Any preventive policy depends on a set of beliefs which will determine the point and method of intervention in a causative chain of events. In the case of heart disease, diet is seen as a causative factor. Prevention therefore demands a change in national diet. However, policy makers can view diet primarily as a matter of individual responsibility and preferences, or as a reflection of social structures. The individual approach emphasises health education. On the other hand, if dietary change is seen as related to structural factors such as income distribution, the division of resources within households and the power of the food industry, preventive policy must take different forms. The paper analyses food Systems in 61 inner city households in terms of gender, health beliefs, family preferences and status. The findings are compared with the results of large scale surveys. The conclusion is that health education needs to be more specifically directed at men but, more importantly, that a policy which ignores the structural features which limit individual capability for change will inevitably increase the health divide between rich and poor.

The theory of incrementalism is a long-standing and influential perspective on policy making and resource allocation in the public sector. Previous research on social services budgeting suggests that resources are allocated incrementally, although there has been some debate as to whether this would persist in an era of prolonged expenditure restraint. Incremental budgetary outcomes are operationalised as percentage changes in budgets pro-rata with percentage changes in the total budget, and as stable shares of total expenditure for each activity. Data for 99 English social service departments supports incrementalism in that budget shares change by only 1.8 per cent, but percentage allocations depart from pro-rata incrementalism by a mean of 74 per cent. The comparison of the two summary indices over time supports those who have argued that prolonged restraint would encourage non-incremental budgeting, but change in the agency's total budget does not consistently predict budgetary outcomes. The effect of restraint on incrementalism varies with the measure used and across the component activities of the measures, but there is enough evidence to suggest a significant decline in the level of incrementalism in social service departments. In particular, non-incremental budgeting is strongly associated with the growth of day centre expenditure on the mentally ill and the elderly before 1982–3, and after that with the pursuit of the ‘community care’ strategy within state provided services for the elderly and children. Incrementalism as a general theory of agency budgeting is limited in its ability to explain variations in the degree of incrementalism between agencies, between component budgets and over time. The conclusion suggests that further research should seek explanations for these variations in the varying balance of the competing forces which shape outcomes in welfare bureaucracies and in the relationship between these forces and the organisation's environment.

There has been growing concern over the consequences for public expenditure of an increasing number of elderly people dependent on a relatively diminishing working population. This concern stems largely from demographically determined dependency ratios and it is not necessarily the case that a change in the age profile of the population will lead to a greater burden of dependency. The ‘engine of dependency’ is shown to have at least two other cylinders—patterns of labour-force participation across age and gender, and levels of unemployment. Policy to date has had a surprisingly narrow focus in view of the dual role of economic and demographic forces in influencing the ratio of dependency. The economic and political feasibility of alternative policy options is discussed.

Within both publicly and privately financed health care Systems different funding mechanisms have evolved, or have been proposed, to deal with the problem of ‘moral hazard’. Moral hazard arises when financial incentives within the health care System lead to either inefficient demands for care by consumers or inefficient supply of care by providers. In this paper the problem of moral hazard is outlined in more detail, and different ways of countering moral hazard are reviewed in terms of three criteria: effect on patient utilisation of health services in general; effect on utilisation by different groups of patients; and effect on health status. It is concluded that evidence on different methods of funding health services can only be judged in the context of objectives. If the objectives of health care delivery are ‘maintenance or improvement of health’ and ‘equal access for equal need’ then charges and finance of care through health maintenance organisations both appear to be less favourable than ‘free’ care at the point of delivery whilst the latter is not necessarily more costly as a resuit. Research on other suggested alternatives is required, otherwise radical changes to health care financing in the UK will simply result in movement from one unproven system to another.

Two decades ago allegations of religious discrimination and the onset of ‘the troubles’ led the British Government to institute a programme of administrative and legislative reform in the province. These reforms culminated in the Fair Employment Act (1976). More recently, the Government began a review of the efficacy of the existing legislation and this has now resulted in a new Fair Employment Bill for Northern Ireland. The new Bill should be seen as a serious attempt to grapple with the chronic problem of religious discrimination in the province. The realisation of equality of opportunity in Northern Ireland, however, continues to be as much a test of political will as of the ability of those who frame ‘fair employment’ legislation.