The territorial bases of health policymaking in the UK after devolution

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Abstract
For all that there is a well-entrenched sense of the differences among the different peoples of the UK, there has been surprising reluctance to accept the extent to which these differences translate into divergent public policy trajectories. That means the extent of policy divergence since devolution has been something of an uncomfortable surprise for many. Its speed, given the common heritages, similar organizations, shared problems, and pressures for convergence between the four systems might startle – in an increasingly globalized world (and medicine has long been cosmopolitan) their divergence is striking and explaining it important. If there is to be change in a mature welfare state such as that of the United Kingdom, it will most likely be through the accretion of such changes to existing systems. And, I argue, the changes reflect the distinct politics of place and the way policy makers, often insensibly, respond to their particular problems and debates in ways that vary territorially and produce territorial policy divergence that matters.

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