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.

Fútbol y redes sociales. Análisis de la gestión de Relaciones Públicas 2.0 por los clubes de fútbol

Las relaciones públicas se configuran como una actividad esencial en la gestión de la comunicación con los públicos de los clubes de fútbol ya que son muy activos y su grado de reactividad es alto. Con este texto se analiza el papel que desempeñan las redes sociales en los clubes de fútbol que poseen mayor número de ingresos. Para ello, se desarrolla una metodología que estudia qué presencia tienen en las redes sociales, el número de seguidores, qué grado de interacción se produce entre clubes y públicos y los contenidos y las temáticas de los textos de las redes sociales. Los resultados muestran un público activo pero con intervenciones relacionadas con los resultados futbolísticos y una gestión comunicativa unidireccional por parte de los clubes.

Risk Consumption: Children and Online Gaming. The Problem of “Responsible Gambling”

Online gambling is a popular activity among adolescents. However, there has been a notable increase in the number of young people who suffer or are on the verge of pathological gambling. We review the impact of online gambling on young people and discuss the desiderability of the concept of “gambling responsibly” in order to alert of their risks and effectively prevent access to minors. The main factors associated with pathological gambling are the age of start, the family environment, the infl uence of advertising, the consumption of stimulants, and the attitudes of the peer group. Both the government and the gaming industry itself should consider these factors and develop comprehensive plans that ensure a safe and controlled model game. In this context, advertising must take into account criteria of consumer protection knowing that even if they are not allowed, children can easily have access to online gambling. All agents involved, including public and social agents, must provide mechanisms for prevention and awareness of a problem that arouses little social consciousness and excessive carelessness.

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.