Health, transatlantic trade, and President Trump's populism: what American Patients First has to do with Brexit and the NHS

Jarman, Holly; McKee, Martin; Hervey, Tamara

doi:10.1016/s0140-6736(18)31492-2

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…It is very unlikely that these protections would be replicated in any future trade deals with, in particular, the USA. 36 It may be, though, that being formally removed from the application of EU competition and procurement law might reassure perceived concerns in a way that would create scope for more efficient organisation of the NHS.…”

Section: Leadership and Governancementioning

confidence: 99%

How will Brexit affect health services in the UK? An updated evaluation

et al. 2019

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All forms of Brexit are bad for health, but some are worse than others. This paper builds on our analysis using the WHO health system building blocks framework to assess the likely effects of Brexit on the NHS in the UK. We consider four possible futures: (1) a "No Deal" Brexit under which the UK leaves the EU on 29 March 2019 without any formal agreement on the terms of withdrawal; (2) the Withdrawal Agreement, as negotiated between the UK and EU and awaiting (possible) formal agreement, which provides a transition period until the end of December 2020; (3) if the Northern Ireland Protocol's 'Backstop' comes into effect after the end of that period; and (4) the Political Declaration on the Future Relationship between the UK and the EU. Our analysis shows that a No Deal Brexit is significantly worse for the NHS than a future involving the Withdrawal Agreement, which provides certainty and continuity in legal relations while the Future Relationship is negotiated and put into legal form. The Northern Ireland 'Backstop' has variable impact, with continuity in some areas, such as health products, but no continuity in others. The Political Declaration envisages a future relationship which is centred around a free trade agreement, in which wider healthrelated issues are largely absent. All forms of Brexit, however, involve negative repercussions for the UK's leadership and governance of health, both in Europe and globally, and significant harmful consequences for the ability of parliament and other stakeholders to scrutinize and oversee governmental actions.

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Section: Leadership and Governancementioning

confidence: 99%

How will Brexit affect health services in the UK? An updated evaluation

et al. 2019

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“…It is primarily driven by an urgent need to overcome a dangerous silence in the health policy and public health community. Despite some important warnings [3][4][5][6][7][8][9][10]58] there is a dearth of knowledge and both methodological approaches and data are lacking, which would allow for a systematic and comprehensive comparison. In this situation, our comparative study is of explanatory nature and has a number of important limitation.…”

Section: Limitationsmentioning

confidence: 99%

Healthcare governance, professions and populism: Is there a relationship? An explorative comparison of five European countries

et al. 2018

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A new wave of support for populist parties and movements represents a serious threat to universal healthcare coverage in traditional liberal democracies and beyond. This article aims to contribute empirical material on the relationships between healthcare governance, professions and populism. It applies an explanatory cross-country comparative approach and uses mixed methods, including micro-level data garnered from international comparative databases and documents. Denmark, England, Germany, Italy and Turkey have been selected for comparison, reflecting different types of healthcare systems and populist movements. The results reveal variety in the ways populist discourses impact in healthcare. Abundant economic resources, network-based governance, high levels of trust in healthcare providers and doctors participating as insiders in the policy process seem to work as a bulwark against populist attacks on healthcare and professional expertise. On the other hand, poorly resourced NHS systems with doctors as outsiders in the policy process and major NPM reforms together with low to medium levels of trust in healthcare providers may be fertile ground for populist discourse to flourish. Our explanatory data provide hints of correlations, which may inform further studies to investigate causality. Yet the research highlights that healthcare governance and professions matter, and brings into view capacity for counteracting populist attacks on universal healthcare and professional knowledge.

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“…Public health researchers and health systems scholars have highlighted the threats to health and healthcare systems that are embedded in these developments (Greer , Jarman et al . , McKee , Pavolini et al . , Speed and Mannion ).…”

Section: Introductionmentioning

confidence: 99%

“…Right-wing populism has received a new relevance in many parts of the world. Public health researchers and health systems scholars have highlighted the threats to health and healthcare systems that are embedded in these developments (Greer 2017, Jarman et al 2018, McKee 2017, Pavolini et al 2018, Speed and Mannion 2017. Growing inequality and a backlash against the global goals of sustainable development and universal healthcare coverage are among the major concerns (Gostin and Friedman 2017).…”

Section: Introductionmentioning

confidence: 99%

New public management, physicians and populism: Turkey's experience with health reforms

Agartan

Kuhlmann

2019

Sociology Health & Illness

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Recent debates on the rise of right‐wing or neoliberal populism globally have prompted public health and health systems researchers to explore its implications in the healthcare systems. This case study of Turkey's recent health reform initiative, the Health Transformation Program, aims to contribute to this debate by examining the nexus among populism, professionalism and the contemporary market and managerial reforms, often described as New Public Management (NPM). Building on document analysis and secondary sources, this article introduces a framework to explore whether and how populist agendas grow up in the shadow of NPM policies. We aim to deepen our understanding of the governance settings that might be used in different ways by right‐wing populist leaders to advance their agendas. Our research reveals that the NPM reforms in Turkey have opened a ‘backdoor’ through which right‐wing populist agendas were supported and the position of the medical profession as an important stakeholder in the institutional settings was weakened. However, what mattered most in the reform process was not the policies themselves but the ways new managerialist policies were implemented. Our analysis makes blind spots of the NPM reforms and healthcare governance research visible and calls for greater attention to implementation processes.

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Health, transatlantic trade, and President Trump's populism: what American Patients First has to do with Brexit and the NHS

Cited by 6 publications

References 11 publications

How will Brexit affect health services in the UK? An updated evaluation

How will Brexit affect health services in the UK? An updated evaluation

Healthcare governance, professions and populism: Is there a relationship? An explorative comparison of five European countries

New public management, physicians and populism: Turkey's experience with health reforms

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