Powell Martin
Health Services Management Centre,University of Birmingham,Birmingham,UK.
Health Econ Policy Law. 2019 Jan;14(1):29-39. doi: 10.1017/S1744133118000117. Epub 2018 Apr 15.
The British National Health Service (NHS) celebrates its 70th birthday on 5 July 2018. This paper examines this anniversary through the lens of previous anniversaries, exploring two strands of political debates and NHS documents. It draws on the basic 'multiple streams model' of Kingdon that argues that an issue reaches the agenda when the policy window opens to allow the coupling of three independent streams - policy, problem and politics. It is found that there appears to be some discontinuity in the problem stream; some periods of relative consensus and sharp political differences in the politics stream; and sharp variations over time in the policy stream. While it is clear that there have been both continuities and discontinuities in the problem, politics and policy streams over the past 70 years, they have rarely come together to result in a policy that has taken it off the agenda.
英国国民医疗服务体系（NHS）于2018年7月5日迎来了其70周年诞辰。本文通过以往周年纪念的视角审视这一周年庆典，探讨两条政治辩论线索以及NHS相关文件。它借鉴了金登的基本“多源流模型”，该模型认为，当政策窗口打开，允许政策、问题和政治这三个独立源流耦合时，一个问题就会进入议程。研究发现，问题源流似乎存在一些不连续性；政治源流存在相对共识期和尖锐政治分歧期；政策源流则随时间有大幅变化。虽然过去70年里，问题、政治和政策源流显然既有连续性又有不连续性，但它们很少结合在一起形成一项将该问题从议程上移除的政策。
