'Good health at low cost' 25 years on

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W. J. M. Mackenzie

Professor Mackenzie's book is an important contribution, possibly unique to the general debate, for despite the author's diffidence in describing it as 'primarily a conceptual and analytical study rather than a practical one', by discussing certain key questions from the point of view of a political scientist, he illuminates as never before the contradictions and mythologies of an institution which has a special niche in British social history and in which there is an almost inordinate pride among the population at large.

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Sheila Leatherman, Kim Sutherland

A collection of charts arranged in six quality domains (effectiveness, access, capacity, safety, patient-centredness, disparities) that aims to provide an accessible overview of the quality of healthcare in the UK.

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Andrew Pettigrew, Ewan Ferlie, Lorna McKee

In this major analysis of the processes and management of strategic change, Pettigrew, Ferlie and McKee develop a new model centred on receptive and non-receptive contexts for change. Both a powerful analytic device and a broad agenda for management practice, the model outlines key features of internal and external context and action to account for success or failure in change efforts, and for differences in the rate and pace of change. The authors consider the role and impact of such factors as environmental pressures for change; the quality and clarity of change goals and strategies; organizational cultures and inter-organizational relations supportive of change; availability of key people to lead change; and capability in managing change processes - turning 'problems and panics' into sustainable action. Underpinning the model is an extraordinarily rich and multilayered analysis which draws and builds on the authors' research in the British National Health Service during a period of dramatic restructuring. Pettigrew and his colleagues use the case material to look at different ends of strategic change - from strategic response to unanticipated crisis, to rationalization and retrenchment, to major growth and the creation of new organizations. They compare and contrast successful with less successful change efforts. They show how the facilitating factors they identify must interconnect to create the directed energy that shapes effective change. . Shaping Strategic Change will be indispensable reading for managers in private or public sector organizations and for all those studying strategic management, organizational change and public management.

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Alan I. Marcus and Hamilton Cravens

"How can we have received so many benefits while still being as worried as ever about our health and the health care system established to ensure and extend those benefits? The historical perspective provided by the essays in this volume helps answer this question by identifying two points of significant change in health care policy. Beginning in the 1950s there emerged a subtle yet critical reconceptualization as the individual rather than the group came to figure prominently as the central policy-making unit. Then in the late 1960s, a palpable sense of limits rendered the individualism of the previous decade into a Malthusian formulation: the greater the access or benefits that any one person received, the less access and fewer benefits others could get. Besides tracing these patterns in health care development, the essays also show how traditional notions of expertise have been affected by the changes."--BOOK JACKET.