A reorganisation you can see from space: The architecture of power in the new NHS

Scott L. Greer, Holly Jarman & Andrew Azorsky | January 27, 2014 | Analyses


This analysis argues that this Government’s NHS reform has created great uncertainty surrounding who makes health policy. It finds that the reformed Department of Health has diminished authority and capacity to steer the health system, but this has not resulted in a less political NHS. Meanwhile, a power struggle has developed between the two most significant non-majoritarian bodies charged with regulating the NHS. These developments raise important questions about who can or should decide the future of healthcare in England.

A reorganisation you can see from space: The architecture of power in the new NHS

Support Our Work

CHPI is the only truly independent health think-tank dedicated to the founding principles of the NHS. To continue our work keeping the public interest at the centre of health and social care policy, we need your help.

Please support CHPI so we can continue to impact the health policy debate.

About the authors

Avatar photo

Scott L. Greer

Scott L. Greer is Associate Professor of Health Management and Policy at the University of Michigan, Research Associate of the European Observatory on Health Systems and Policies, and Senior Visiting Fellow of LSE Health. His most recent books include European Union Public Health Policy (with Paulette Kurzer) and Federalism and Decentralization in European Health and Social Care (with Joan Costa i Font) and he has been published in a variety of journals including the Lancet, BMJ, and Social Policy and Administration; in the last, he edited a 2010 special issue on health departments.See all posts by Scott L. Greer
Avatar photo

Holly Jarman

Holly Jarman is a Research Assistant Professor with a joint appointment in the Center for Law, Ethics, and Health and the Department of Health Management and Policy at the University of Michigan. Holly is a political scientist who studies the effects of market regulation on health and social policy. Her book, The Politics of Trade and Tobacco Control, is forthcoming with Palgrave Macmillan press, and her articles appear in journals including the European Journal of Public Health, the Journal of Public Health Policy, BMJ Tobacco Control, and Social Policy and Administration.See all posts by Holly Jarman
Avatar photo

Andrew Azorsky

Andrew Azorsky is currently working as a Healthcare Intern at the Podesta Group Washington, D.C. and was formerly Research Assistant at the University of Michigan School of Public Health, Department of Health Management and Policy.See all posts by Andrew Azorsky