本文嘗試從較為宏觀的角度，探討英國地方治理發展中社會建構的過程與困境。從地方治理理論的反思出發，以健康醫療政策作為代表性個案，並綜合整理英國推展地方治理經驗的困境與爭議問題。英國地方治理所展現出的挑戰是非常複雜的，新工黨政府致力於地方治理，但卻未能洞燭其複雜性。近年來，英國地方政府進行許多重大的變革，如區級政府的出現，並予以適當的授權。此外，地方政府與區級準政府組織也作了適當的調整，大量夥伴協力組織相繼成立，從最初欠缺管理多層次治理的思維，逐漸由中央集權途徑下的協力型治理所取代，但在此過程中，卻導致大量資源消耗在重建夥伴協力關係，而非著力於整體夥伴協力的方針與目的上。

This article discusses the social construction and developmental difficulties of local governance in Great Britain from a macro point of view. The article starts with a reflection on local governance and takes health policy as the typical case; furthermore, it generalizes the prob-lems of promoting local governance in Britain. The challenges of local governance in Britain are complicated. The New Labour government devotes much effort to local governance, but unfortunately fails to grasp the complexity of the issue. Local British governments have re-cently dealt with several important revolutions. For example, district governments have been established and empowered adequately. From a severe lack of thought on multi-level governance, it is gradually re-placed by collaborative governance under central authority; moreover, local governments and the local QUANGOs have been adjusted prop-erly, and a great number of cooperative organizations have been set up, one after another. However, many resources have been invested in rebuilding partnership relations but failing to focus on the purpose of integral partnership relations.