Abstract
What role does public opinion play in forging health policies in a democracy? That is a complicated question to answer, because all democracies are different and thus the role of public opinion varies greatly. In the United Kingdom, the public is generally more accepting of changes in policy than are the populations of many other countries. But that docility often changes when it comes to the subject of Britain's national Health Service (NHS). Indeed, politicians of every persuasion in the United Kingdom seem duty-bound not to be seen as attacking the NHS. The NHS became a particular source of controversy in 1989 because British Prime Minister Margaret Thatcher proposed some major reforms through a White Paper that was tabled in January. In the article that follows, Robert Blendon and Karen Donelan of the Harvard School of Public Health analyze twenty British national opinion polls regarding public attitudes toward the NHS. The analysis of public opinion seems to be a less well developed activity in the United Kingdom. Thus, this may be the first essay that looks broadly at British public opinion, as measured by scientifically valid survey instruments. Blendon is a long-time student of the role of public opinion in health policy making, first as an executive of The Robert Wood Johnson Foundation who supported a variety of survey pursuits and in the past two years as chairman of the Department of Health Policy and Management at Harvard's School of Public Health. Under the leadership of Blendon, who holds a doctorate in science from The Johns Hopkins University, the department is developing a program on public opinion and health care. This program will deal with public opinion as it influences health policy in the domestic and international spheres. Donelan, who holds a master of education degree, is a research associate in the same department. Following their essay is an invited response from David Willetts, director of studies for the Centre for Policy Studies in London.