SciELO - Scientific Electronic Library Online

 
vol.32 issue8Comprehensiveness and healthcare technologies: a narrative on conceptual contributions to the construction of the comprehensiveness principle in the Brazilian Unified National Health System author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

Share


Cadernos de Saúde Pública

On-line version ISSN 1678-4464

Abstract

FILIPPON, Jonathan; GIOVANELLA, Ligia; KONDER, Mariana  and  POLLOCK, Allyson M.. "Liberalizing" the English National Health Service: background and risks to healthcare entitlement. Cad. Saúde Pública [online]. 2016, vol.32, n.8, e00034716.  Epub Aug 29, 2016. ISSN 1678-4464.  http://dx.doi.org/10.1590/0102-311X00034716.

The recent reform of the English National Health Service (NHS) through the Health and Social Care Act of 2012 introduced important changes in the organization, management, and provision of public health services in England. This study aims to analyze the NHS reforms in the historical context of predominance of neoliberal theories since 1980 and to discuss the "liberalization" of the NHS. The study identifies and analyzes three phases: (i) gradual ideological and theoretical substitution (1979-1990) - transition from professional and health logic to management and commercial logic; (ii) bureaucracy and incipient market (1991-2004) - structuring of the bureaucracy focused on administration of the internal market and expansion of pro-market measures; and (iii) opening to the market, fragmentation, and discontinuity of services (2005-2012) - weakening of the territorial health model and consolidation of health as an open market for public and private providers. This gradual but constant liberalization has closed services and restricted access, jeopardizing the system's comprehensiveness, equity, and universal healthcare entitlement in the NHS.

Keywords : Health Systems; Health Services; Health Policy; Health Programs and Plans.

        · abstract in Portuguese | Spanish     · text in English | Portuguese     · English ( pdf ) | Portuguese ( pdf )