The stimulus for this research was the publication of the Green and White papers: Our Healthier Nation (OHN) - Saving Lives (DoH, 1998/9). The aim was to ascertain factors affecting the pattern and speed of local reactions to the new policy. These factors were predicted to be similar to those found in analysis of pre-1997. Conservative government, public health policy. However, the particular hypothesis of the thesis was that tensions in the Labour Party and government concerning aspects of the wider determinants of health would also play a role in affecting local implementation. Of specific importance was the equivocal determinant of 'income inequalities'. A case study of one inner-London borough was undertaken. Data collection was by way of in-depth interviews, participant observation and a review of local and national policy documents. Findings based on fieldwork are: 1. The implementation process was protracted. Delays need to be distinguished from policy failure. 2. Staff views did influence the pattern of implementation. However, some widely-held beliefs did not affect local work developed in response to the policy. This was primarily because no permission had been granted by central government for local staff to act on these opinions. 3. Local NHS staff needed clear guidance on how to prioritise work, this was not provided until 2003. 4. Unresolved anomalies exist in NHS and local authority public involvement work relating to health inequalities reduction. This is because the policy highlights the wider determinants of health, including income distribution. The latter is a politically partisan subject. The 'neutral' state bureaucracy is less adept at facilitating 'citizen' influence over the issue than political parties have been. However, sections of the Labour Party itself appear to have some interest in directing involvement away from party organisation.

British Labour government policy to reduce inequalities in health: Responses in an inner London borough, 1997-2003.

After election defeats, parties usually engage in post-mortem rituals. These can take a wide variety of forms. Committees of inquiry may be established. 'Rankand-file' members may be given opportunities to have their say about 'what went wrong'. Parliamentary leaders may attempt to convince voters that the party has mended its ways. Within the party, matters of organisational structure, programme and ideology may be debated, although post-mortems are often effectively confined to a narrow range of topics. Post-mortem ritual talk generally includes reference to more effective campaigning, intra-party democracy and 'adaptation' to 'social change'. 'Managerial' discourses, emphasising electoral success, efficiency and party professionalism jostle with the 'participatory' discourses embodying activists' aspirations (emphasising the party's mission, 'rank-and-file' rights and 'educating' the electorate). Commentators often dismiss these rituals as meaningless exercises, interesting only insofar as they provide a backdrop for vealpolit-ik power plays about who is to be 'blamed' for the defeat. However, if we analyse post­ mortem rituals seriously, we have a useful vantage point for examining what goes on within political parties. Both 'managerial' and 'participatory' forms of 'rationalistic idealism' may be little more than camouflage for realpolitik manoeuvre and machination. However, party reform involves the crystallisation of new meanings as well as factional struggles. 'Rationalistic idealism' may help new meanings

Post-mortem rituals and party reform: Australian Labor debates, 1963-1981

Party organisation is about more than structure and power: it is an important means through which political elites define a party and its political identity. This thesis examines narratives of organisational reform in the British Labour Party between 1979 and 2014, at times of significant debate about methods of leadership election, party governance, processes of policy-making and the union link. When arguing for particular kinds of organisational reform, elites within the Party have constructed different stories in order to contest proposals and present their visions for structural change. In doing so, they have tied together interpretations of Labour’s past, present and future with particular notions of what makes for ‘democratic’ and ‘legitimate’ politics. This temporal and cultural politics lies at the heart of the transformation the Party underwent in this period and underpins the challenges posed to its identity in recent years.

In the course of this thesis, three related arguments are made. First, it is argued that the organisational debates that took place between 1979 and 2014 offer a unique perspective on the complicated and fractious identity politics of the Party as being historically rooted in collectivism or individualism, movement politics or parliamentarism. Second, it is argued that Labour’s elites have increasingly sought to individualise party structures since the decline of the left in the ‘80s. In contrast to other accounts of Labour’s organisation that focus on its structures, this thesis argues that this individualisation was as much about party identity as it was process. Third, this thesis argues that the prolonged debates about Labour’s organisational identity demonstrate how unsettled and divided the Party has been throughout its recent history. The lack of a common sense understanding of the Party's organisational character can help to explain its fractured internal dynamics since its loss in the General Election of 2015.

Narratives of organisational reform in the British Labour Party, 1979-2014

This thesis concerns the impact of purchase of service contracts on voluntary sector providers of social care. Voluntary agencies in Britain have traditionally received annual grant-aid from local authority social services departments in acknowledgement of the many different care and support services they have provided to the community. However, following the reorganisation of the personal social services in the early 1990s (National Health Service and Community Care Act 1990), this funding mechanism shifted increasingly towards a tighter, contractual, relationship in which expectations about service levels, monitoring arrangements, quality and costs were made explicit and formally agreed. This changes the way in which voluntary sector providers have to work, their relationship with statutory sector agencies and their interface with the wider community.Whilst interest in social care contracting is growing, policy analysts have done little to qualitatively study the contracting process from the voluntary sector perspective. This study aims to bridge this gap. It offers a close examination of twenty-three voluntary sector agencies in four local authorities in England. It sheds light on the impact of replacing grant-aid with contractual income, contributes to the understanding of how voluntary sector providers of social care services experience the contracting process and explores how the local authority-voluntary sector interface is developing. Understanding the voluntary sector perspective on social care contracting can assist statutory sector purchasers to develop systems that best meet both sectors' needs.Prominent amongst the findings are the following: (1) despite the introduction of a 'quasi-market' in social care there was little evidence of a competitive market for contracts between voluntary sector providers; (2) local authorities were inclined to offer service agreements to recognised and trusted voluntary sector providers; (3) the language and legal status of social care contracting is regarded as ambiguous by voluntary managers - different local authorities have adopted distinct language and definitions; (4) the notion that voluntary providers are the preferred providers of local authorities was questioned by a number of statutory sector respondents - there was evidence that statutory sector purchasers were willing to make use of the for profit sector for service provision; (5) whilst some voluntary providers had been able to negotiate successful contracts with purchasers many commented on the conflictual nature of this process; (6) the monitoring of contracts is very mixed and there were concerns over the robustness of local authorities in collecting relevant data.

Social care, conrtacts and volutary sector providers.

The national shift to the left, with all its implications for the balance of power, may be accepted as permanent . . . Any Government which tampered seriously with the basic structure of the full-employment Welfare State would meet with a sharp reverse at the polls . . . It is this which explains the otherwise curious phenomenon that the Conservatives now fi ght elections largely on policies which twenty years ago were associated with the left, and repudiated by the right . . . The fact that the political battle today is waged mainly on ground chosen by the left is remarkable evidence of the change in national ideology . . . (C. A. R. Crosland, The Future of Socialism, 1956: 28–9, 61)

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From The Future of Socialism (1956) to a future without socialism?: The crisis of British social democratic political economy

In the blood of the socialist, Anthony Crosland argued, 'there should always run a trace of the anarchist and the libertarian, and not too much of the prig and the prude.' His classic manifesto, The Future of Socialism, first appeared when its author was thirty-eight years old. Asa Briggs described it in the Observer as 'a fascinating an original survey of contemporary British society which will appeal to a far wider circle of readers than confirmed Socialist.' More than twenty years on, the brilliance, urgency, humanity and eloquence of Crosland's message are not diminished: Croslandism, as it now is know, remains the aim of democratic socialists in many countries besides Britain. Crosland's philosophy stemmed from his feelings for man as an individual - passionate feelings for equality matched by respect for personal liberty. He combined the intellectual and the politician in a way that was perhaps unique in this century. Irreverence and humour add to the penetration and width of his argument. 'Total abstinence and a good filing-system are not now the right sign-posts to the socialist Utopia,' Crosland once said; 'or at least, if they are, some of us will fall by the wayside.' Shortly after Crosland died, Michael Young wrote in Encounter: 'His voice carried conviction because it was the voice of someone thinking out his position for himself.' It is a measure of the book that John Strachey's directive in the New Statesman is as true and relevant today as ever it was. 'No-one must in future take part in the controversy on Socialism without having read it.'

H. Smith

Papers

The Future of Socialism.