What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).
For many citizens primary health care is the first point of contact with their health care system, where most of their health needs are satisfied but also acting as the gate to the rest of the system. In that respect primary care plays a crucial role in how patients value health systems as responsive to their needs and expectations. This volume analyses the way how primary are is organized and delivered across European countries, looking at governance, financing and workforce aspects and the breadth of the service profiles. It describes wide national variations in terms of accessibility, continuity and coordination. Relating these differences to health system outcomes the authors suggest some priority areas for reducing the gap between the ideal and current realities.
In the 1930s, the French Third Republic banned naturalized citizens from careers in law and medicine for up to ten years after they had obtained French nationality. In 1940, the Vichy regime permanently expelled all lawyers and doctors born of foreign fathers and imposed a 2 percent quota on Jews in both professions. On the basis of extensive archival research, Julie Fette shows in Exclusions that doctors and lawyers themselves, despite their claims to embody republican virtues, persuaded the French state to enact this exclusionary legislation. At the crossroads of knowledge and power, lawyers and doctors had long been dominant forces in French society: they ran hospitals and courts, doubled as university professors, held posts in parliament and government, and administered justice and public health for the nation. Their social and political influence was crucial in spreading xenophobic attitudes and rendering them more socially acceptable in France. Fette traces the origins of this professional protectionism to the late nineteenth century, when the democratization of higher education sparked efforts by doctors and lawyers to close ranks against women and the lower classes in addition to foreigners. The legislatively imposed delays on the right to practice law and medicine remained in force until the 1970s, and only in 1997 did French lawyers and doctors formally recognize their complicity in the anti-Semitic policies of the Vichy regime. Fette's book is a powerful contribution to the argument that French public opinion favored exclusionary measures in the last years of the Third Republic and during the Holocaust.
The eleven essays in this volume illustrate the richness, complexity, and diversity of French medical culture in the nineteenth century, a period that witnessed the medicalization of French society. Medical themes permeated contemporary culture and politics, and medical discourse infused many levels of French society from the bastions of science - the medical faculties and research institutions - to novels, the theater, and the daily lives of citizens as patients. The contributors to this volume - all established scholars in the history of medicine - present the French medical experience from the point of view of both practitioners and patients, and show how medical themes colored popular perceptions and shaped public policies. Topics addressed range from popular medicine to elite Parisian medicine, the interaction of literary and medical discourse, social theater, medical research and practice, medical specialization and education. The essays reflect current trends of medico-historical analysis which emphasize the centrality of class, race, and gender in understanding concepts of disease and the practice of medicine. They show how the medical experience of patients, practitioners, students, and researchers varied according to social class, gender, and geography and the importance of these factors for the construction of disease.
Gender is an exciting area of current research in the medical humanities, and by combining the study of medical narratives with theories of gender and sexuality, the essays in Gender Scripts in Medicine and Narrative illustrate the power of gender stereotypes to shape the way medicine is practiced and perceived. The chapters of Gender Scripts in Medicine and Narrative investigate gendered perceptions and representations of healers and patients in fiction, memoir, popular literature, poetry, film, television, the history of science, new media, and visual art. The fourteen chapters of Gender Scripts in Medicine and Narrative are organized into four cohesive sections. These chapters investigate the impact of gender stereotypes on medical narratives from a variety of points of view, considering narratives from diverse languages, time periods, genres, and media. Each section addresses some of the most pressing and provocative issues in theories of gender and the medical humanities: I. Gendering the Medical Gaze and Pathology; II. Monitoring Race through Reproduction; III. Rescripting Trauma and Healing; and IV. Medical Masculinities. Along with these sections, Gender Scripts Medicine and Narrative features a preface by Rita Charon, MD, PhD, Director and Founder, The Program in Narrative Medicine, Columbia University, a foreword by Marcelline Block, and an introduction by Angela Laflen. This collection takes a truly interdisciplinary look at the topic of gender and medicine, and the impressive group of contributors to the anthology represent a wide range of academic fields of inquiry, including medical humanities, bioethics, English, modern languages, women’s studies, film theory, postcolonial theory, art history, the history of science and medicine, new media studies, theories of trauma, among others. This approach of crossing boundaries of genre and discipline makes the volume accessible to scholars who are concerned with narrative, gender, and/or medical ethics. Click here for a recent review of this title.
This collection of essays looks at issues of health and citizenship in Europe across two centuries. Contributors examine the extent to which the state can interfere with the private lives of its citizens, the role of individual responsibility and if any boundary occurs in terms of what the state can realistically provide.
This wide-ranging and imaginative book examines the social and scientific role of the French Academy of Medicine from its creation in 1820 to the outbreak of the Second World War. It employs academic activities and sources to explore such major questions in the social and scientific history of medicine as the nature of therapeutic reasoning, the specificity of French medicine, and the consequences of hierarchial centralization for the medical profession.
Nineteenth-century France was a society of apparent paradoxes. It is famous for periodic and bloody revolutionary upheavals, for class conflict and for religious disputes, yet it was marked by relative demographic stability, gradual urbanisation and modest economic change, class conflict and ongoing religious and cultural tensions. Incorporating much recent research, Roger Magraw draws both upon still-valuable insights derived from the 'new social history' of the 1960s and upon more recent approaches suggested by gender history , cultural anthropology and the 'linguistic turn'.