Fierlbeck K
Department of Political Science, Dalhousie University Halifax, Nova Scotia, Canada.
Int J Health Serv. 1996;26(3):529-46. doi: 10.2190/WUGN-YY3Y-8PLU-NUGT.
While it is commonly accepted that the broader political and economic climate directly influences the nature of any major changes in the provision of health care (witness the 1991 National Health Service reforms in the United Kingdom), there is less consideration of the effect of paradigm changes in health care and health care management themselves on wider political and ideological strategies. This article examines the recent health policy initiatives presented by Britain's Labour Party. The author argues that while the Conservatives' market-oriented reforms reflected the perceived political and economic realities of the 1980s, the rapidly increasing credibility of strategies of prevention within the health care sector (including an emphasis on the social determinants of ill-health, the need to plan a shift from acute to community care, and the desire for greater lay participation in policy-making) allows Labour to highlight the limitations of a strongly market-oriented system in the health care sector more so than in any other policy area.
虽然人们普遍认为,更广泛的政治和经济环境直接影响着医疗保健服务提供方面任何重大变革的性质(如英国1991年的国民医疗服务体系改革),但对于医疗保健及医疗保健管理领域的范式转变对更广泛的政治和意识形态战略的影响却较少有人考虑。本文审视了英国工党近期提出的卫生政策举措。作者认为,保守党以市场为导向的改革反映了20世纪80年代人们所感知到的政治和经济现实,而医疗保健领域内预防策略的可信度迅速提高(包括强调健康不良的社会决定因素、规划从急症护理向社区护理转变的必要性以及让更多非专业人士参与决策的愿望),这使得工党比在任何其他政策领域更能凸显医疗保健领域高度市场化体系的局限性。