Healthy public policy: factors driving the regional agenda

Abstract

Throughout New Labour’s term in office, from 1997 to 2010, the Government placed increasing emphasis on both healthy policy and regionalism. No longer was health merely part of the National Health Service agenda. Instead, all policies had to take health into account, to address the wider determinants of health, such as housing, employment and poverty. New regional agencies were created to aid policy development and implementation at the regional level. This study considered the way healthy public policy reached and climbed the decision-makers’ agendas within these regional structures.

The North East region of England was chosen as a case study. A series of interviews took place with those most heavily involved in policy-making in the region. Documents from the regional agencies and other organizations playing a part in the decision-making process were examined. Along with general policy, four specific policy areas were investigated: tobacco control, housing, worklessness and climate change. These were chosen to allow comparison of influential factors, particularly those factors identified in the agenda-building literature.

Several agenda-building models proved helpful, suggesting factors shown to influence agendas, although many related to national agendas. The most significant factors were the people and organizations involved and the ways they worked together, formally and informally, across departments and across organizations. Informal joint working was also particularly useful in enhancing decision-makers’ awareness of health issues so that health would be considered in all policy.

The recently elected Government plans to move away from regionalism towards localism. The North East currently has an ethos of joint working and a commitment to healthy policy. Losing the supportive regional structures could well mean losing the capacity to make all policy healthy policy.