Health policy: An introduction to process and power.

• Jurisdiction: Australia
• Author: Lewis, Jenny
• Date: 01 January 1997

Gill Walt, Health policy: An introduction to process arm power, (London, Zed Books, 1994)

Perhaps the most surprising thing about this book, on first glance, is the lack of mention of the dominance of the medical profession. Neither the standard works on the professions from sociologists, most notably Eliot Freidson,(1) nor a structural interest perspective of health by political scientists, such as Robert Alford,(2) can be found listed in the Bibliography. This, in itself, leads to some interesting questions around precisely what concepts of the policy process and power underly this book on health policy, subtitled "An introduction to process and power". Is it simply that conditions are vastly different in Britain, where the author is based, compared with other Western democracies (including Australia and North America)? Or have circumstances changed so much that medical dominance is not an important consideration in the nineties?

The book takes a three tiered approach to health policy analysis, starting with an international perspective. As the author asserts: "States increasingly make policy in an interdependent world, and are not always sovereign decision makers, especially in the economic sphere".(3) At this level, the impact on health policy of multinational companies, the World Bank, the International Monetary Fund, and international donor agencies comes under scrutiny. This catalogue gives the impression that this international perspective is confined to third world countries, and this is certainly a major part of the book. However, an international perspective is also important in...