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.

Humanism is a violence typical of the beasts. Philosozing with a Hammer, using Levinas and Derrida, the Measure of the Human and the Human as a measure

Levinas’s reflections arose as a critique of traditional philosophy which, since it was based on presence and identity, leads to the exclusion of the other. Instead of an onto-logical thought the Lithuanian proposes that the ipseity of the human being be constituted by alterity, and that it be so ethically, because the subject is sub-ject, that is, that which upholds, responsibility. In an attempt to take the obligatory attention to the otherness of the other even further, Derrida would develop a radical critique of the Levinasian posture. Deconstruction of every trace of ipseity and sovereignty in the relationship with the other, the reading that we have done of the work of Derrida opts for a no definable understanding of the human. That is why every de-limitation of an ethical field as a properly human implies a brutal violence that the levinasian humanism of the other tried to exceed.