Abstract
This paper explores how ‘place’ is conceptualised and mobilised in health policy and considers the implications of this. Using the on-going spatial reorganizing of the English NHS as an exemplar, we draw upon relational geographies of place for illumination. We focus on the introduction of ‘Sustainability and Transformation Plans’ (STPs): positioned to support improvements in care and relieve financial pressures within the health and social care system. STP implementation requires collaboration between organizations within 44 bounded territories that must reach ‘local’ consensus about service redesign under conditions of unprecedented financial constraint. Emphasising the continued influence of previous reorganizations, we argue that such spatialized practices elude neat containment within coherent territorial geographies. Rather than a technical process financially and spatially ‘fixing’ health and care systems, STPs exemplify post-politics—closing down the political dimensions of policy-making by associating ‘place’ with ‘local’ empowerment to undertake highly resource-constrained management of health systems, distancing responsibility from national political processes. Relational understandings of place thus provide value in understanding health policies and systems, and help to identify where and how STPs might experience difficulties.
Original language | English |
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Pages (from-to) | 217-226 |
Number of pages | 9 |
Journal | Social Science and Medicine |
Volume | 190 |
Early online date | 11 Aug 2017 |
DOIs | |
Publication status | Published - 1 Oct 2017 |
Keywords
- UK
- NHS
- Place
- Post politics
- Relational geographies
- Sustainability and Transformation Plans
- Health Policy
- Organizing healthcare