S. Nettleton et R. Burrows, KNIT YOUR OWN WITHOUT A PATTERN - HEALTH PROMOTION SPECIALISTS IN AN INTERNAL MARKET, Social policy & administration, 31(2), 1997, pp. 191-201
The reforms of the National Health Service in England have given an em
phasis to ''strategic'' approaches to health and health care, in that,
ideally, purchasing decisions will be made on the basis of evidence f
rom various forms of ''needs assessment''. Alongside these reforms a s
trategic approach to the promotion of health has been set out in the '
'Health of the Nation'' (DoH 1992). However, although the promotion of
health is high on the policy agenda, the occupational group of health
promotion specialists, whose prime function it is to devise, develop
and implement health promotion strategies, have been ignored. Drawing
on qualitative interview data with these specialists in both provider
and purchasing settings in England this paper argues that thus far the
reforms have actually hindered the development of a strategic approac
h to the promotion of health by health promotion specialists. Three ma
in reasons for this are suggested; a confusion over the most appropria
te institutional location for health promotion specialists; a lack of
clarity by key actors as to the role and function of health promotion
specialists; and the emergence of a model of effectiveness and efficie
ncy which is largely antithetical to the philosophy and practice of he
alth promotion.