UK Health action zones: political accountability and political marketing - perspectives from the South West

This article evaluates the accountability of the strategic layer of Plymouth Health Action Zone (HAZ) and identifies conclusions with a wider application to partnership governance. The structures of Plymouth HAZ are assessed in the context of horizontal, vertical and downward models of accountability. The study finds fundamental weaknesses in the accountability regime. Vertical mechanisms are superficial and often inappropriate. The impact of horizontal accountability is marginalised through factors such as informal networks of dependency and a culture that discourages rigorous scrutiny. Downward accountability is addressed through the dissemination of information about achievements. In particular, the study highlights the difficulties of relying on local partners as the main mechanism of accountability. Plymouth HAZ is also evaluated in relation to political marketing and found to possess a sales-orientation