Contextual pressures on health—implications for policy making and service provision

This article posits that health is one of the more difficult areas of public policy making and service provision, owing to a variety of circumstantial and contextual issues. It suggests that advancements in medical practice and organization are not simplifying health policy; along with the changing context of health, they are complicating the processes of policy making and provision. The article discusses a number of trends and emerging issues in public policy philosophy, health care financing, structures and service delivery. It concludes that the complex context of health care requires approaches to policy making which are participatory and consultative.