This study identifies the different combinations of market, profession, management and civil society that England, Northern Ireland, Scotland, and Wales chose in their efforts to provide health services to all. It explains why these four health systems, despite facing similar pressures and opportunities, have developed dramatically different health policy trajectories.
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
Evidence indicates that actions within four main themes (early child development fair employment and decent work social protection and the living environment) are likely to have the greatest impact on the social determinants of health and health inequities. A systematic search and analysis of recommendations and policy guidelines from intergovernmental organizations and international bodies identified practical policy options for action on social determinants within these four themes. Policy options focused on early childhood education and care; child poverty; investment strategies for an inclusive economy; active labour market programmes; working conditions; social cash transfers; affordable housing; and planning and regulatory mechanisms to improve air quality and mitigate climate change. Applying combinations of these policy options alongside effective governance for health equity should enable WHO European Region Member States to reduce health inequities and synergize efforts to achieve the United Nations Sustainable Development Goals.
All advanced health care systems face severe difficulties in financing the delivery of today's sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables--the autonomy of the state and the strength and cohesiveness of organized medicine--explain this variance. In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult. Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession's clinical autonomy and physicians' incomes.
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).
Despite the recent proliferation of literature on nationalism and on social policy, relatively little has been written to analyse the possible interaction between the two. Scholars interested in social citizenship have indirectly dealt with the interaction between national identity and social programs such as the British NHS, but they have seldom examined this connection in reference to nationalism. Specialists of nationalism rarely mention social policy, focusing instead on language, culture, ethnicity, and religion. The main objective of this book is to explore the nature of the connection between nationalism and social policy from a comparative and historical perspective. At the theoretical level, this analysis will shed new light on a more general issue: the relationships between identity formation, territorial politics, and social policy. Although this book refers to the experience of many different countries, the main cases are three multinational states, that is, states featuring strong nationalist movements: Canada (Québec), the United Kingdom (Scotland), and Belgium (Flanders). The book looks at the interplay between nationalism and social policy at both the state and sub-state levels through a detailed comparison between these three cases. In its concluding chapter, the book brings in cases of mono-national states (i.e. France, Germany, Sweden, and the United States) to provide broader comparative insight on the meshing of nationalism and social policy. The original theoretical framework for this research is built using insight from selected scholarship on nationalism and on the welfare state.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
How physician executives and managers can become outstanding leaders in times of rapid change Written by authors who have more than sixty years of combined experience in healthcare, physician, and organizational leadership, this groundbreaking book is an innovative blueprint for overcoming the complex changes and challenges faced by leaders in today's healthcare environment. Rather than being a theoretic work, The Manual of Healthcare Leadership is intended to be a relevant, practical, and real-world guide that addresses the myriad organizational, regulatory, budgetary, legal, staffing, educational, political, and social issues facing leaders in the healthcare industry. One of the primary goals of this book is to enable readers to maximize the performance of each staff member in the interest of collectively providing peerless healthcare to their service community. The strategies offered throughout the text include the "why, what, and how" necessary to solve specific problems and challenges encountered by healthcare managers and leaders. Instruction is provided not only with text, but with diagrams and other resources specifically designed to demonstrate sequential thinking and the progressive application of solutions. With this book in hand, healthcare leaders will be able to confidently select, train, guide, and assess their staff. They will also be able to negotiate, plan, resolve problems, manage change and crisis, and handle the thousand and one other challenges that come their way on a daily basis.
Scotland and Catalonia, both ancient nations with strong nationalisms within larger states, are exemplars of the management of ethnic conflict in multinational democracies and of global trends toward regional government. Focusing on these two countries, Scott L. Greer explores why nationalist mobilization arose when it did and why it stopped at autonomy rather than statehood. He challenges the notion that national identity or institutional design explains their relative success as stable multinational democracies and argues that the key is their strong regional societies and their regional organizations' preferences for autonomy and environmental stability
Civil Society Organizations (CSOs) can make a vital contribution to public health and health systems but harnessing their potential is complex in a Europe where government-CSO relations vary so profoundly. This study is intended to outline some of the challenges and assist policy-makers in furthering their understanding of the part CSOs can play in tandem and alongside government. To this end it analyses existing evidence and draws on a set of seven thematic chapters and six mini case studies. They examine experiences from Austria Bosnia-Herzegovina Belgium Cyprus Finland Germany Malta the Netherlands Poland the Russian Federation Slovenia Turkey and the European Union and make use of a single assessment framework to understand the diverse contexts in which CSOs operate. The evidence shows that CSOs are ubiquitous varied and beneficial and the topics covered in this study reflect such diversity of aims and means: anti-tobacco advocacy food banks refugee health HIV/AIDS prevention and cure and social partnership. CSOs make a substantial contribution to public health and health systems with regards to policy development service delivery and governance. This includes evidence provision advocacy mobilization consensus building provision of medical services and of services related to the social determinants of health standard setting self-regulation and fostering social partnership. However in order to engage successfully with CSOs governments do need to make use of adequate tools and create contexts conducive to collaboration. To guide policy-makers working with CSOs through such complications and help avoid some potential pitfalls the book outlines a practical framework for such collaboration. This suggests identifying key CSOs in a given area; clarifying why there should be engagement with civil society; being realistic as to what CSOs can or will achieve; and an understanding of how CSOs can be helped to deliver.
