The Soviet Union and the International Brigades, 1936-1939

The International Brigades are typically viewed as a fighting force whose impetus came from the Comintern, and thus from within the walls of the Kremlin. If the assumption is essentially correct, the broader relation between Stalin’s USSR and the IB has received little attention. This chapter constitutes an empirically-based study of the Soviet role not only in the formation of the IB, but of the Red Army’s collaboration with IB units, and Moscow’s role in the climax and denouement of the brigadistas’ Spanish experience. This study’s principal conclusion is twofold: First, that the creation and sustenance of the IB was part of Stalin’s goal of linking the Loyalist cause with that of the Soviet Union and international communism, a component of a larger geo-strategic gamble which sought to create united opposition to the fascist menace, one which might eventually bring Moscow and the West into a closer alliance. The second conclusion is that the IB, like the broader projection of Soviet power and influence into the Spanish theater, was an overly ambitious operational failure whose abortive retreat is indicative of the basic weakness of the Stalinist regime in the years prior to the Second World War.

Perceived and reported access to the general practitioner: an international comparison of universal access and mixed private/public systems.

Timely and convenient access to primary healthcare is essential for the health of the population as delays can incur additional health and financial costs. Access to health care is under increasing scrutiny as part of the drive to contain escalating costs, while attempting to maintain equity in service provision. The objective was to compare primary care services in Republic of Ireland and Northern Ireland, and to report on perceived and reported access to GP services in universal access and mixed private/public systems. A questionnaire study was performed in Northern Ireland (NI) and the Republic of Ireland (ROI). Patients of 20 practices in the ROI and NI were contacted (n = 22,796). Main outcome measures were overall satisfaction and the access to GP services. Individual responses and scale scores were derived using the General Practice Assessment Questionnaire (G-PAQ). The response rate was 52% (n = 11,870). Overall satisfaction with GP practices was higher in ROI than in NI (84.2% and 80.9% respectively). Access scores were higher in ROI than in NI (69.2% and 57.0% respectively) Less than 1 in 10 patients in ROI waited two or more working days to see a doctor of choice (8.1%) compared to almost half (45.0%) in NI. In NI overall satisfaction decreased as practice size increased; 82.8%, 80.4%, and 75.8%. In both systems, in large practices, accessibility is reduced when compared to smaller practices. The faster access to GP services in ROI may be due to the deterrent effect of the consultation charge freeing up services although, as it is the poorest and sickest who are deterred by the charge this improved accessibility may come at a significant cost in terms of equity. The underlying concern for policy makers centres around provision of equitable services.