (Candace Imison)

2.45-3.45 ii Beyond the NHS

• The Health/Social Care Boundary since 1960: the challenges of integration and joint-working for older people with complex health needs (Gerald Wistow)
• Contemporary reflections: solutions to a recurrent problem? (Will Blandamer)

ii. Public Health, Local Government and Social Inequalities

• In and out of Local Government 1948-2012: decline, fall and revival of the Public Health function (Alex Mold)
• Contemporary reflections: where is public health now in the wake of the return to local government? (Yvonne Doyle)

3.45-4.45 Conclusion: Historical Lessons for the Localism Debate?

• Panel overviews and reactions by contemporary respondents.

  (Nick Timmins, Norman Lamb MP, Lord Peter Smith, Candace Imison, and Will Blandamer)

Please register to attend this event.

Refreshments will be available in the South Courtyard Cafe' area.