El sistema hospitalario catalán entre 1889 y 1986: el predominio de lo privado sobre lo público / The Catalonian hospital system between 1889 and 1986: the predominance of the private over the public

Este trabajo se centra en el estudio del sistema hospitalario catalán desde la década de 1880 hasta la aprobación de la primera Ley General de Sanidad (1986), ya en el marco democrático. Dentro de este contexto, el estudio trata de analizar las diferencias del modelo hospitalario catalán respecto a otros territorios, sigularidades basadas sobre todo en la importancia de su red hospitalaria privada, que presenta un mayor peso desde el punto de vista histórico que la oferta pública. El estudio determinará los principales factores que han configurado esta diferencia histórica y sus consecuencias sobre la construcción y funcionamiento del sistema hospitalario catalán en el largo plazo

This work focussess on the study of the Catalonian hospital system from the decade of the 1889s to the approval of the first General Law of Halthcare (1986), already within the democratic framework. Within this context, the study tries to analyse the Catalonian hospital system with respect to other territories, peculiarities based above all on the importance of its network of private hospitals, which has more weight historically than the public offer. This study Will determine the primary factors that have mad up this historical difference and their long term consequences on the construction and functioning of the Catloniana hospital system

Understanding and Treating Offenders with Serious Mental Illness in Public Sector Mental Health.

This article begins with the history of the rise and fall of the state hospitals and subsequent criminalization of persons with serious mental illness (SMI). Currently, there is a belief among many that incarceration has not been as successful as hoped in reducing crime and drug use, both for those with and those without SMI. Moreover, overcrowding in correctional facilities has become a serious problem necessitating a solution. Consequently, persons with SMI in the criminal justice system are now being released in large numbers to the community and hopefully treated by public sector mental health. The issues to consider when releasing incarcerated persons with SMI into the community are as follows: diversion and mental health courts; the expectation that the mental health system will assume responsibility; providing asylum and sanctuary; the capabilities, limitations, and realistic treatment goals of community outpatient psychiatric treatment for offenders with SMI; the need for structure; the use of involuntary commitments, including assisted outpatient treatment, conservatorship and guardianship; liaison between treatment and criminal justice personnel; appropriately structured, monitored, and supportive housing; management of violence; and 24-hour structured in-patient care. Copyright © 2017 John Wiley & Sons, Ltd.

The precariousness of the franchise state: Voluntary sector health services and international NGOs in Tanzania, 1960s - mid-1980s.

This paper challenges conventional narratives on the role of international non-governmental organisations (INGOs) in the delivery of health services in Tanzania. Adopting an historical gaze which focuses on the 1960s to mid-1980s the paper argues that the 'franchise state' in the Tanzanian health system was not created by collusion between international donors and INGOs, underpinned by a set of health sector reforms that advocated the use of non-state actors; but was rather the legacy of the colonial health system bequeathed to the post-independence state. It was a system in which voluntary non-state actors (but, importantly, not INGOs) were already entrenched as key providers; and in which many of the features of the franchise state - fragmentation, structural weaknesses, lack of accountability to users - were already long established. But if INGOs did not create these features, as their critics attest, they did contribute to the maintenance and extension of these features. The short-term perspectives of NGOs, their small-scale piecemeal engagement, and the extra demands they placed upon their voluntary actor partners, left little scope for the development of sustainable, national and accountable solutions to the health needs of the country. In exploring these ideas, the paper contributes to a more nuanced understanding of the path dependency that created Tanzania's health system. The analysis also contributes to a deepening of the understanding of the make-up of the voluntary sector beyond a narrow gaze on the institution of the INGO.

[Historic Development of Clinical Biology Laboratories in Luxembourg]. / Evolution historique des laboratoires de biologie médicale au Luxembourg.

After a short overview on the development of diagnostic tools in clinical biology at an international level from Antiquity towards today, a history of the clinical biology including public and private institutions in Luxembourg will be outlined.

Estimating preferences for local public services using migration data.

Using Swedish micro data, the paper examines the impact of local public services on community choice. The choice of community is modelled as a choice between a discrete set of alternatives. It is found that, given taxes, high spending on child care attracts migrants. Less conclusive results are obtained with respect to the role of spending on education and elderly care. High local taxes deter migrants. Relaxing the independence of the irrelevant alternatives assumption, by estimating a mixed logit model, has a significant impact on the results.

Confrontations and donations: encounters between homeless pet owners and the public.

This study examines the interactions between homeless pet owners and the domiciled public with a focus on how the activities of pet ownership help construct positive personal identities. Homeless people are often criticized for having pets. They counter these attacks using open and contained responses to stigmatization. More often, they redefine pet ownership to incorporate how they provide for their animals, challenging definitions that require a physical home. Homeless pet owners thus create a positive moral identity by emphasizing that they feed their animals first and give them freedom that the pets of the domiciled lack. Through what we call "enabled resistance," donations of pet food from the supportive public provide the resources to minimize the impact of stigmatization.

Good governance of animal health systems and public-private partnerships: an Australian case study.

The animal health system in Australia has evolved over more than 100 years and includes innovative public-private partnership arrangements. The establishment in 1996 of Animal Health Australia (AHA), a not-for-profit company, was a crucial development which formalised arrangements for shared decision-making and funding across both government and industry stakeholders. However, Federal and State governments retain legislative authority for animal health control. Accordingly, all programmes must recognise that the public sector remains an executive arm of government, accountable for its actions. Hence, much effort has been invested in ensuring that the governance arrangements within AHA are lawful and transparent. The Emergency Animal Disease Response Agreement (EADRA) is a very good example of governance arrangements that are sustainably financed, widely available, provided efficiently, without waste or duplication, and in a manner that is transparent and free of fraud or corruption. The benefits of EADRA include certainty and greater transparency of funding; greater efficiency through increased probability of a rapid response to an occurrence of any of 65 diseases; and industry participation in the management and financing of such a response.

The third sector, user involvement and public service reform: a case study in the co-governance of health service provision.

The 'modernization' of British public services seeks to broaden public sector governance networks, bringing the views of third sector organizations, the public and service users (among others) to the design, management and delivery of welfare. Building on previous analyses of the contradictions generated by these roles, this paper draws on longitudinal qualitative research to enunciate the challenges faced by one third-sector organization in facilitating service user influence in a UK National Health Service (NHS) pilot programme, alongside other roles in tension with this advocacy function. The analysis highlights limits in the extent to which lateral governance networks pluralize stakeholder involvement. The 'framing' of governance may mean that traditional concerns outweigh the views of new stakeholders such as the third sector and service users. Rather than prioritizing wider stakeholders' views in the design and delivery of public services, placing third sector organizations at the centre of governance networks may do more to co-opt these organizations in reproducing predominant priorities.

Who owns what? Private ownership and the public interest in recombinant DNA technology in the 1970s.

This essay analyzes how academic institutions, government agencies, and the nascent biotech industry contested the legal ownership of recombinant DNA technology in the name of the public interest. It reconstructs the way a small but influential group of government officials and university research administrators introduced a new framework for the commercialization of academic research in the context of a national debate over scientific research's contributions to American economic prosperity and public health. They claimed that private ownership of inventions arising from public support would provide a powerful means to liberate biomedical discoveries for public benefit. This articulation of the causal link between private ownership and the public interest, it is argued, justified a new set of expectations about the use of research results arising from government or public support, in which commercialization became a new public obligation for academic researchers. By highlighting the broader economic and legal shifts that prompted the reconfiguration of the ownership of public knowledge in late twentieth-century American capitalism, the essay examines the threads of policy-informed legal ideas that came together to affirm private ownership of biomedical knowledge as germane to the public interest in the coming of age of biotechnology and genetic medicine.

The role of public-sector research in the discovery of drugs and vaccines.

BACKGROUND: Historically, public-sector researchers have performed the upstream, basic research that elucidated the underlying mechanisms of disease and identified promising points of intervention, whereas corporate researchers have performed the downstream, applied research resulting in the discovery of drugs for the treatment of diseases and have carried out development activities to bring them to market. However, the boundaries between the roles of the public and private sectors have shifted substantially since the dawn of the biotechnology era, and the public sector now has a much more direct role in the applied-research phase of drug discovery. METHODS: We identified new drugs and vaccines approved by the Food and Drug Administration (FDA) that were discovered by public-sector research institutions (PSRIs) and classified them according to their therapeutic category and potential therapeutic effect. RESULTS: We found that during the past 40 years, 153 new FDA-approved drugs, vaccines, or new indications for existing drugs were discovered through research carried out in PSRIs. These drugs included 93 small-molecule drugs, 36 biologic agents, 15 vaccines, 8 in vivo diagnostic materials, and 1 over-the-counter drug. More than half of these drugs have been used in the treatment or prevention of cancer or infectious diseases. PSRI-discovered drugs are expected to have a disproportionately large therapeutic effect. CONCLUSIONS: Public-sector research has had a more immediate effect on improving public health than was previously realized.

Modernisation as a professionalising strategy: the case of critical care in England.

There has been broad agreement about how to characterise the processes of 'modernisation' of the public sector in welfare societies, but rather less consensus on the impact of this modernisation on professionals. This paper takes critical care in England as a case study to explore how professionals in one setting account for the changes associated with modernisation. In contrast to reports from other arenas, critical care professionals were positive about the processes and outcomes of 'modernisation' in general, and there was a surprising lack of nostalgia in their accounts of organisational changes. However, joking comments suggested considerable scepticism about the initiatives explicitly associated with the national organisation that was charged with 'modernising' critical care, the Modernisation Agency. We suggest that the relative optimism of staff is in part explained by historical and political contingencies which meant that critical care, as a relatively new clinical specialty, benefited in tangible ways from modernisation. Further, all staff groups were able to attribute gains, rather than losses, in autonomy and authority to the modernisation of critical care. Their accounts suggest that modernisation can be a professionalising strategy, with responses to change being neither resistant nor compliant, but sceptically strategic.

The new left and public health the Health Policy Advisory Center, community organizing, and the big business of health, 1967-1975.

Soon after its founding in the politically tumultuous late 1960s, the Health Policy Advisory Center (Health/PAC) and its Health/PAC Bulletin became the strategic hub of an intense urban social movement around health care equality in New York City. I discuss its early formation, its intellectual influences, and the analytical framework that it devised to interpret power relations in municipal health care. I also describe Health/PAC's interpretation of health activism, focusing in particular on a protracted struggle regarding Lincoln Hospital in the South Bronx. Over the years, the organization's stance toward community-oriented health politics evolved considerably, from enthusiastically promoting its potential to later confronting its limits. I conclude with a discussion of Health/PAC's major theoretical contributions, often taken for granted today, and its book American Health Empire.

Addressing fear of crime in public space: gender differences in reaction to safety measures in train transit.

Research has identified several factors that affect fear of crime in public space. However, the extent to which gender moderates the effectiveness of fear-reducing measures has received little attention. Using data from the Chicago Transit Authority Customer Satisfaction Survey of 2003, this study aims to understand whether train transit security practices and service attributes affect men and women differently. Findings indicate that, while the presence of video cameras has a lower effect on women's feelings of safety compared with men, frequent and on-time service matters more to male passengers. Additionally, experience with safety-related problems affects women significantly more than men. Conclusions discuss the implications of the study for theory and gender-specific policies to improve perceptions of transit safety.

The economics and ethics of Hurricane Katrina.

How might free enterprise have dealt with Hurricane Katrina and her aftermath. This article probes this question at increasing levels of radicalization, starting with the privatization of several government "services" and ending with the privatization of all of them.

Does public reporting measure up? Federalism, accountability and child-care policy in Canada.

Governments in Canada have recently been exploring new accountability measures within intergovernmental relations. Public reporting has become the preferred mechanism in a range of policy areas, including early learning and child-care, and the authors assess its effectiveness as an accountability measure. The article is based on their experience with a community capacity-building project that considers the relationship between the public policy, funding and accountability mechanisms under the federal/provincial/territorial agreements related to child-care. The authors argue that in its current form, public reporting has not lived up to its promise of accountability to citizens. This evaluation is based on the standards that governments have set for themselves under the federal/provincial/territorial agreements, as well as guidelines set by the Public Sector Accounting Board, an independent body that develops accounting standards over time through consultation with governments.

Improving the public house in Britain, 1920-40: Sir Sydney Nevile and "social work".

The "improved public house" movement in the inter-war years was a central part of the shift towards retailing by the brewing industry. An important part of the reform movement was the alliance between certain brewers, notably Whitbread, and "social workers", particularly those associated with the University Settlement movement in London. Using the papers of Sydney Nevile, the importance of a particular social milieu is outlined, calling into question attempts to align the movement to improve public houses with transatlantic Progressivism. Rather, this alliance drew upon longstanding English traditions of public service and religious affiliation amongst a fraction of the gentry.

Sociology, the public sphere, and modern government: a challenge to the dominance of Habermas.

There is an unfortunate tendency within some branches of sociology - particularly those usually called 'critical', that is, those associated with 'critical social theory'- to treat with disdain the understanding of the public sphere that many modern governments use daily in making and implementing public policy. The majority of sociologists in those branches seem to prefer, as part and parcel of their normative commitments, Jürgen Habermas's Kantian understanding of the public sphere, which focuses primarily on reason and morality and insists that these two forces are of a higher order than politics and law. This paper offers a set of criticisms of the Habermas-Kant understanding, arguing that its focus on reason and morality, were it to become more widespread, would steer sociology into public policy irrelevance. The paper goes on to describe a very different understanding of the public sphere, a politico-legal or civil-peace understanding which operates as the public policy focus of those governments that have relegated questions of salvation (whether religious or ideological) to the private sphere. This understanding emerged from early modern attempts to carve out a domain of relative freedom and security against the deadly violence of religious disputation sweeping across Europe. The paper readily acknowledges that some 'non-critical' branches of sociology already employ a version of this understanding.