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.

Of Marx and Makers: an Historical Perspective on Generative Justice

In Marxist frameworks “distributive justice” depends on extracting value through a centralized state. Many new social movements—peer to peer economy, maker activism, community agriculture, queer ecology, etc.—take the opposite approach, keeping value in its unalienated form and allowing it to freely circulate from the bottom up. Unlike Marxism, there is no general theory for bottom-up, unalienated value circulation. This paper examines the concept of “generative justice” through an historical contrast between Marx’s writings and the indigenous cultures that he drew upon. Marx erroneously concluded that while indigenous cultures had unalienated forms of production, only centralized value extraction could allow the productivity needed for a high quality of life. To the contrary, indigenous cultures now provide a robust model for the “gift economy” that underpins open source technological production, agroecology, and restorative approaches to civil rights. Expanding Marx’s concept of unalienated labor value to include unalienated ecological (nonhuman) value, as well as the domain of freedom in speech, sexual orientation, spirituality and other forms of “expressive” value, we arrive at an historically informed perspective for generative justice. 

The Communicative Dimension and Security in Asia-Pacific: A communicative-viewing proposal for reform of the Japanese Intelligence Services

The postwar development of the Intelligence Services in Japan has been based on two contrasting models: the centralized model of the USA and the collegiality of UK, neither of which has been fully developed. This has led to clashes of institutional competencies and poor anticipation of threats towards national security. This problem of opposing models has been partially overcome through two dimensions: externally through the cooperation with the US Intelligence Service under the Treaty of Mutual Cooperation and Security; and internally though the pre-eminence in the national sphere of the Department of Public Safety. However, the emergence of a new global communicative dimension requires that a communicative-viewing remodeling of this dual model is necessary due to the increasing capacity of the individual actors to determine the dynamics of international events. This article examines these challenges for the Intelligence Services of Japan and proposes a reform based on this new global communicative dimension.