Health Policy, Governance and Economics

This module explores how contemporary health systems operate. Whilst the British NHS and Public Health systems will provide us with a reference point, the module is not restricted to the UK. International comparisons of different types of health systems, and public health policies and interventions are also included in order to promote deeper learning and a global perspective.

Course Description

There are three components: we blend these together, rather than studying each in turn. Health policy defines what ‘we’ want a health system to do. This ‘we’ might be society as a whole, the government, or any group of interested persons – patients, taxpayers, health care workers. We will reflect on how policy is made, implemented and reviewed, looking at how public health advocates can seek an impact on policymaking. Some recent British history provides useful examples of these processes.

We will also look at the notion of governance as applied to health systems, paying particular attention to how these are defined, organised and funded. Attention is also given to how the performance of health systems is measured and assessed. This includes international comparisons and consideration of public, private and mixed economy models.

Governance is one facet of management theory. It is not possible to cover every aspect of management theory. However, there are some core themes which appear throughout the module. These include;

• Organisational analysis – strengths and weaknesses of different models.
• Resource allocation and finance – matching resources to needs and demands.
• Quality – assessment, evaluation, performance management.
• Organisational change – concepts, models, frameworks.
• Leadership – styles, traits, behaviours.

Thinking about the measurement of effectiveness, and about how to allocate resources, brings us to health economics. We will introduce you to its key concepts, and particularly its application to public health. We will cover the evaluation of programmes and interventions, and ways to think about cost effectiveness (‘value for money’). The aim is not to start training you as economists, but to allow you to understand what health economics does, and to think critically about how it can be useful to public health, as well as its possible pitfalls.

By studying these three components the module looks at how health (and social care) services are planned and managed and also how change and service improvements are implemented and led, at both the national, or system-wide, level and also at the organisational level. All these themes are put into public health related contexts during the weekly sessions, and developed through the use of reflective exercises/ scenarios.