Health in all policies
: A case study of the policy process in Northern Ireland

  • Anne-Marie Doherty

Student thesis: Doctoral ThesisDoctor of Philosophy


This thesis involves an investigation of the policy making process in Northern Ireland. The area to be investigated is ‘health’ policy and the specific focus is on HiAP or ‘Health in All Policies’. The main objective is to study the potential for and barriers against the introduction of HiAP into Northern Ireland (Nl). The thesis is built primarily around analysis of interview data and policy documents. The data were mainly obtained from interviews (N=34) conducted with various Officials, Members of the Nl Assembly, (including ex-Ministers and Ministers) and Special Advisers (SPADs) between 2010 and 2012. The relevant (policy) documents were those published between the appearance of Investing for Health (DHSSPS, 2002), and Making Life Better (DHSSPS, 2014). Using such sources the author traces the emergence of HiAP in discourse and practice during the key period of interest. The thesis is presented in seven chapters. Chapter 1 outlines the intellectual basis of HiAP and its key recommendations for public health. Chapter 2 offers details as to how the investigation was conducted and focuses on the concept of policy ethnography. Chapter 3 reviews literature on the policy process and highlights some key concepts that emerge from that literature. Chapter 4 is concerned with sources of influence on the policy making process in Nl. Chapter 5 uses interview data to examine the processes by means of which health policy emerges in the Nl Assembly. Chapter 6 offers a discussion of findings. It links interview and documentary evidence together and advances the concept of 'distributed policy making’, indicating how policy making is diffused over time, place, document and process. In the course of this thesis the author identifies different forces acting on different aspects of health policy (e.g. the media on short-term issues, the civil service on strategic issues and politicians shifting between horizons in accordance with contingent pressures). Policy making, in the context of the Nl Assembly, was found to be made in a context of disagreement and conflict. Nevertheless, despite discord and antagonism, policy gets made. In the concluding Chapter (7), the importance of what is called ‘karaoke’ policy making and the globalisation of health policy are emphasised. The thesis ends at the point at which HiAP (as an explicit concept) was finally integrated into Nl policy discourse.
Date of AwardJul 2019
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SponsorsNorthern Ireland Public Health Agency
SupervisorLindsay Prior (Supervisor) & Frank Kee (Supervisor)

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