Senior Research Fellow
Public Service International Research Unit
PSIRU- CMS, University of Greenwich
Park Row
London SE10 9LS
+44 8331 7781
Social and economic destabilisation in Europe: implications for health
Abstract
This paper will examine how public (health) sector unions are responding to changes caused by deregulation. Some of these changes – the impact of EU internal market legislation on national health systems, reform of national health systems, introduction of contracting, public-private partnerships – are introducing a form of commercialisation to the public health care system but are not yet leading to full privatisation. These present direct challenges to health workers in terms of pay, terms and conditions but also raise questions about accessibility of health care services for many disadvantaged groups. Some of the trade union responses are aimed at preserving terms and conditions but trade unions are increasingly forming alliances with other civil society groups to develop joint campaigns to preserve both user and workers rights.
These campaigns are also raising questions for trade unions about future health care policy and how to develop health care systems that address both the needs of the users and health workers. However the process of bringing trade unions and civil society organisations together is not an easy one. In some countries these alliances have not developed, in others the progress has been slow. There are underlying tensions between health workers and users of services, which are not easily resolved. The growing influence of users of health services (often with a focus on individual rather than collective needs) within health care systems requires new systems of participation and accountability to address these underlying conflicts. The challenges of deregulation and privatisation make the need to resolve these differences and develop long term strategic alliances which encompass a vision of a public health sector more urgent.
International Association of Health Policy 