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.

Japan´s energy future: Between a return to nuclear energy and a turn to renewables

After the triple disaster of 11 March 2011, Japan is at an energy crossroad. In the short and medium run it depends on fossil fuel imports to ensure its energy security, but the long term will be determined by the decisions taken at present. For Japan energy security is a national security challenge, as stated in its National Security Strategy. The article reviews the Japanese nuclear path, studies the factors shaping the Japanese electricity market and analyzes the current energy situation. Moreover, it also assesses the principles that have marked Japan’s energy policy and the two last Strategic Energy Plans -one prior to Fukushima and the other after it- before tackling the debate on the optimal future energy mix that Japan should adopt to meet its energy security trilemma, marked by its environmental commitment.