6. 6.1 What happened locally? Hospitals INTRODUCTION In the previous chapter we experienced a first encounter with some of the (many) broad quantitative indicators of policy inputs, processes, outputs and outcomes. In doing so we were obliged to face up to the complexities and ambiguities of linkages between what policymakers say, what they do, and what eventually happens, ‘out there’, ‘in the field’. In this chapter (and the next) we move closer to that ‘field’. We look at what happens when national polices ‘hit the ground’ locally. Are they enthusiastically embraced, reluctantly accepted and implemented, creatively interpreted, astutely deflected, diluted, delayed, resisted or even ignored? And how far do national policies dominate the local agenda anyway? Are there also significant locally generated polices, particular to the place (as one would expect in a genuinely multilevel system)? How do local and national agendas interact? To create this local perspective, we conducted research in two cities: Brighton and Hove (southern England) and Leuven (just east of Brussels, in the Vlaams Brabant – Flemish Brabant – region). As we said in Chapter 1, we chose these as two reasonably prosperous, reasonably cosmopolitan, middle-sized cities which were not burdened with any major handicaps such as the collapse of local industries, geographical remoteness or high levels of ethnic tension and division. (For details of the research, see Appendix). Brighton was, with neighbouring Hove, jointly designated a ‘city’ (rather than just a town) in 2000. Together they have a population of roughly 250 000. On the south coast,...
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