Divergence or convergence? Health inequalities and policy in a devolved Britain

• Published in: Critical social policy Vol. 29; no. 2; pp. 216 - 242
• Main Authors: Smith, Katherine E., Hunter, David J., Blackman, Tim, Elliott, Eva, Greene, Alexandra, Harrington, Barbara E., Marks, Linda, Mckee, Lorna, Williams, Gareth H.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.05.2009; Sage Publications Ltd
• Subjects: Decentralization; Decentralization in government; Devolution; Discourse analysis; Equality; Great Britain; Health care policy; Health Care Services; Health Care Services Policy; Health disparities; Health inequality; Health Policy; Health Problems; Inequality; Medical Model; Medicine; National health insurance; Norms; Public Health; Public policy; United Kingdom; health inequalities; Britain; critical discourse analysis; policy divergence; devolution
• ISSN: 0261-0183; 1461-703X
• DOI: 10.1177/0261018308101627

Since the advent of political devolution in the UK, it has been widely reported that markedly different health policies have emerged. However, most of these analyses are based on a comparison of health care policies and, as such, only tell part of a complex and evolving story. This paper considers official responses to a shared public health policy aim, the reduction of health inequalities, through an examination of national policy statements produced in England, Scotland and Wales respectively since 1997. The analysis suggests that the relatively consistent manner in which the `policy problem' of health inequalities has been framed combined with the dominance of a medical model of health have constrained policy responses. Our findings differ from existing analyses, raising some important questions about the actuality of, and scope for, policy divergence since devolution.