Social science research and health service management

Abstract

The changes in health policy and strategy in many western developed countries during the 1980s and early 1990s centre around common themes. The economic recession that is gripping Europe and North America and the related political pressures combined with broader uncertainties about the distribution of power and control have caused a major rethinking of the role of welfare. The question of cost containment has floated to the top of the political agenda. Flynn (1992) argues that the key theme for most western developed countries has been the restructuring of state activity in the economy and polity. Many governments have opted to introduce some form of market mechanism in the provision of health care, whether they have a national health service, one based on social insurance or a predominantly private insurance based model.