"Liberalizing" the English National Health Service: background and risks to healthcare entitlement

Detalhes bibliográficos
Autor(a) principal: Jonathan Filippon
Data de Publicação: 2016
Outros Autores: Ligia Giovanella, Mariana Konder, Allyson M. Pollock
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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spelling "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
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dc.language.iso.fl_str_mv eng
por
language eng
por
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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
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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
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institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
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repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
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