Greece

2021 ◽  
pp. 353-374
Author(s):  
Ilias Kyriopoulos ◽  
Elias Mossialos

This chapter offers an in-depth look at health politics and the health system in Greece. It traces the development of the Greek healthcare system, characterized by an historical inability to implement significant reform, despite ambitious ideas. The chapter outlines the politics behind several reform attempts, among them the creation in the 1980s of the national health service, key elements of which were never implemented, and more recent efforts to establish a single purchaser of health services and a primary care network, both of which became law but were slow to take off. The chapter argues that the difficulty in undertaking reform can be explained by two elements that have historically influenced the policymaking process in Greece: electoral competition and the power of interest groups.

2021 ◽  
pp. 275-306
Author(s):  
Maria Asensio

This chapter provides an extended look at health politics and the health system in Portugal, characterized by overlapping tiers of coverage including a national health service. The chapter traces the historical development of the Portuguese healthcare system through a series of regime changes, particularly the transition from conservative dictatorship to democracy beginning in 1974. Since the 1979 foundation of the National Health Service, the main issues facing the health system have been the relationship between public and private provision of services and the system’s fiscal solvency. A 1989 constitutional revision, which redefined healthcare from being a constitutional right to universal free healthcare to one which “tended towards” no cost at the time of treatment and was based on individuals’ particular social and economic situation, shifted the system away from universalism, removed obstacles to privatization, and allowed the introduction of other forms of market mechanisms. As the chapter argues, though left and right political parties have differed in their approaches, actors in health politics seem to have largely agreed to move in the direction of a public–private mix of service providers.


2010 ◽  
Vol 34 (4) ◽  
pp. 140-142 ◽  
Author(s):  
Simon Wilson ◽  
Katrina Chiu ◽  
Janet Parrott ◽  
Andrew Forrester

Aims and methodTo consider the link between responsible commissioner and delayed prison transfers. All hospital transfers from one London prison in 2006 were audited and reviewed by the prisoner's borough of origin.ResultsOverall, 80 prisoners were transferred from the audited prison to a National Health Service (NHS) facility in 2006: 26% had to wait for more than 1 month for assessment by the receiving hospital unit and 24% had to wait longer than 3 months to be transferred. These 80 individuals were the responsibility of 16 different primary care trusts. Of the delayed transfer cases (n=19), the services commissioned by three primary care trusts were responsible for the delays.Clinical implicationsThere are significant differences in performance between different primary care trusts related to hospital transfers of prisoners, with most hospitals able to admit urgent cases within 3 months. This suggests that a postcode lottery operates for prisoners requiring hospital transfer. Data from prison services may be useful in monitoring and improving the performance of local NHS services.


2000 ◽  
Vol 6 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Chris Simpson

The current National Health Service (NHS) approach to commissioning health services is in flux. The purchasing of care from providers by general practitioner fundholders (GPFHs) and health authorities has changed with the new White Papers. GPFHs no longer exist and the commissioning role is being handed over from health authorities to primary care groups (PCGs). An understanding of the reasons for change and current arrangements will aid the consultant psychiatrist in influencing this process.


2018 ◽  
Author(s):  
Matthew Willis ◽  
Paul Duckworth ◽  
Angela Coulter ◽  
Eric T Meyer ◽  
Michael Osborne

BACKGROUND Recent advances in technology have reopened an old debate on which sectors will be most affected by automation. This debate is ill served by the current lack of detailed data on the exact capabilities of new machines and how they are influencing work. Although recent debates about the future of jobs have focused on whether they are at risk of automation, our research focuses on a more fine-grained and transparent method to model task automation and specifically focus on the domain of primary health care. OBJECTIVE This protocol describes a new wave of intelligent automation, focusing on the specific pressures faced by primary care within the National Health Service (NHS) in England. These pressures include staff shortages, increased service demand, and reduced budgets. A critical part of the problem we propose to address is a formal framework for measuring automation, which is lacking in the literature. The health care domain offers a further challenge in measuring automation because of a general lack of detailed, health care–specific occupation and task observational data to provide good insights on this misunderstood topic. METHODS This project utilizes a multimethod research design comprising two phases: a qualitative observational phase and a quantitative data analysis phase; each phase addresses one of the two project aims. Our first aim is to address the lack of task data by collecting high-quality, detailed task-specific data from UK primary health care practices. This phase employs ethnography, observation, interviews, document collection, and focus groups. The second aim is to propose a formal machine learning approach for probabilistic inference of task- and occupation-level automation to gain valuable insights. Sensitivity analysis is then used to present the occupational attributes that increase/decrease automatability most, which is vital for establishing effective training and staffing policy. RESULTS Our detailed fieldwork includes observing and documenting 16 unique occupations and performing over 130 tasks across six primary care centers. Preliminary results on the current state of automation and the potential for further automation in primary care are discussed. Our initial findings are that tasks are often shared amongst staff and can include convoluted workflows that often vary between practices. The single most used technology in primary health care is the desktop computer. In addition, we have conducted a large-scale survey of over 156 machine learning and robotics experts to assess what tasks are susceptible to automation, given the state-of-the-art technology available today. Further results and detailed analysis will be published toward the end of the project in early 2019. CONCLUSIONS We believe our analysis will identify many tasks currently performed manually within primary care that can be automated using currently available technology. Given the proper implementation of such automating technologies, we expect considerable staff resources to be saved, alleviating some pressures on the NHS primary care staff. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11232


2018 ◽  
Vol 14 (1) ◽  
pp. 11-14
Author(s):  
David J. Hunter

AbstractAmidst the NHS’s (National Health Service) success lies its major weakness, although one that Klein overlooks in his reflections on the NHS as it approaches 70. The focus on, and investment in, curing ill-health has been at the expense of attending to the public’s overall health and well-being. This preoccupation poses a greater threat to the NHS’s future than privatisation. Despite the weakness having been diagnosed decades ago, redressing the imbalance has proved stubbornly hard to achieve. Rhetoric has not been translated into reality. Yet, we may be on the cusp of a tipping point where in order to ensure a sustainable NHS, and one that is capable of meeting the 21st century challenges facing it, there is a renewed and overdue interest in promoting health and well-being in communities. But for this to succeed, the NHS will need to embrace its bete noire, local government.


The benefits of a fully-digitalised public healthcare system are significant. Digital health is an essential tool in order to improve efficiency, provide coordinated care, and make real health improvements. However, the National Health Service (NHS) has yet to provide a fully digitalised system to patients and providers despite technological advances in recent years. This chapter will thus describe the progress which has already been made in providing remote health services within the NHS. It will also explore problems arising from digitalising health services and the management of health both within the institution and through more informal networks beyond the NHS.


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