Technocracy, the Market and the Governance of England's National Health Service

Horton, DP ORCID: 0000-0002-0243-0587 and Lynch-Wood, Gary (2020) Technocracy, the Market and the Governance of England's National Health Service. Regulation and Governance, 14 (2). pp. 295-315.

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Abstract

England's National Health Service, the fifth largest employer in the world, has become heavily influenced by expert authority and the market economy, which has had implications for accountability and the receptiveness of health decisions to stakeholder needs. One response has been the introduction of a range of regulatory provisions designed to facilitate effective governance and stakeholder engagement. These provisions are scrutinized using three conceptual devices: core accountability, social reporting and social learning. These devices have significant implications, as they enable technical experts to form closed communities, communicate among themselves mainly about economic and financial matters, and make decisions that aid the market without meaningful recourse to citizens. While technical experts are necessary to help manage complex areas, current arrangements reinforce an existing gap between economic and democratic values through hardened technocratic approaches to health care governance.

Item Type:	Article
Uncontrolled Keywords:	accountability, expertise, health care regulation, stakeholder engagement, technocracy
Depositing User:	Symplectic Admin
Date Deposited:	10 Jul 2018 08:39
Last Modified:	19 Jan 2023 01:30
DOI:	10.1111/rego.12208
Open Access URL:	https://doi.org/10.1111/rego.12208
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3023577