As indicated in the earlier chapters, the work of the OECD varies over time, reflecting the interests and priorities of its members plus, at least to some extent, the interests and priorities of its Secretariat. In the 1960s, for example, there was very little work undertaken in relation to the environment and innovation, and only a modest extent on tax, yet by the first decade of the twenty-first century all of these areas had a high profile. Work on the environment had expanded to such an extent that it warranted a directorate of its own; that on innovation had spread to almost all directorates, and that on tax warranted a separate Centre for Tax Policy and Administration. The primary focus of this chapter is to examine more closely the factors associated with changes over time in the extent and type of OECD work on health. Health was selected as the primary focus for a number of reasons. One, when the OECD was established, it was undertaking very little work in this area. Hence, tracing the growth of health-related work over the next 50 years offered the opportunity of a detailed case study of organisational change and the factors stimulating change, enriching our understanding of the still little understood process of change within international organisations (Helfer, 2006). A second reason was that at the national level health is a politically sensitive issue in all OECD countries, one that excites strong feelings and almost constant, often divisive debate when reforms to national...
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