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Social problems

How do social problems become policy problems? Discuss with reference to any

specific area of public policy.

The role of policy makers, mostly governments have been steadily evolving and changing with
an increasing emphasis directed at setting out a general direction through strategic policy
planning while engaging all the stakeholders and the citizens to deliver effectively in all its
programs and services
Public Policy
Public policy is a proposed intended course of action of either a person group of people or
the government within a specific environment providing obstacles, chances or opportunities
within the proposed policy which it utilizes to overcome in a sustained effort to achieve a
specific goal or realize certain objective or purpose. (Dunn, 2008)
A public policy acts as a guide to present future decisions that have been selected in a view of
certain conditions from many other alternatives, the proposed decision or a number of proposed
decisions that have been designed to implement the intended course of actions i.e. a projected

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designed program that consists of the given objectives and the proposed means of achieving
them. (John, 2000)
Case sturdy, British health Services and the social problems.
For instance, in Britain the NHS makes all the decisions about the ownership and management
of health care providers. In the early 1990s, the hospitals and all the other providers of health
were under the Health authorities that designed all the all the national health policies to be
implemented by the health providers. The 2000 NHS plan contained a number of critical
proposals but most of them needed the utmost support of the central government to be fully
implemented. Most public policies arise because of a certain need from the society. By the year
2002, the British department of health policies of highly centralized management was becoming
a liability in the provision of health services in the country, it reached a point where the secretary
of state had to explain to the public the general conditions of specific hospitals that were highly
mismanaged and an alternative policy was adopted that created radical reforms in the NHS
which included the self-governing organizations and the extra use of incentives.(Bosanquet,
2008) For example, hospitals that perfected their operations would be allowed to apply to
become members of the NHS foundation trusts. (Department of Health, 2002)
A public policy is simply a decision that has been made by the government to guide any other
actions in the same or similar situation or circumstances. Government policies are mostly
referred to as public policies as their set of decisions and actions guide the whole society in
general. These public policies are initiated and developed by the provincial, municipal, federal or
even territorial levels of government. (Bardach, 2000)
Policy matters are normally divided into two main categories i.e. the policies that are already on
the public policy discussions or agendas and those that have not been formulated or even

Economics 3
discussed. These are the social problems before they actually become public policy issues. A
social problem affects the whole community before it’s debated to become a public policy. When
these policy issues have found their way into the public policy formal agenda, then they gain a
higher profile and the formal process is most likely to follow unlike when it’s not on the
proposed public policy agenda.(Brewer, Garry and deLeon, 1983) Whenever there is a problem
or an issue that has not been ratified and it’s not on the general public domain, it’s the duty of all
the stakeholders and also the general community to educate others within themselves provides
information and takes all the necessary steps after educating most of the community, to have it
listed on the agenda. For an issue to qualify and be able to stand out in all the processes and
eventually become a public policy then it must have the following. One, it must have sufficient
and logical scope i.e. it must be affecting a good fraction of the people or the community, it must
also have a high intensity i.e. the magnitude of its impact must be high and it must have been an
issue for a long period of time. (Gerston, 1997) A number of problems may trigger the
development of public policy whose response can either be reactive, as in most cases or preactive
or proactive.
Policy development becomes reactive when it literally reacts or responds to issues and other
factors that have emerged mostly with very little notice or warning from either external or even
internal environment. (Pollitt and Bouckaert,2004) These may be by listening and solving
problems or issues, allocating resources i.e. either fiscal or natural resources, reactions to
emergencies or major catastrophes or emergencies among other reactionary measures.(Ferlie,
Lynn and Pollitt, 2007) Policy development can also be preactive i.e. it reacts or responds to
those triggers that are already recognized because the operating environment is usually scanned
and potential issues and other factors are indentified before they occur i.e. the issues are already

Economics 4
predicted before they occur and mitigation and contingency matters are already in place before
they occur. (Bovaird and Löffler, 2009) This is done by making strategic decisions, choices, risk
management, planning and setting the right priorities. Formal policies are rarely proactive when
it comes to their developments. The nature of developing a policy is such that most of the key
and majority of the major decisions only reflect little changes to the existing status quo. The
challenges that are connected to or associated with the development of an integrated policy
needs a big and broader picture, a general system perspective that can be able to identify and
address all the root causes or other symptoms. These policies can be driven by politicians,
powerful stakeholders, lobby groups, community leaders, departments and many other
bureaucratic committees. (Baldwin and Cave, 1999)
In Britain, the Foundation trust in the health department were introduced as governance
models with very important characteristics enacted in the constitution under the health and social
care Act of 2003.(HM Government, 2003) These were established for the benefit of the public.
They were to provide accountability among the staff and the patients and the local people. They
were independent units and they could even form joint ventures and other related business. Over
time the UK government tailored more policies to streamline the health sector as the Foundation
Trusts continued to evolve.( Lynn, 2006)
Public policies can be divided into two major categories. Vertical policy is mostly developed by
companies that have the authority and the means to implement their decisions. The horizontal
policy popularly known as the integrated policy is normally developed by two or even more
organizations with abilities to implement only portions of the integrated processes or policies.

Economics 5
The key factors that need to be considered when developing a public policy are, the public
interest i.e. is the public policy for the interest of the public or the society, is the process
inclusive and is it balanced i.e. between special interest and private interest. The public policy
must also be very effective in achieving its stated goals and objective. It also has to be efficient
and consistent while representing fairness and equity. It must also be politically and socially
acceptable. It must be based on a foundation of values that have been acknowledged and
discussed in a democratic process by the society. (Bickford, 1996)
Policy development takes the form of six stages i.e. Problem definition, goal or objective
clarification, option generation and selection, implementation and finally evaluation. Problem
definition involves the recognition of the existence of a problem that requires situational
analysis. This is followed by the real problem definition and the determination of all priorities.
For instance in an effort to of achieving equity of access to adequate and appropriate clinical care
for all citizens in all sectors regardless of income disparities or professional qualification or
status in the society in all public hospitals in the UK, a policy was introduced within the larger
system of public facilities and responsibilities for all public health services and were connected
to all other health services to the public at the lower levels. (Healy & McKee, 2002) The
importance of the primary health care in all public hospitals rendered their development to be
critical in their major objective of becoming an equal provider of public health services.
(Saltman, Rico, and Boerma, 2006) Also there were also some discussions concerning the
integration of chronic and other elderly care and medical coverage services in all primary care
public hospitals (Nolte and Mckee, 2008) The NHS project of foundation trusts was actually
market oriented i.e. it adopted measures that were needed by the general public. The general
governance of the Foundation Trusts as set out by the NHS, targeted the rules of the market.

Economics 6
These included the foundation trusts taking full responsibility to ensure they are successful.
Foundation trusts had significant and mostly beneficial impact on the quality of service and
financial control. These required strategic planning and proper governance structures which
needed innovation and some structural changes to succeed. While the health sector started to
experience improvement the advocates or the proponents of the policy noted that the Foundation
trusts were not in any way improving faster than the non- Foundation trusts. (Monitor, 2009)
These was mostly due to the cultural stereotype that existed since the second world war that
related to the centralized the way NHS had been managing its institutions in which new ideas
only originated from the top of the ladder and certainly not the bottom. The payers and the
providers still had a long way of achieving their targets and requirements.( Richards and Smith,
2002) The hospitals face no threat as such the motivation to work harder or compete is
nonexistent. The most important issue however was the extent to which the success of the model
was likely to be affected in the long term. The major expectation of the autonomous foundation
trust was that they would be self supportive and they would actually reinvent themselves. The
major reason for the Health providers to be independent was actually to prevent interference
from the executive arm of the government and the politicians would actually stop meddling in its
operations for provisions of quality health care for all. The new move to increase the
independence for the health providers was made in a way that it would very difficult to change it
back to the way it was as its the basis of the government’s reform program in the health sector.
Value and Goal or objective clarification involves the consideration of values and its stated
objectives. They clarify the normative foundation and describing the desired or the required
results, developing the criteria and all the general indicators.

Economics 7
The option generation focuses on the goals and the development of alternatives. The focus
should be broad and diverse and not restricted to the established norms.
The selection procedure should utilize tools to evaluate all alternatives and understanding all
their potential impacts while debating them. The selection procedure should bargain on
alternatives and make recommendations. (Richards and Smith, 2002)
During the implementation the factors that are critical to its success should be assessed, and the
instruments chosen and aligned in accordance to the stated objectives of the policies.
The evaluation stage requires monitoring to obtain feedback, comparing the actual and the
desired results and learning in the process. (Sabatier, 2007)
It’s important that those developing the desired public policy get the right information from
the right source and those who will be affected by the issue or those who may be affected by the
decisions of the policy. (Parsons, 2005)
To conclude, the power of the people and their authority is the basis of the development
of public policies. The biggest challenges are the collection of the diverse opinions of public
participation and the groups who represent other interested parties. Interest groups gather to
speak for common interests, individual or even for organizations. They give varied political
expressions, views or concerns. Public policies are the eventual expressions of the people’s
views on how to solve issues affecting. The NHS major task was to address the shortcomings in
the British hospitals hence the introduction of the Foundation trust which were to provide
autonomy and incentives to the best managed health facilities. The social problem initially was

Economics 8
the lack of adequate health facilities that prompted the introduction of the NHS policies and the
subsequent Foundations trusts that attempted to address the needs of the British health needs. It
successfully succeeded in providing standard health care services though it still needs some more
improvements as health needs continue to be become more challenging and complex.

Bardach, E. (2000) A Practical Guide for Policy Analysis, Chatham House Publishers,
Bickford, Susan (1996) Listening, Conflict and Citizenship: The Dissonance of
Democracy, Cornell University Press, Ithaca, New York,
Bourgon, Jocelyn, .Strengthening Our Policy Capacity, in Rethinking Policy:

Economics 9
Brewer, Garry D. and Peter deLeon,( 1983) The Foundations of Policy Analysis, Brooks/Cole
Publishing Company, Pacific Grove, California,.
Baldwin, R. and M. Cave (1999) Understanding Regulation, Oxford: OUP
 Bovaird, T and E Löffler (2009) eds. Public Management and Governance Oxford: Routledge
Bosanquet N (2008). The health and welfare legacy. In: Seldon A, ed. Blair’s Britain, 19972007
Cambridge, Cambridge University Press.
Department of Health (2002). Delivering the NHS plan: next steps on investment, next steps on
Reform London, Department of Health
( http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolic
y And Guidance/DH_4005818 accessed 2 May 2011)
Dunn, W (2008) Public Policy Analysis: An Introduction. Englewood Cliffs: Prentice Hall.
 Ferlie, E, L E Lynn and C Pollitt, eds. (2007) The Oxford Handbook of Public Management 
Oxford: Oxford University Press 
 Lynn, L E (2006) Public Management Old and New London: Routledge
 Parsons, W (2005) Public Policy. London: Edward Elgar.
 Pollitt, C, and G Bouckaert (2004) Public Management Reform: A Comparative Analysis
Oxford: Oxford University Press
 Richards, D and Smith, M. (2002) Governance and Public Policy in the UK. Oxford: OUP.
 Sabatier, P ed. (2007) Theories of the Policy Process. Boulder: Westview Press.
Saltman RB, Rico A, Boerma W, eds. (2006). Primary care in the driver’s seat? Organizational
reform in European primary careMaidenhead, Open University Press
Healy J, McKee M (2002). The role and functions of hospitals. In: McKee M,
Nolte E, McKee M (2008). Caring for people with chronic conditions: a health system

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Perspective Maidenhead, Open University Press.
HM Government (2003). Health and Social Care (Community Health and Standards) Act 2003
London, National Archives

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