The connection-friction axis in devolved health policy and law-making in the UK: A case study of organ donation

This article explores the dynamics of devolved health policy and law-making in the UK, drawing on a case study of opt-out organ donation reform. Given that health is a significant area of devolved competence, such case studies offer the opportunity to examine both similarities and differences in approach between the four nations in the context of the UK’s evolving constitutional settlement. We argue that there is a need to move away from the characterisation of the devolved health policy-making process as being grounded in a convergence-divergence approach towards one that recognises the connection-friction axis around which such process takes place. To explore this, we present findings from empirical research on opt-out organ donation law reform. This, we suggest, demonstrates that whilst connectedness between government stakeholders, experts and advocacy groups was clearly vital in structuring the policy process, account should also be taken of how law operates not only as a medium for the playing out of political and ideological friction, but also for the achievement of connection to overcome this.