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1 Section A: Health reforms in context

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A Comparative Study of England and Canada

This timely comparative study assesses the role of medical doctors in reforming publicly funded health services in England and Canada.

Respected authors from health and legal backgrounds on both sides of the Atlantic consider how the high status of the profession uniquely influences reforms. With summaries of developments in models of care, and the participation of doctors since the inception of publicly funded healthcare systems, they ask whether professionals might be considered allies or enemies of policy-makers.

With insights for future health policy and research, the book is an important contribution to debates about the complex relationship between doctors and the systems in which they practice.

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365 EIGHTEEN Never again? A retrospective and prospective view of English health reforms Martin Powell and Mark Exworthy This Chapter takes retrospective and prospective perspectives on health reforms in English NHS. Retrospectively, we offer a precis of the preceding chapters, taking stock of the cumulative lessons from the significant body of evidence that has been presented in this book. Moreover, we seek to explain the ‘how and why’ of these reforms, using a specific conceptual model (multiple streams approach (MSA)). Prospectively, we consider the

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Evaluating the impact of health reforms

This book provides an in-depth analysis of the NHS reforms ushered in by UK Coalition Government under the 2012 Health and Social Care Act, arguably the most extensive reforms ever introduced in the NHS.

Contributions from leading researchers from the UK, the US and New Zealand examine the reforms in the contexts of national health policy, commissioning and service provision, governance and others. Collectively, the chapters presents a broader assessment of the trajectory of health reforms in the context of marketisation, the rise of health consumerism and the revelation of medical scandals.

This is essential reading for those studying the NHS, those who work in it, and those who seek to gain a better understanding of this key public service.

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343 SEVENTEEN A view from abroad: a New Zealand perspective on the English NHS health reforms Robin Gauld Introduction 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. Compared with, say, the United States, with its multiple competing health insurers and

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97 SEVEN From adversary to ally: the evolution of non-governmental organisations in the context of health reform in Santiago and Montevideo Javier Pereira Bruno and Ronald Angel Introduction The non-governmental organisation (NGO), which traces the beginning of its modern mission to the need to rebuild a Europe ravaged by the Second World War, represents an organisational form that is rapidly evolving in response to complex global, national and local forces, and that at the same time is redefining the role of the state and of civil society in the provision

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Cholera to the Coalition
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The first digital-only ebook taster of Unequal health: The scandal of our times by Danny Dorling. Competitively priced, it gives a flavour of one of the major themes: public health and contains three chapters from the book, preceded by an all-new introduction specially written by Danny Dorling. This ‘must-read’ will introduce an even wider readership to his work.

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Health care systems everywhere face multiple pressures from changing demography, the rise of non-communicable disease, the growing demand on health services, and limited resources at a time of austerity.

Focusing on the British NHS from a political science perspective, this second edition of this best-selling book offers a fresh look at how it is coping with such pressures. The book explores the complexity of health policy and health services, offering a critical perspective on concerns including integrated care, the return of public health to local government and moves to devolve health services to local level. Crucially, it offers a critique of the market-style changes introduced by the Coalition government between 2010 and 2015.

Students of health care and health policy, policy-makers and public health and health care professionals will find this lively and accessible reassessment of NHS reforms invaluable.

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Understanding continuity and change
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This book contends that attempts to reform the NHS can only be understood by reference to both the wider social and political context, and to the organisational and ideational legacies present within the NHS itself. It aims to take students beyond a basic understanding of the historical development of health policy in the UK, to one that demonstrates an appreciation of the interactions between health policy, organisation and society.

Continuity and change in the NHS:

· acts as a crucial bridge between conventional textbooks on the NHS and contemporary health policy research;

· provides a theoretically rigorous but accessible account of the development of policy and organisational change not found elsewhere;

· presents new scholarship in the political economy of welfare in a clear format.

The book is aimed at third year and post-graduate students of politics, public management and health studies. It provides a theoretically inspired account of the development of health policy and organisation in the UK which will also be of interest to academics and researchers in the field.

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Reinventing professions, the state and the public
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Modernising health care: Reinventing professions, the state and the public is a crucial contribution to debates about the rapid modernisation of health care systems and the dynamics of changing modes of governance and citizenship.

Structured around the role of the professions as mediators between state and citizens, and set against a background of tighter resources and growing demands for citizenship rights, Ellen Kuhlmann’s book offers a much-needed comparative analysis, using the German health care system as a case study. The German system, with its strongly self-regulatory medical profession, exemplifies both the capacity of professionalism to re-make itself, and the role of the state in response, highlighting the benefits and dangers of medical self-regulation, while demonstrating the potential for change beyond marketisation and managerialism.

Kuhlmann critically reviews dominant models of provider control and user participation, and empirically investigates different sets of dynamics in health care, including tensions between global reform models and nation-specific conditions; interprofessional dynamics and changing gender arrangements; the role of the service-user as a new stakeholder in health care; and the rise of a new professionalism shaped by social inclusion.

Modernising health care provides new approaches and a wealth of new empirical data for academics and students of health policy, medical sociology and sociology of professions, and for health policy makers and managers.

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