Policy Analysis and Policy Know-how: A Case Study of Civil Servants in England’s Department of Health

Abstract

What kind of work is policy-making, and what kinds of knowledge do public administrators draw on in practice? This paper draws on an ethnographic study of civil servants working in England’s Department of Health to offer an account of public administration work as directed towards building connections between ideas and actors to make policies “happen”. The knowledge which is critical to this work is a shared “policy know-how” about how to enact policy-making in this context. However, rational-technocratic accounts of the work of public administration as problem solving informed by expert knowledge claims and analysis were also found to play an important role in the civil servants’ work, both as a legitimating device and a source of meaning and faith for individual actors seeking to make sense of their work.

Keywords:

• policy knowledge
• policy work
• practice
• British civil service
• UK Department of Health

Notes

^1. The Big Society was a key plank of the Conservative Party’s 2010 election manifesto, and also featured in the Government’s Coalition Agreement. The stated aim of the policy is “to create a climate that empowers local people and communities, building a big society that will ‘take power away from politicians and give it to people’” (Number 10 2010).

^2. The Coalition Government’s reform programme for health included a stated commitment that oversight of the health system should be focused on the “outcomes”, rather than “processes” of healthcare (see Secretary of State for Health 2010: 1) .

^3. “QIPP” stands for the Quality, Innovation, Productivity and Prevention programme. Initiated by the department in 2009, its broad stated aim at the time of my fieldwork was to improve productivity in the health service. After the reforms associated with the Health and Social Care Bill, this was one of the most high-profile policy agendas at the time of my data collection.

Additional information

Notes on contributors

Jo Maybin

Jo Maybin is a fellow in health policy at the King’s Fund, a London-based think-tank. In 2013 she completed a part-time PhD at the University of Edinburgh, where she was awarded a Sir Bernard Crick Fellowship in Politics.