title: "Liberalizing" the English National Health Service: background and risks to healthcare entitlement.
abstract: The recent reform of the English National Health Service (NHS) through the Health and Social Care Act of 2012 introduced important changes in the organization, management, and provision of public health services in England. This study aims to analyze the NHS reforms in the historical context of predominance of neoliberal theories since 1980 and to discuss the "liberalization" of the NHS. The study identifies and analyzes three phases: (i) gradual ideological and theoretical substitution (1979-1990) - transition from professional and health logic to management and commercial logic; (ii) bureaucracy and incipient market (1991-2004) - structuring of the bureaucracy focused on administration of the internal market and expansion of pro-market measures; and (iii) opening to the market, fragmentation, and discontinuity of services (2005-2012) - weakening of the territorial health model and consolidation of health as an open market for public and private providers. This gradual but constant liberalization has closed services and restricted access, jeopardizing the system's comprehensiveness, equity, and universal healthcare entitlement in the NHS.
authors: Centre for Primary Care and Public Health, Queen Mary & University of London, London, U.K.
authors: Jonathan
authors: J
authors: Filippon
authors: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
authors: Ligia
authors: L
authors: Giovanella
authors: Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
authors: Mariana
authors: M
authors: Konder
authors: Centre for Primary Care and Public Health, Queen Mary & University of London, London, U.K.
authors: Allyson M
authors: AM
authors: Pollock
mesh_terms: D003695:Delivery of Health Care / Q000191:economics; D004739:England; D015276:Health Care Rationing; D018166:Health Care Reform / Q000191:economics* / Q000458:organization & administration; D019981:Health Care Sector / Q000191:economics* / Q000458:organization & administration / Q000639:trends; D006291:Health Policy / Q000191:economics*; D006801:Humans; D009313:National Health Programs / Q000331:legislation & jurisprudence; D011057:Politics