A view from abroad: a New Zealand perspective on the English NHS health reforms

Author(s):  
Robin Gauld

The English NHS is of significance among health policy observers around the globe for various reasons. The NHS is particularly noteworthy for the fact that, for many, it represents the high-income world’s best attempt to have built and maintained a ‘national’ health system with a focus on universal access to care that is free at point of service. The NHS has been in transition for several years. Many commentators have highlighted the role and influence of US market ideals in this transition, with various UK governments clearly pushing this agenda. However, is often useful to look to countries more closely comparable to England, such as New Zealand, for comparison with a view to improvement. This chapter takes such an approach in looking at the NHS from abroad. It draws upon the case of NZ which, in many ways, is very similar to England when it comes to health policy and the healthcare system. In doing so, it aims to provide a critique of the NHS reforms and demonstrate that there are alternatives to the policies and structures being pursued for the English NHS by the Coalition government.

2019 ◽  
Vol 40 (3) ◽  
pp. 370-388
Author(s):  
Dimitra Giannou ◽  
Vasilios Ioakimidis

This article presents findings from a research study aiming at exploring in-depth experiences of lesbian, gay, bisexual and transgender (LGBT) individuals and communities in the Greek healthcare system. This was the first study of its kind in Greece. Data collected from interviews with LGBT groups and individuals, as well as doctors, suggest that homophobia and transphobia are profound factors of systematic exclusion and restriction from access to good quality healthcare. Our findings suggest that within the healthcare context, LGBT people are routinely invisibilised and/or pathologised. The authors emphasise the urgent need for challenging chronic and institutionalised invisibility experienced by LGBT people as a necessary precondition of social equality and genuine universalism within the Greek Health System.


2021 ◽  
pp. 232020682110301
Author(s):  
Colleen Watson ◽  
Laura Rhein ◽  
Stephanie M. Fanelli

Aim: To compare following the Cuban Revolution, Cuba’s economy and civil society was transformed by the initiation of a program of nationalization and political consolidation. The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the healthcare of its citizens. Other industrialized nations continue to surpass the US in health-related outcomes indicating areas of improvement in its healthcare system. Assessing the successes and failures as well as the advantages and disadvantages of other countries’ healthcare systems may be instrumental in the development of modifications to the organization and delivery system of healthcare in the US. This paper aims to report the information attained from previous literature as well as from first-hand observations from a public health trip to Cuba in order to compare the healthcare systems in Cuba and the United States. Materials and Methods: A group of New York University College of Dentistry faculty and students traveled to Cuba in April 2019 for professional research and professional meetings (CFR 515.564). While in Cuba, the researchers took written notes of the lecture-based material and conversations. Upon return to the United States, published literature was searched for the collection of any additional data and all qualitative data and quantitative data was compiled and organized. Since 1959, Cuba has made continuous adjustments and improvements to its universal, free and accessible healthcare system. Results: There have been notable improvements to the country’s public health status, such as the implementation of an immunization program and subsequent eradication of communicable diseases, such as polio and rubella. Additionally, the implementation of the National Program on Dentistry guarantees dental care to all Cuban children under the age of 19. Today, the Cuban National Health System (NHS) initiatives have evolved to combat the novel coronavirus (COVID-19) pandemic. Conclusion: Recognizing the advantages as well as the disadvantages of the Cuba’s National Health System (NHS) would be useful for future policymakers in the United States. Cuban approaches to health could be tailored to the United States environment to improve healthcare effectiveness and population health status in the future.


Author(s):  
Paolo Bonaretti

The recent availability of innovative, costly cancer drugs has prompted the search for a sustainable health economics model that would allow universal access to treatment coupled with long-term viability of the national health system. The huge R&D investment and the relatively short life of drugs, which must face not only the market entry of competitor products but also a growing trend to limit the type and number of patients in whom their use is allowed, are the main factors underlying the high unit cost of innovative drugs; this ultimately has a major impact on overall drug expenditure, especially for in-hospital treatment. To facilitate the inclusion of innovative drugs and maximize their beneficial effect on patients, we need to increase the efficiency of the national health system overall, and be able to measure the costs that can be avoided through a coherent HTA system apt to leverage synergies at a regional level, thereby freeing wasted resources that can be better invested in this area. Secondly, the continuous monitoring of an innovative drug throughout its life cycle, based on the correct comparative evaluation of its efficacy for each therapeutic indication, can lead to a more refined definition of drug prices. Furthermore, cost containment must in all instances include appropriate negotiation of the unit price based on the overall volume acquired. Last but not least, a significant R&D investment in clinical research is a fundamental step that can leverage synergies between public funds and contributions from pharma companies, allowing to overcome systems based on ceilings and/or payback models that, in the current scenario, appear undoubtedly outdated.


2021 ◽  
pp. 375-394
Author(s):  
Mamas Theodorou ◽  
Kostas Athanasakis

This chapter offers an in-depth look at health politics and the health system in Cyprus. It traces the development of Cyprus’s healthcare system, which underwent only minor incremental change from its founding in 1957 until 2019, despite numerous studies and proposals. Though calls for universal coverage and free-at-the-point-of-service care had become louder in the early 1990s, it took until 2001 for Parliament to establish the legal foundation for a new national health system. Still, full implementation was repeatedly postponed for many reasons, from concerns about the new system’s cost to resistance from important stakeholders, especially those that benefitted from the shortcomings of the earlier system. As the chapter explains, economic crisis ultimately created the momentum for reform, resulting in the actual full launch of the new system in 2019 and 2020.


2009 ◽  
Vol 3 (2) ◽  
pp. 346
Author(s):  
Erica Toledo Mendonça ◽  
Wellington Mendonça Amorim

ABSTRACT Objective: to describe the circumstances in which was gave the proposal for recasting and operationalization of the National Health Policy, in the period from 1973 to 1979. Methodology: historical and social study, based on documentary analysis. Results: in reviewing the circumstances in which was gave the proposal for recasting and operationalization of the National Health Policy in the 1970s, we found that it was striking inequality that existed in the level of health of people, caused by factors constraints of the most varied and characterized so peculiar to each company, led the government, the international organizations and world community had the primary targets in its policies. It was in that moment that the federal government, through Law No. 6229/1975, organized the National Health System. So, in the 1970s, it was started the discussions about the politics of the extension of coverage, which centered in the primary care basic point of departure that can be achieved better care coverage to people, to try to reach adequate levels of health. Conclusion: as actors participants of the constitution of the new health system, called "network", the nurses, in order to understand the social reality and to articulate in socioeconomic structure, they needed to pass through a process with significant changes in their academic training, and consequently, in the care. Descriptors: nursing; public health; health policies.RESUMOObjetivo: descrever as circunstâncias em que se deu a proposta de reformulação e operacionalização da Política Nacional de Saúde, no período de 1973 a 1979. Metodologia: estudo histórico-social, embasado na análise documental. Resultados: ao analisarmos as circunstâncias em que se deu a proposta de reformulação e operacionalização da Política Nacional de Saúde, na década de 1970, encontramos que, era marcante a desigualdade que existia no nível de saúde dos povos, provocada por fatores condicionantes dos mais variados e caracterizada de modo peculiar em cada sociedade, o que fez com que o governo, as organizações internacionais e a comunidade mundial tivessem como preocupação primordial metas em suas políticas de saúde. Foi nesse momento que o governo federal, por meio da Lei nº 6229/1975, estruturou o Sistema Nacional de Saúde. A partir daí, nos anos de 1970, começaram as discussões acerca das políticas de extensão de cobertura, que centravam, na assistência primária o ponto básico de partida para que fosse alcançada melhor assistência de cobertura às populações, a fim de que atingisse níveis adequados de saúde. Conclusão: como atores participantes da constituição do novo sistema de saúde, denominado “rede”, as enfermeiras, no intuito de apreender a realidade social e se articular na estrutura socioeconômica, necessitavam passar por um processo de mudanças significativas em sua formação acadêmica, e conseqüentemente, assistencial. Descritores: enfermagem; saúde pública; políticas de saúde.RESUMENObjetivo: describir las circunstancias en que se dio a la propuesta de la refundición y la puesta en marcha de la Política Nacional de Salud, en el período comprendido entre 1973 a 1979. Metodologia: estudio histórico y social sobre la base de análisis documental. Resultados: al examinar las circunstancias en que se dio a la propuesta de la refundición y la puesta en marcha de la Política Nacional de Salud en el decenio de 1970, encontramos que era notable la desigualdad que existía en el nivel de salud de las personas, causados por factores de las limitaciones de las más variadas y caracterizado por lo peculiar de cada una de las empresas, llevó al gobierno, las organizaciones internacionales y la comunidad mundial son los principales objetivos en sus políticas. Fue entonces que el gobierno federal, a través de la Ley N º 6229/1975, organizado el Consejo Nacional de Salud. A partir desde alli, en el decenio de 1970, inició los debates sobre la política de la ampliación de la cobertura, que se centró en la atención primaria punto básico de partida que se puede lograr una mejor cobertura de atención a las personas a fin de que alcance niveles adecuados de salud. Conclusión: como los actores participantes de la constitución del nuevo sistema de salud, denominado red, las enfermeras, a fin de comprender la realidad social y se articulan en la estructura socioeconómica, es necesario pasar por un proceso de importantes cambios en su formación académica y, en consecuencia, asistencial. Descriptores: enfermería; salud pública; politicas de salud.


2010 ◽  
Vol 18 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Janet Marsden ◽  
Mary E. Shaw ◽  
Sue Raynel

This paper compares the results of studies of ophthalmic advanced practice in two similar but distinct health economies and integrates the effects of the setting, health policy and professional regulation on such roles. A mixed method questionnaire design was used, distributed at national ophthalmic nursing conferences in the UK and in New Zealand. Participants were nurses undertaking advanced practice who opted to return the questionnaire. Data were analysed separately, and are compared here, integrated with national health policy and role regulation to provide commentary on the findings. The findings suggest that health policy priorities stimulate the areas in which advanced practice roles in ophthalmic nursing emerge. The drivers of role development appear similar and include a lack of experienced doctors and an unmanageable rise in healthcare demand. Titles and remuneration are different in the two health economies, reflecting the organisation and regulation of nursing. In clinical terms, there are few differences between practice in the two settings and it appears that the distinct systems of regulation have minimal effect on role development. Ophthalmic nursing, as a reactive, needs based profession and in common with nursing in general, evolves in order that practice reflects what is needed by patients and services.


Author(s):  
S. S. Budarin ◽  
N. V. Yurgel

The article examines the experience of the national audit office of the United Kingdom in conducting an audit of the effectiveness of budget funds aimed at providing medicines to English citizens. The reasons for the sharp increase in budget expenditures for providing the population with reproduced medicines in 2017—2018 are described in detail.The article analyzes the shortcomings of the system of regulation of drug pricing procedures and the resulting risks to the budget of the national health system in United Kingdom.It is concluded that the effectiveness audit has allowed us to identify not only the reasons for significant overspending of the NHS budget to provide the population with medicines, but also to assess the actions of organizations authorized by the UK Government to address issues of regulation of the pharmaceutical market.


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