POLICY AND IDEOLOGY - THE POLITICS OF POSTREFORM HEALTH-POLICY IN THEUNITED-KINGDOM

While it is commonly accepted that the broader political and economic climate directly influences the nature of any major changes in the pro vision of health care (witness the 1991 National Health Service reform s in the United Kingdom), there is less consideration of the effect of paradigm changes in health care and health care management themselves on wider political and ideological strategies. This article examines the recent health policy initiatives presented by Britain's Labour Par ty. The author argues that while the Conservatives' market-oriented re forms reflected the perceived political and economic realities of the 1980s, the rapidly increasing credibility of strategies of prevention within the health care sector (including an emphasis on the social det erminants of ill-health, the need to plan a shift from acute to commun ity care, and the desire for greater lay participation in policy-makin g) allows Labour to highlight the limitations of a strongly market-ori ented system in the health care sector more so than in any other polic y area.