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This chapter addresses inequalities in the United Kingdom through the lens of health inequalities. Driven by inequalities in income and power, health inequalities represent a microcosm of wider debates on inequalities. They also play a role as the more politically unacceptable face of inequalities – where other types of inequality are more blatantly argued as collateral damage of advanced neoliberalism including ‘inevitable’ austerity measures, politicians are more squeamish about discussing health inequalities in these terms.

The chapter starts by depicting health inequalities in Scotland and summarises health policy analyses of the causes of, and solutions to, health inequalities. It then describes the concept of ‘proportionate’ universalism’ and sets this within the context of debates around universal versus targeted welfare provision in times of fiscal austerity.

It then turns to a small empirical case-study which investigates these tensions within the Scottish National Health Service. The study asks those operating at policy and practice levels: how is proportionate universalism understood; and, is it a threat or ballast to universal welfare provision?

Findings are discussed within the political context of welfare retrenchment, and in terms of meso- and micro-practices. We conclude that there are three levels at which proportionate universalism needs to be critiqued as a means of mitigating the impacts of inequalities in the social determinants of health. These are within the political arenas, at a policy and planning level and at the practice level where individual practitioners are enabled or not to practice in ways that might mitigate existing inequalities.

The purpose of this paper was to test and explore alignment theory as a guiding principle for human resource development (HRD) by performing an empirical study. HRD scholars, professionals and others have adopted or assumed alignment theory to help explain HRD effectiveness.

Constructs to measure an organisation’s strategic priorities and its HRD practices. A measure of HRD effectiveness was developed. A survey gathered data from 270 employees, managers and HRD staff in a sample of 76 organisations.

The results show that HRD effectiveness does not vary with alignment as predicted. Forms of partial alignment, or the relations of an “odd couple”, are more strongly associated with HRD effectiveness than high alignment.

The use and integration of both normative measures (Likert scale) and ipsative measures (ranking) is necessary to capture alignment, but this limits the inferential statistics available to test validity and reliability. Qualitative data on case studies would be useful to explore alignment issues in context and depth.

Stakeholders in organisations can use the “odd couple” interpretation of alignment as a fresh way to review and explore the opportunities and challenges of managing HRD effectiveness in an era where a narrowing and retrenchment of provisions is occurring and increasing.

This study provides evidence which raises questions about alignment theory and policies intended to increase alignment. It suggests in the case of HRD, an alternative perspective that validates partial alignment can support effective HRD provisions.

Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).