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.

Discourses on Modernization in the Employment Public Services: Towards a New Form of Governance?

The “crisis of the social issue” in the EU has led to a certain consensus in the need to renew the organizational and institutional model of public administration. The core of the reform implies important administrative changes in most of the European welfare states. Those changes are inspired on theories such as the new public management, management by objectives or partnership. Such changes involve both semantic (“sharing responsibilities”, “effective costs”, or the substitution of “citizen under an administration” by “consumer”) and political (predominance of scattered forms of power and the individualization of responsibilities) transformations which operate in the framework of individuals and State relations. The paradigms of activation and flexicurity have been central in this public administration modernization project. This commitment with new forms of governance of social issues has important consequences for the political and moral foundations of social cohesion, and the Spanish case is not an exception. This paper aims at looking at those representations of “modernization” (as they appear in debates about the employment services restructuring policies) in detail as well as providing references to the trajectory of such reforms of public services since the early eighties to the beginning of the crisis.

The reform of Welfare Regimes in Costa Rica, Chile, Argentina, Brazil and Uruguay

The aim of this article is to analyze the social policy in Latin America in a context of emerging welfare states. To understand the changes one takes into consideration the theories about institutional reform and the transformations produced in the XX century and the beginning of the XXI to substitute a social security regime mainly based on segmentation of benefi ts and on programs to fi ght poverty by another with an institutional and redistributive nature. The paper pays attention in particular to the path of the most developed welfare states of Latin America: Costa Rica, Chile, Argentina, Brasil y Uruguay.

Dynamic analysis of employment trajectories through the concept of fl exicurity

The paper presents a dynamic study of the Spanish labour market which tries to determine if it matches the characteristics of transitional labour markets from a fl exicurity approach. Employment trajectories of Spanish workers during the years 2007-2010 are studied using the Continuous Sample of Working Lives. This period covers the end of the expansion of the Spanish economy and the beginning of the current employment crisis. From the combination of the chosen topic, the approach, and the database used, this is a novel perspective in our country. The article shows evidence of the evolution of the employment and unemployment spells, the Spanish labour market turnover degree, and the diffi culties of some groups for carrying out transition between employment and unemployment. The results obtained show a labour market in which a) transitions have come to a halt, and b) there is high job insecurity.