Health Care Systems in Europe under Austerity: Institutional by Emmanuele Pavolini, Ana M. Guillén (eds.)

By Emmanuele Pavolini, Ana M. Guillén (eds.)

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In addition the NHS market was gradually opened up, mainly to the private sector, although some voluntary-sector providers also appeared.

The period of reform between 1997 and 2010 saw a mixture of strong central direction alongside the devolution of decision-making away from the centre. 3 billion (Harker, 2012). In its first health White Paper, The New NHS: Modern, Dependable, the Labour Government had made it clear that it intended to reform the English NHS fundamentally (Department of Health, 1997). However, its focus initially was on regulation rather than major structural change. Thus, the National Institute for Clinical Excellence (NICE) was established in 1999 with a remit to ensure that treatment decisions were based on the best available clinical evidence.

There are also indications that Swedes are somewhat less satisfied than patients in other comparable health care systems with patient responsiveness, an indicator which can be understood as measuring how patients experience the service level within the system (Swedish Agency for Healthcare Systems Analysis, 2012: 7). Improved public satisfaction with the system was, as we could see above, one of the main goals behind the reforms undertaken in Swedish health care in the 2000s. , 2012). Given that both the waiting-time guarantee and the primary care choice reform did improve access to care for patients in the 2000s, it seems likely that the increase in satisfaction can be due at least in part to these reforms.

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