Reconfiguring Local Health Economies
Reconfiguring local health economies: Evidence, policy, practice, and participation.
Evidence from social science studies plays an increasing role in consultation in governance processes and in justifying recommended change. An example of such justifications can be seen in health service reconfigurations that concentrate services in large units and in the use of population projections in extending plans for local services. Often this evidence is given a status that ignores its uncertainties and qualifications. This study builds on lessons from research on the deeply contested structural changes in Manchester UK that overlapped Accident and Emergency with Maternity services, where both public consultation and evidence based on opinions of clinicians played a major role. It focuses on the nature of social science evidence in such processes, on the way in which evidence is understood and deployed by policy makers and on what evidence means in relation to consultation and participation in democratic societies. With David Byrne and Andrew Fletcher.