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Article ID: CBB059455782

From “Honeymoon Period” to “Stable Marriage”: The Rise of Management Consultants in British Health Policymaking (2021)

Begley, Philip (Author)
Sheard, Sally (Author)

Bulletin of the History of Medicine
Volume: 95
Issue: 2
Pages: 227-255

DOI: 10.1353/bhm.2021.0031

URI: http://muse.jhu.edu/article/802298

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Health policy Policy making Bureaucracy Health care 21st century 20th century, late Great Britain National Health Service (Great Britain)

Since the creation of the National Health Service in 1948, different groups of experts have competed to inform the development of British health policy. This article analyzes the long-term rise of one of these groups—management consultants. The scale and regularity of their engagement has increased considerably over time, strikingly in recent years, and the functions fulfilled by consultants have become ever more diverse. At important moments they were often seen by policymakers—particularly when there was understood to be a lack of internal expertise—as possessors and imparters of important knowledge. Firms and individuals worked consciously to integrate themselves into emerging health policy networks. But there has often been relatively little consideration of their real suitability for work in the health field. Many debates around the use of external consultants today—accountability, value for money, dependency—were foreshadowed during earlier periods, with implications for current policymakers.

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