Health reforms in Latin America: processes and results

Two types of health reforms in Latin America are analysed: one based on insurance and service commodification and the one referred to the unified public systems of progressive governments. Health insurance with explicit service packages has not fulfilled their purposes of universal coverage, equal access to necessary health services and improvement of health conditions but has opened health as a field of profit making for insurance companies and private health providers. The national health services as a state obligation have developed territorialized health services and widened substantially timely access to the majority of the population. The adoption of an integrated and wide social policy has an impact on population well fare. It faces some problems derived from the old health systems and the power of the insurance and medical complex.

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 intersectorial approach in providing guidance and school support. The perspective of counsellors, tutors and principals

The provision of guidance and educational support requires joint work and the collaboration of different professionals and institutions, especially when we face complex problems that require a high level of specialization and the combination of knowledge from different areas. The research has aimed to examine the proximity of the institutional system of guidance and support to school in nine Autonomous Communities, to the intersectorial approach of counselling. We present the results of a descriptive study using the survey method, which allows knowing the opinions of counsellors, tutors and principals of Primary and Secondary Compulsory Education about the collaboration with the local public services (social, health, education, and employment) in the specialized support to students and schools. The final sample consisted of 9732 subjects who were selected from a random sampling proportional to the size of the subpopulations of each Autonomous Community. Results indicate how, in general terms, there is collaboration among the school and the local public services, although not as frequently as it would be desirable. In the same way, the professionals that were interviewed believe that the collaboration with social and educational services is quite adequate, but the assessment is not as positive when health and employment services are analysed. Finally, taking into account the different professionals considered, tutors from both educational stages are the ones that show a higher degree of satisfaction with the collaboration between the school and the local public services, except in the case of social services.

Immigration in Spain: Integration with Feet of Clay?

The aim of the paper is to analyze the impact of the economic crisis on the integration of the immigrant population in Spain. The Spanish case is singular because during the years of intense immigration achieved a remarkable degree of socio-cultural integration. The paper argues that such integration it has been the result of the confluence of exceptional factors rather than the result of the policy making. From a mixed methodology approach, it shows that, during the period of expansion, two factors of the immigration contribute to their coexistence with native population: finding job and access to public services. But the economic crisis, with its impact in terms of job losses and austerity policies, expose the weaknesses of the Spanish model of integration.

De la moral del sacrificio a la conciencia de la precariedad. Un análisis cualitativo de los discursos sobre la evolución de la crisis en España

La larga crisis económica que padece España está teniendo importantes consecuencias sociales. La más comentada por académicos, mass media y parte del arco político es la fractura social que se está abriendo en el país, ante el aumento de las desigualdades económicas que generan el enorme desempleo y las duras políticas de ajuste del gasto público. Sin embargo, más allá de cuestiones económicas la crisis está haciendo mella de forma muy profunda en el imaginario social del país en relación a las razones y consecuencias de la crisis, tanto a corto como a largo plazo. El objetivo de este artículo es el realizar una valoración de esas percepciones sociales de la ciudadanía en relación con la crisis, centrándonos en un aspecto como es el de la relación de la población española con el consumo de bienes y servicios públicos, en un escenario de hegemonía de la austeridad como única receta anti-crisis. Para ello, realizaremos un análisis de los discursos recogidos en una investigación cualitativa realizada en el año 2014 mediante grupos de discusión. Los resultados muestran un pesimismo enorme de la población en relación al futuro del Estado del Bienestar y de la propia clase media española, junto a una frustración que puede anunciar futuros ciclos de movilización social.

Gobierno abierto y competencias digitales: Transformando la administración pública para afrontar los retos del nuevo paradigma

El artículo plantea una contribución al debate académico sobre el surgimiento del Gobierno Abierto y los requerimientos de transformación de las Administraciones Públicas para afrontar a los retos que plantea. El texto, en base a la aportación de reflexiones y evidencias, se centra en el ámbito de los profesionales del sector público y la generación de competencias digitales. El marco analítico se combina con la presentación de evidencias basadas en dos estudios de caso de innovación en gestión de recursos humanos. Los resultados obtenidos permiten ilustrar las sinergias que se dan entre el Gobierno Abierto y el desarrollo de las competencias digitales, y cómo con ello se puede orientar la mejora las capacidades institucionales de las Administraciones públicas.

Commodification of health care systems: The Catalan case

Commodification of the public healthcare system has been a growing process in recent decades, especially in universal healthcare systems and in high-income countries like Spain.  There are substantial differences in the healthcare systems of each autonomous region of Spain, among which Catalonia is characterized by having a mixed healthcare system with complex partnerships and interactions between the public and private healthcare sectors.  Using a narrative review approach, this article addresses various aspects of the Catalan healthcare system, characterizing the privatization and commodification of health processes in Catalonia from a historical perspective with particular attention to recent legislative changes and austerity measures.  The article approximates, the eventual effects that commodification and austerity measures will have on the health of the population and on the structure, accessibility, effectiveness, equity and quality of healthcare services.