Hostname: page-component-6bb9c88b65-vmslq Total loading time: 0 Render date: 2025-07-27T00:47:12.800Z Has data issue: false hasContentIssue false
  • English
  • Français

The Discursive Turn in Policy Analysis and the Validation of Policy Stories

Published online by Cambridge University Press:  06 January 2012

LINDSAY PRIOR ,
DAVID HUGHES  and
STEPHEN PECKHAM
LINDSAY PRIOR*
Affiliation:
Centre of Excellence in Public Health & School of Sociology, Social Policy and Social Work, Queen's University, Belfast
DAVID HUGHES
Affiliation:
Department of Public Health & Policy Studies, Swansea University email: d.Hughes@swansea.ac.uk
STEPHEN PECKHAM
Affiliation:
Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine email: stephen.Peckham@lshtm.ac.uk
*
email: l.prior@qub.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper is concerned with the language of policy documents in the field of health care, and how ‘readings’ of such documents might be validated in the context of a narrative analysis. The substantive focus is on a comparative study of UK health policy documents (N = 20) as produced by the various assemblies, governments and executives of England, Scotland, Wales and Northern Ireland during the period 2000–09. Following the identification of some key characteristics of narrative structure the authors indicate how text-mining strategies allied with features of semantic and network analysis can be used to unravel the basic elements of policy stories and to facilitate the presentation of data in such a way that readers can verify the strengths (and weaknesses) of any given analysis – with regard to claims concerning, say, the presence, absence or relative importance of key ideas and concepts. Readers can also ‘see’ how the different components of any one story might fit together, and to get a sense of what has been excluded from the narrative as well as what has been included, and thereby assess the reliability and validity of interpretations that have been placed upon the data.

Information

Type
Articles
Information
Journal of Social Policy , Volume 41 , Issue 2 , April 2012 , pp. 271 - 289
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

References

Aristotle (1995), Poetics, translated S. Halliwell, Cambridge, MA: Harvard University Press.Google Scholar
Anderson, B. (1983), Imagined Communities: Reflections on the Origin and Spread of Nationalism, London: Verso.Google Scholar
Bevan, G. and Hood, C. (2006), ‘What's measured is what matters: targets and gaming in the English public health system’, Public Administration, 84: 3, 517–38.CrossRefGoogle Scholar
Blank, R. (2006), ‘Setting health priorities across nations: more convergence than divergence?’, Journal of Public Health Policy, 27: 3, 265–81.CrossRefGoogle ScholarPubMed
Cabinet Office (2010), The Coalition: Our Programme for Government, London: HM Government.Google Scholar
Calnan, M. and Gabe, J. (2001), ‘From consumerism to partnership? Britain's National Health Service at the turn of the century’, International Journal of Health Services, 31: 1, 119–31.CrossRefGoogle ScholarPubMed
Charon, R. (2006), Narrative Medicine: Honoring the Stories of Illness, New York: Oxford University Press.CrossRefGoogle Scholar
Czarniawska, B. (2004), Narratives in Social Science Research, London: Sage.CrossRefGoogle Scholar
DeVault, M. L. (1990), ‘Novel readings: the social organization of interpretation’, American Journal of Sociology, 95: 4, 887–921.CrossRefGoogle Scholar
Fairclough, N. (2001), ‘The discourse of New Labour: critical discourse analysis’, in Wetherell, M., Taylor, S. and Yates, S. J. (eds.), Discourse as Data: A Guide for Analysis, Buckingham: Oxford University Press, pp. 229–66.Google Scholar
Fischer, F. (2003), Reframing Public Policy: Discursive Politics and Deliberative Practices, Oxford: Oxford University Press.CrossRefGoogle Scholar
Fischer, F. and Forrester, J. (eds.) (1993), The Argumentative Turn in Policy Analysis and Planning, Durham, NC: Duke University Press.Google Scholar
Frank, A. (1995), The Wounded Storyteller: Body, Illness, and Ethics, Chicago, IL: University of Chicago Press.CrossRefGoogle Scholar
Freud, S. (1961), Civilization and Its Discontents, translated and edited by Strachey, James, London: W.W. Norton.Google Scholar
Garvin, T. and Eyles, J. (2001), ‘Public health responses for skin cancer prevention: the policy framing of sun safety in Australia, Canada and England’, Social Science and Medicine, 53: 9, 1175–89.CrossRefGoogle ScholarPubMed
Greener, I. (2004), ‘The three moments of New Labour's health policy discourse’, Policy and Politics, 32: 3, 303–16.CrossRefGoogle Scholar
Greer, S. (2004), Territorial Politics and Health Policy: UK Health Policy in Comparative Perspective, Manchester: Manchester University Press.Google Scholar
Greer, S. (2009), ‘Devolution and divergence in UK health policies’, British Medical Journal, 338: 78–80.Google Scholar
Greimas, A. J. (1970), Du Sens: Essays Sémiotiques, Paris: Ėditions du Seuil.Google Scholar
Hughes, D. and Vincent-Jones, P. (2008), ‘Schisms in the church: NHS systems and institutional divergence in England and Wales’, Journal of Health and Social Behavior, 49: 4, 400–16.CrossRefGoogle ScholarPubMed
Hydén, L. C. (1997), ‘Illness and narrative’, Sociology of Health and Illness, 19: 1, 48–69.CrossRefGoogle Scholar
Iannantuono, A. and Eyles, J. (1997), ‘Meanings in policy: a textual analysis of Canada's “Achieving Health for All” document’, Social Science and Medicine, 44: 11, 1611–21.CrossRefGoogle ScholarPubMed
Iannantuono, A. and Eyles, J. (1999), ‘Environmental health metanarratives: an analysis of policy making in Ontario, Canada’, Health and Place, 5: 2, 139–56.CrossRefGoogle ScholarPubMed
Kaplan, T. J. (1986), ‘The narrative structure of policy analysis’, Journal of Policy Analysis and Management, 5: 4, 761–78.CrossRefGoogle Scholar
Majone, G. (1989), Evidence, Argument, and Persuasion in the Policy Process, New Haven, CT: Yale University Press.Google Scholar
Mays, N. and Pope, C. (2000), ‘Assessing quality in qualitative research’, British Medical Journal, 320: 50–2.CrossRefGoogle ScholarPubMed
Moon, G. and Brown, T. (2000), ‘Governmentality and the spatialized discourse of policy: the consolidation of the post 1989 NHS reforms’, Transactions of the Institute of British Geographers, 25: 65–76.CrossRefGoogle Scholar
Newman, J. and Vidler, E. (2006), ‘Discriminating customers, responsible patients, empowered users: consumerism and the modernisation of health care’, Journal of Social Policy, 35: 2, 193–210.CrossRefGoogle Scholar
Rein, M. and Schön, D. (1993), ‘Reframing policy discourse’, in Fischer, F. and Forester, J. (eds.), The Argumentative Turn in Policy Analysis and Planning, Durham, NC: Duke University Press, pp. 145–66.CrossRefGoogle Scholar
Roe, E. (1994), Narrative Policy Analysis, Theory and Practice, Durham, NC: Duke University Press.Google Scholar
Russell, J., Greenhalgh, T., Byrne, E. and McDonnell, J. (2008), ‘Recognizing rhetoric in health care policy analysis’, Journal of Health Service Research and Policy, 13: 1, 40–6.CrossRefGoogle ScholarPubMed
SPSS (2007), Text Mining for Clementine, 12.0 User's Guide, Chicago, IL: SPSS.Google Scholar
Saltman, R. B. (1997), ‘Convergence versus social embededness: debating the future direction of healthcare systems’, European Journal of Public Health, 7: 4, 449–53.CrossRefGoogle Scholar
Scrase, J. I. and Ockwell, D. G. (2010), ‘The role of discourse and linguistic framing effects in sustaining high carbon energy policy – an accessible introduction’, Energy Policy, 38: 2225–33.CrossRefGoogle Scholar
Shaw, S. (2010), ‘Reaching the parts that other theories and methods can't reach: how and why a policy-as-discourse approach can inform health-related policy’, Health, 14: 2, 196–212.CrossRefGoogle Scholar
Van Dijk, T. (1997), ‘Editorial: analysing discourse analysis’, Discourse and Society, 8: 1, 5–6.CrossRefGoogle Scholar
Walt, G., Shiffman, J., Schneider, H., Murray, S., Brugha, R. and Gilson, L. (2008), ‘“Doing” health policy analysis: methodological and conceptual reflections and challenges’, Health Policy and Planning, 23, 308–17.CrossRefGoogle ScholarPubMed
Yanow, D. (2000), Conducting Interpretive Policy Analysis, London: Sage.CrossRefGoogle Scholar

Policy documents

Department of Health (DH) (2000), The NHS Plan: A Plan for Investment, a Plan for Reform, London: Stationery Office.Google Scholar
Department of Health (DH) (2003), Building on the Best: Choice, Responsiveness and Equity in the NHS, London: Stationery Office.Google Scholar
Department of Health (DH) (2004a), The NHS Improvement Plan: Putting People at the Heart of Public Services, London: Stationery Office.Google Scholar
Department of Health (DH) (2004b), Choosing Health: Making Healthier Choices Easier, London: Stationery Office.Google Scholar
Department of Health (DH) (2005), Creating a Patient Led NHS: Delivering the NHS Improvement Plan, London: Stationery Office.Google Scholar
Department of Health (DH) (2006), Our Health Our Care Our Say: A New Direction for Community Services, London: Stationery Office.Google Scholar
Department of Health, Social Services and Public Safety (DHSSPS) (2002), Investing for Health, Belfast: Department of Health Social Services and Public Safety.Google Scholar
Department of Health, Social Services and Public Safety (DHSSPS) (2004), A Healthier Future: A Twenty Year Vision for Health and Wellbeing in Northern Ireland, 2005–25, Belfast: Department of Health Social Services and Public Safety.Google Scholar
Department of Health, Social Services and Public Safety (DHSSPS) (2006), Investing for Health, update, Belfast: Department of Health Social Services and Public Safety.Google Scholar
Department of Health, Social Services and Public Safety (DHSSPS) (2008), Proposals for Health and Social Care Reform, Belfast: Department of Health, Social Services and Public Safety.Google Scholar
Department of Health, Social Services and Public Safety (DHSSPS) (2009), Priorities for Action 2009–2010, Belfast: Department of Health Social Services and Public Safety.Google Scholar
Scottish Executive (SE) (2000), Our National Health: A Plan for Action a Plan for Change, Edinburgh: Scottish Executive.Google Scholar
Scottish Executive (SE) (2005)a, Building a Health Service Fit for the Future: A National Framework for Service Change in the NHS in Scotland, vol. I, Edinburgh: Scottish Executive.Google Scholar
Scottish Executive (SE) (2005)b, Building a Health Service Fit for the Future: A National Framework for Service Change in the NHS in Scotland, vol. II, Edinburgh: Scottish Executive.Google Scholar
Scottish Government (SG) (2007), Better Health, Better Care Action Plan, Edinburgh: Scottish Government.Google Scholar
Welsh Assembly Government (WAG) (2001), Improving Health in Wales: A Plan for the NHS with Its Partners, Cardiff: Welsh Assembly Government.Google Scholar
Welsh Assembly Government (WAG) (2003), The Review of Health and Social Care in Wales, Cardiff: Welsh Assembly Government.Google Scholar
Welsh Assembly Government (WAG) (2005), Designed for Life: Creating World Class Health and Social Care for Wales in the 21st century, Cardiff: Welsh Assembly Government.Google Scholar
Welsh Assembly Government (WAG) (2006), Making the Connections: Delivering beyond Boundaries, Cardiff: Welsh Assembly Government.Google Scholar
Welsh Assembly Government (WAG) (2007), One Wales: A Progressive Agenda for the Government of Wales, Cardiff: Welsh Assembly Government.Google Scholar