title: Regional Decentralisation in the Greek Health Care System: Rhetoric and Reality.
abstract: Decentralisation is a complex, yet basic feature of health care systems in many countries entailing the transfer of authority or dispersal of power in public planning, management and decision making from higher to lower levels of government. This paper describes the attempts made in Greece from 1923 until today to decentralise its highly centralised health care system, drawing on a thorough documentary analysis of legislative acts and official reports regarding regional health policy. The analysis shows that, although decentralisation has been attempted on several occasions, in the end it was abandoned every time. The first ever implementation of a decentralised system of governance in 2001 was also curtailed, resulting in only minor decentralisation of authority and real powers. It is suggested that decentralisation has been impeded by many factors, especially obstruction by opposition from key interest groups, absence of policy continuity between governments, the inability to tackle the bureaucratic and highly centralised system and lack of political will.
authors.affiliation: Health Planning Unit, Department of Social Medicine,Faculty of Medicine, University of Crete, Heraklion, Greece and Foundation for Economic & Industrial Research (IOBE). athanasiadis@iobe.gr.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Athanasiadis
authors.forename: Stella
authors.initials: S
authors.lastname: Kostopoulou
authors.forename: Anastas
authors.initials: A
authors.lastname: Philalithis
mesh_terms: D003695:Delivery of Health Care / Q000266:history*; D006115:Greece; D006291:Health Policy / Q000266:history; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D011057:Politics