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.

Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

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.

The elderly care and domestic services sector during the recent economic crisis. The case of Italy, Spain and France.

Over the past ten years in Italy, Spain and France, the demographic pressure and the increasing women’s participation in labour market have fuelled the expansion of the private provision of domestic and care services. In order to ensure the difficult balance between affordability, quality and job creation, each countries’ response has been different. France has developed policies to sustain the demand side introducing instruments such as vouchers and fiscal schemes, since the mid of the 2000s. Massive public funding has contributed to foster a regular market of domestic and care services and France is often presented as a “best practices” of those policies aimed at encouraging a regular private sector. Conversely in Italy and Spain, the development of a private domestic and care market has been mostly uncontrolled and without a coherent institutional design: the osmosis between a large informal market and the regular private care sector has been ensured on the supply side by migrant workers’ regularizations or the introduction of new employment regulations . The analysis presented in this paper aims to describe the response of these different policies to the challenges imposed by the current economic crisis. In dealing with the retrenchment of public expenditure and the reduced households’ purchasing power, Italy, Spain and France are experiencing greater difficulties in ensuring a regular private sector of domestic and care services. In light of that, the paper analyses the recent economic conjuncture presenting some assumptions about the future risk of deeper inequalities rising along with the increase of the process of marketization of domestic and care services in all the countries under analysis.    

Contemporary Transformations of the Relations between Politics, Culture and Religion in Western Europe. Some Notes on the Spanish Case

According to Tilly, two laws shaped the process of transformation undergone by Western European societies since the Peace of Westphalia until the end of the 20th century: their increasing inner homogenisation and their growing heterogeneity between them. Cultural inner homogenisation affected, fi rst, those ethnic groups living within the territories of the said states. The second phase of homogenisation impinged on those groups that immigrated after World War II. This process followed different models according to the country considered, but the 1973 oil crisis revealed their general lack of success. During the last quarter of the 20th century and onwards, these European societies have been altered by two progressive and contradictory global logics: a process of cultural homogenisation at the world level (rather than society level) and a process of cultural re-creation led by those groups with an immigrant background, who have reacted against their integration shortcomings by searching for new sources of social and personal esteem in their respective cultural and religious traditions. This paper seeks to clarify these processes from a social differentiation and political representation theory perspective. The latter becomes indispensable, as the said processes have happened in a context in which the structure of relations (i.e. communication) between civil society and the democratic political sphere have experienced a radical crisis. In this way, the complex relations that exist between civil society, culture, religion and politics in these Western European societies are depicted.

Net-surplus as a useful tool to analyse financial information in co-op societies

This paper aims to analyse a sample of Galician co-ops to verify whether or not it is possible to deduce different financial behaviours among co-op partners from the amount of net-surplus. To this end, our study adds net-surplus to the variation registered in some account entries so that other residual incomes yielded by the co-op may be considered. The distribution of these revenues shows that partners do not usually choose to fully anticipate residual incomes. This reveals that some firms follow a positive net-surplus strategy, which is actually different from the null net-surplus strategy asserted by the classical financial theory. Furthermore, results show that differences between both strategies are statistically significant. This opens a path to future research on determinants explaining why co-op partners voluntarily renounce to anticipating these residual incomes. Such behaviour only arises when yearly accounts render a positive result, thereby making the accounting net-surplus a useful tool to analyse financial information in co-op societies.

Special employment centers in Castile and León 2007-2013: effects of the crisis in relation to these centers’ registered legal personalities

The aim of this paper is to carry out an economic and financial study of the Special Employment Centres in Castile and León based on a classification of these entities’ registered legal personalities in order to view how the economic crisis that began at the end of 2007 may have affected them. Various items from the Centres’ financial statements are analysed and the results are compared to those from the period 2007-2013 as to provide a broader perspective of their size, development, growth and behaviour. The following economic figures were used: total assets, turnover and revenue. The variable “employment” is compared with the subsidies received by the Centres, showing that the crisis does affect the Centres depending on their registered legal personalities. Associations and physical persons are the most affected personalities, to the point of possible extinction. An account reversal for the Centres is also included in this article, which measures the percentage of public aid received by the Centres that is returned to society.

La Fundación Manuel Benedito: Problemática de un museo de autor

Se presenta la Fundación Manuel Benedito como ejemplo de museo privado, sin financiación externa, para explicar cómo es la actualidad de este tipo de instituciones ante la crisis económica y cuál es el futuro que se les presume, dando alternativas para su subsistencia.

El PCE y el movimiento comunista internacional (1969-1977)

El artículo se centra en la actividad internacional del Partido Comunista de España (PCE) desde las secuelas de la represión de la Primavera de Praga hasta 1977. Fue un período caracterizado por el principio del declive definitivo del movimiento comunista internacional. El análisis abarca múltiples cuestiones. Examina las crecientes críticas del PCE hacia el modelo soviético, y sus repercusiones en las relaciones entre el partido liderado por Santiago Carrillo y el movimiento comunista. Además, el artículo explora el intento del PCE de promover un nuevo tipo de internacionalismo en Europa occidental, auspiciando una renovada colaboración entre comunistas y socialistas y aprovechando las condiciones brindadas por la distensión. En este contexto tuvo lugar el surgimiento del eurocomunismo, que el ensayo analiza ilustrando los factores internos y externos que determinaron su crisis en la segunda mitad de los setenta.

Diplomacia y misión en Europa durante la Guerra de Sucesión: los Habsburgo- Wolfenbüttel, el estado de Milán y el catolicismo septentrional

Las perspectivas geopolíticas de la guerra de Sucesion espanola traspasaron ampliamente los limites de la herencia territorial de Carlos II. El político enlace del candidato austriaco al trono de Madrid, Carlos III de Austria, con Isabel Cristina de Braunschweig-Wolfenbuttel, una princesa luterana convertida ex profeso al catolicismo, vinculó las dos dinastias con el esfuerzo misionero de la Santa Sede en el norte del Sacro Imperio. En el presente estudio se propone reconstruir la relacion de la red diplomatica Wolfenbuttel con el papado y la monarquia carolina, ademas de apuntar la difusa -pero constante- presencia de la soberana dentro del proceso de financiación lombarda del misionalismo germánico a comienzos del Setecientos.

Entretenimientos, fiestas, juegos y placeres en la corte de los reyes de Aragón en el siglo xiv Steffano

Este trabajo estudia la presencia e importancia de las diversiones y el placer en distintos momentos de la vida de la corte de los reyes de Aragón: las prostitutas, dirigidas por el rey Arlot, la música, el juego, el baile o los juglares, observando el aumento de su presencia a lo largo del siglo xiv, con el correlativo aumento de los gastos. También se observa el incremento en el lujo y la complejidad de estas actividades y la siempre mayor presencia de elementos espectaculares como bestias, carros, figuras alegóricas y otros entremeses en coronaciones, bodas o entradas reales, todos ellos aspectos de la progresiva glorificación de la monarquía.

Buenas prácticas de los centros de rehabilitación laboral (CRL) para personas con enfermedad mental grave de la Comunidad de Madrid a tener en cuenta para el diseño de un nuevo modelo de gestión de los servicios de empleo

El presente artículo tiene como objetivo principal identificar las variables que explican por qué los Centros de Rehabilitación Laboral (CRL) para personas con enfermedad mental grave y duradera de la Comunidad de Madrid consiguen tasas de inserción sociolaboral cercanas al 50%, siendo un colectivo que presenta unas tasas de desempleo superiores al 80%. La metodología empleada en la investigación del recurso (documental, cualitativa y cuantitativa) demuestra que estos resultados son posibles gracias a la conjunción de varios elementos: financiación sostenible, método de trabajo, fuerte liderazgo político, trabajo con el tejido empresarial (presentando a las empresas, perfiles profesionales basados en un certero análisis de las competencias), trabajo en red, plazo de intervención marcado por la persona y la composición de los equipos multiprofesionales, entre otros factores.