Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

The value of military oath in civil wars in Rome: The example of conflict 49-45 BC

During the civil war between Caesar and Pompey, the military oath which binds the soldier to his army is often openly violated. Yet despite this offense, commanders of armed struggle require recursively the oath to their men. Admittedly, this ritual act seems ineffective given the many desertions and mutinies identified, but military leaders use its symbolic and sacred meaning to legitimize one hand their “anti-republican” actions, on the other armies fighting in a context deemed impius.