books

Published: 06/02/2003, Volume II3, No. 5841 Page 24 25

Delivering Welfare Second edition By Tony Butcher Publisher: Open University Press. ISBN: 0335210163. 240 pages.£19.99.

Key Concepts and Debates in Health and Social Policy By Nigel Malin, Stephen Wilmot and Jill Manthorpe Publisher: Open University Press. ISBN: 0335199054. 170 pages.£16.99.

Both these books are based on the same historical assumption; that there was a broad consensus on the welfare state from the late 1940s to the 1970s and that this has now gone. Beyond that, they diverge in both style and argument.

Tony Butcher's Delivering Welfare is much the more useful of the two. Perhaps it is simply better to have a single author. Or possibly the book benefited from being refined in its transition from first edition to second. Either way, it is engaging and accessible, presenting a wealth of useful research in a helpful manner.

Butcher's clear view is that most of the new thinking on public policy began on the Right.He does not regard New Labour as the ideological opponents of the Tories of the 1980s and 1990s, but as fellow travellers in a more or less unbroken process of public sector reform.

This seems to me a fair cop.

After all, as Butcher says, few if any of the public sector reforms of 1979-97 have been reversed.

In health, the purchaserprovider split has been replaced by the commissioner-provider split - and Labour's pre-1997 hostility to the private finance initiative has been replaced by pretty hardline advocacy.

In contrast, Key Concepts and Debates in Health and Social Policy struck me as highly jaundiced. It is depressingly light on facts and figures and laden with hoary old political value judgements.

For example, the authors say that 'community and civil society played a very limited part in the strategy of the Thatcher and Major governments' and go on to parrot the line that New Labour wants 'constructive partnership'.

It is surprising and disappointing that they did not instead bang the current crop of ministers to rights for their incessant use of just this kind of woolly, insubstantial, feel-good rhetoric.

It seems the fundamental problem with Key Concepts is that the authors have fallen for the publicity of politicians.

They have bought the rhetoric about the Tories 'rolling back the frontiers of the state' and of New Labour reversing all the wickedness.

But since there is not really that much ideological division in politics these days - particularly where the public services are concerned - this kind of polarising analysis is bound to come to grief. I know from my own time as a special adviser that policies usually change not because ideologies have changed, but because circumstances have.

One final thought: Key Concepts closes with the authors arguing that the NHS 'should have a civilising function and endeavour to promote tolerance and understanding among different social groupings'. Can I be the only person who thinks that more pressing priorities might be to provide first-class services, reduce waiting times and treat patients in a humane manner? I do hope not.