"Liberalizing" the English National Health Service: background and risks to healthcare entitlement
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Data de Publicação: | 2016 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng por |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160 |
Resumo: | The recent reform of the English National Health Service (NHS) through the Health and Social Care Act of 2012 introduced important changes in the organization, management, and provision of public health services in England. This study aims to analyze the NHS reforms in the historical context of predominance of neoliberal theories since 1980 and to discuss the "liberalization" of the NHS. The study identifies and analyzes three phases: (i) gradual ideological and theoretical substitution (1979-1990) - transition from professional and health logic to management and commercial logic; (ii) bureaucracy and incipient market (1991-2004) - structuring of the bureaucracy focused on administration of the internal market and expansion of pro-market measures; and (iii) opening to the market, fragmentation, and discontinuity of services (2005-2012) - weakening of the territorial health model and consolidation of health as an open market for public and private providers. This gradual but constant liberalization has closed services and restricted access, jeopardizing the system's comprehensiveness, equity, and universal healthcare entitlement in the NHS. |
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"Liberalizing" the English National Health Service: background and risks to healthcare entitlementA "liberalização" do Serviço Nacional de Saúde da Inglaterra: trajetória e riscos para o direito à saúdeHealth SystemsHealth ServicesHealth PolicyHealth Programs and PlansSistemas de SaúdeServiços de SaúdePolítica de SaúdePlanos e Programas de SaúdeThe recent reform of the English National Health Service (NHS) through the Health and Social Care Act of 2012 introduced important changes in the organization, management, and provision of public health services in England. This study aims to analyze the NHS reforms in the historical context of predominance of neoliberal theories since 1980 and to discuss the "liberalization" of the NHS. The study identifies and analyzes three phases: (i) gradual ideological and theoretical substitution (1979-1990) - transition from professional and health logic to management and commercial logic; (ii) bureaucracy and incipient market (1991-2004) - structuring of the bureaucracy focused on administration of the internal market and expansion of pro-market measures; and (iii) opening to the market, fragmentation, and discontinuity of services (2005-2012) - weakening of the territorial health model and consolidation of health as an open market for public and private providers. This gradual but constant liberalization has closed services and restricted access, jeopardizing the system's comprehensiveness, equity, and universal healthcare entitlement in the NHS.La reciente reforma del Servicio Nacional de Salud (NHS) inglés a través de la Health and Social Care Act de 2012 introdujo cambios importantes en la organización, gestión y prestación de los servicios de salud pública en Inglaterra. El objetivo de este estudio es analizar las reformas del NHS en el contexto histórico del predominio de las teorías neoliberales desde 1980 y discutir el proceso de "liberalización" del NHS. Fueron identificados y se analizaron tres momentos: (i) sustitución gradual ideológica y teórica (1979-1990) -transición de la lógica profesional y de salud para una lógica de gestión/negocio; (ii) la burocracia y el mercado incipiente (1991-2004) -estructuración de la burocracia dedicada a la gestión del mercado interior y la expansión de las medidas pro-mercado; y (iii) la apertura del mercado, la fragmentación y la discontinuidad de los servicios (2005-2012) -fragilización del modelo de salud territorial y consolidación de la salud como un mercado abierto para los proveedores públicos y privados. Este proceso gradual y constante de la liberalización ha provocado el cierre de los servicios y la restricción del acceso, comprometiendo la integridad, justicia y derecho universal a la salud en el NHS.A recente reforma do Serviço Nacional de Saúde (NHS) inglês por meio do Health and Social Care Act de 2012 introduziu mudanças importantes na organização, gestão e prestação de serviços públicos de saúde na Inglaterra. O objetivo deste estudo é analisar as reformas do NHS no contexto histórico de predomínio de teorias neoliberais desde 1980 e discutir o processo de "liberalização" do NHS. São identificados e analisados três momentos: (i) gradativa substituição ideológica e teórica (1979-1990) - transição da lógica profissional e sanitária para uma lógica gerencial/comercial; (ii) burocracia e mercado incipiente (1991-2004) - estruturação de burocracia voltada à administração do mercado interno e expansão de medidas pró-mercado; e (iii) abertura ao mercado, fragmentação e descontinuidade de serviços (2005-2012) - fragilização do modelo de saúde territorial e consolidação da saúde como um mercado aberto a prestadores públicos e privados. Esse processo gradual e constante de liberalização vem levando ao fechamento de serviços e à restrição do acesso, comprometendo a integralidade, a equidade e o direito universal à saúde no NHS.Reports in Public HealthCadernos de Saúde Pública2016-08-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160Reports in Public Health; Vol. 32 No. 8 (2016): AugustCadernos de Saúde Pública; v. 32 n. 8 (2016): Agosto1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160/13016https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160/13017https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160/13018https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160/13019Jonathan FilipponLigia GiovanellaMariana KonderAllyson M. Pollockinfo:eu-repo/semantics/openAccess2024-03-06T15:29:09Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/6160Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:07:02.202970Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
"Liberalizing" the English National Health Service: background and risks to healthcare entitlement A "liberalização" do Serviço Nacional de Saúde da Inglaterra: trajetória e riscos para o direito à saúde |
title |
"Liberalizing" the English National Health Service: background and risks to healthcare entitlement |
spellingShingle |
"Liberalizing" the English National Health Service: background and risks to healthcare entitlement Jonathan Filippon Health Systems Health Services Health Policy Health Programs and Plans Sistemas de Saúde Serviços de Saúde Política de Saúde Planos e Programas de Saúde |
title_short |
"Liberalizing" the English National Health Service: background and risks to healthcare entitlement |
title_full |
"Liberalizing" the English National Health Service: background and risks to healthcare entitlement |
title_fullStr |
"Liberalizing" the English National Health Service: background and risks to healthcare entitlement |
title_full_unstemmed |
"Liberalizing" the English National Health Service: background and risks to healthcare entitlement |
title_sort |
"Liberalizing" the English National Health Service: background and risks to healthcare entitlement |
author |
Jonathan Filippon |
author_facet |
Jonathan Filippon Ligia Giovanella Mariana Konder Allyson M. Pollock |
author_role |
author |
author2 |
Ligia Giovanella Mariana Konder Allyson M. Pollock |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Jonathan Filippon Ligia Giovanella Mariana Konder Allyson M. Pollock |
dc.subject.por.fl_str_mv |
Health Systems Health Services Health Policy Health Programs and Plans Sistemas de Saúde Serviços de Saúde Política de Saúde Planos e Programas de Saúde |
topic |
Health Systems Health Services Health Policy Health Programs and Plans Sistemas de Saúde Serviços de Saúde Política de Saúde Planos e Programas de Saúde |
description |
The recent reform of the English National Health Service (NHS) through the Health and Social Care Act of 2012 introduced important changes in the organization, management, and provision of public health services in England. This study aims to analyze the NHS reforms in the historical context of predominance of neoliberal theories since 1980 and to discuss the "liberalization" of the NHS. The study identifies and analyzes three phases: (i) gradual ideological and theoretical substitution (1979-1990) - transition from professional and health logic to management and commercial logic; (ii) bureaucracy and incipient market (1991-2004) - structuring of the bureaucracy focused on administration of the internal market and expansion of pro-market measures; and (iii) opening to the market, fragmentation, and discontinuity of services (2005-2012) - weakening of the territorial health model and consolidation of health as an open market for public and private providers. This gradual but constant liberalization has closed services and restricted access, jeopardizing the system's comprehensiveness, equity, and universal healthcare entitlement in the NHS. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-08-29 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160 |
dc.language.iso.fl_str_mv |
eng por |
language |
eng por |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160/13016 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160/13017 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160/13018 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/6160/13019 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html text/html application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 32 No. 8 (2016): August Cadernos de Saúde Pública; v. 32 n. 8 (2016): Agosto 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943381791965184 |