Health Action Zones: the ‘third way’ of a new area-based policy?

Abstract

The notion of the action zone has emerged as a key feature of New Labour's approach to social policy. There is some debate about whether Labour's area-based policies reflect the Old Left, the New Right or the "third way". This paper critically examines these issues for Health Action Zones (HAZs). First, it outlines the development of HAZs and their main features. It then examines the themes that may have underpinned the HAZ strategy. Finally it examines critiques of HAZs in the light of wider debates about area-based strategies. It is concluded that HAZs fit well with some of New Labour's key themes, and may have some characteristics of a third way in that they incorporate features of both the "Old Left" of the Black Report and the New Right of competitive, bidding exercises. Moreover, they have addressed some of the main criticisms of earlier area-based policies, arguably being based on place rather than people poverty. However, some of the issues regarding their designation illustrate unresolved problems.

The manager's role in mobilizing and nurturing development: entrenched and engaged approaches to change

“…It is obvious that the principles of single or adaptive and double loop or generative learning are both applied to the health care context and current agendas. Powell and Moon (2001) and Maddock (2002) have identified that demands to satisfy some stakeholders, particularly those with a financial remit, with early wins and good publicity, can distract from really challenging ways of working. This could be seen as an example of agenda dissonance inhibiting organizational learning.…”

A service users’ research advisory group from the perspectives of both service users and researchers

“…In the initial proposal for the project, provision was made for a single user representative from outside the area to sit on the project steering group, which comprised around 20 members and was scheduled to meet twice a year. However, it was agreed that this was not sufficient for the needs of the project and that a more participative approach would conform more closely with the spirit of the HAZ, a fundamental aim of which is to foster greater community engagement (HAZnet 2000, Powell & Moon 2001). In addition, it was feared that a single service user might be intimidated by both the venue (the board room at the hospital trust headquarters), and by the array of professionals, including three consultants and three professors.…”

Health Action Zones and the problem of community

“…Health Action Zones (HAZs) have been identified as policy initiatives reflecting the ‘third way’ espoused by the UK New Labour Government (Powell & Moon 2001). Like other area‐based initiatives or zones, HAZs are programmes designed to tackle inequalities and exclusion in areas of high deprivation.…”

“…This is in recognition that the deprivation and inequalities experienced by specific geographical areas and populations are the result of complex processes of social and economic decline with multiple consequences for the groups concerned. In response, HAZs embrace New Labour's commitment to joined‐up policy, and a discourse of collaboration and partnerships (Powell & Moon 2001), and include innovative coalitions between the public and private sectors, as well as local communities.…”