Toward Evidence-Based Policy Making and Standardized Assessment of Health Policy Reform

JAMA ◽  
2007 ◽  
Vol 298 (6) ◽  
pp. 676 ◽  
Author(s):  
J. Frank Wharam ◽  
Norman Daniels
2011 ◽  
Vol 60 (1) ◽  
pp. 20-43 ◽  
Author(s):  
Robert Geyer

For much of the twentieth century UK public policy has been based on a strong centralist, rationalist and managerialist framework. This orientation was significantly amplified by New Labour in the 1990s and 2000s, leading to the development of ‘evidence-based policy making’ (EBPM) and the ‘audit culture’ – a trend that looks set to continue under the current government. Substantial criticisms have been raised against the targeting/audit strategies of the audit culture and other forms of EBPM, particularly in complex policy areas. This article accepts these criticisms and argues that in order to move beyond these problems one must not only look at the basic foundation of policy strategies, but also develop practical alternatives to those strategies. To that end, the article examines one of the most basic and common tools of the targeting/audit culture, the aggregate linear X-Y graph, and shows that when it has been applied to UK education policy, it leads to: (1) an extrapolation tendency; (2) a fluctuating ‘crisis–success' policy response process; and (3) an intensifying targeting/auditing trend. To move beyond these problems, one needs a visual metaphor which combines an ability to see the direction of policy travel with an aspect of continual openness that undermines the extrapolation tendency, crisis–success policy response and targeting/auditing trend. Using a general complexity approach, and building on the work of Geyer and Rihani, this article will attempt to show that a ‘complexity cascade’ tool can be used to overcome these weaknesses and avoid their negative effects in both education and health policy in the UK.


2020 ◽  
Vol 135 (1) ◽  
pp. 38-49 ◽  
Author(s):  
Kari Lancaster ◽  
Tim Rhodes

Abstract Background Evidence-based policy decision-making is a dominant paradigm in health but realizing this ideal has proven challenging. Sources of data This paper conceptually maps health policy, policy studies and social science literature critically engaged with evidence and decision-making. No new data were generated or analysed in support of this review. Areas of agreement Barriers to evidence-based policy have been documented, with efforts made to increase the uptake of evidence. Areas of controversy Evident complexities have been regarded as a problem of translation. However, this assumes that policy-making is a process of authoritative choice, and that ‘evidence’ is inherently valuable policy knowledge, which has been critiqued. Growing points Alternative accounts urge consideration of how evidence comes to bear on decisions made within complex systems, and what counts as evidence. Areas timely for developing research An ‘evidence-making intervention’ approach offers a framework for conceptualizing how evidence and interventions are made relationally in practices, thus working with the politics and contingencies of implementation and policy-making.


1995 ◽  
Vol 21 (2-3) ◽  
pp. 241-258 ◽  
Author(s):  
Marc A. Rodwin

Owen Barfield, the British solicitor and literary scholar, reminds us that many legal concepts have their origin as metaphors and legal fictions. We often fail to see the nature of legal metaphors, Barfield argues, because over time they ossify and we read them literally rather than figuratively. Look closely at changes in law over time, Barfield advises us, to see how effectively metaphor works in law and language. Many legal categories and procedures we now use had their origin in using a metaphor that revealed a new way of looking at a problem or that helped solve a legal problem. Legal metaphors also help us to identify critical limits and strains in adapting to new facts and circumstances.George Annas has pointed out that our choice of metaphors for medicine can reframe our debates about health policy reform. And Analee and Thomas Beisecker remind us that patient-physician relations have been viewed through many metaphors. These include parent-child relations (paternalism); seller-purchaser transactions (consumerism); teacher-student learning (education); relations among partners or friends (partnership or friendship); or rational parties entering into negotiations or contracts (negotiation or rational contract).


2009 ◽  
Vol 68 (12) ◽  
pp. 2256-2262 ◽  
Author(s):  
M. Ramesh ◽  
Xun Wu

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