Introduction: The role of civil society in healthcare systems reforms

Giarelli, Guido; Annandale, Ellen; Ruzza, Carlo

doi:10.1016/j.socscimed.2014.10.046

Cited by 11 publications

(7 citation statements)

References 45 publications

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“…Understanding the role of organisations that work outside of formal health systems – within civil society, for example ( Borzaga and Fazzi, 2014 , Giarelli et al, 2014 ) – but which act to address factors in the social environment that favour or harm health, has been the subject of significant focus in recent times. Social enterprises – organisations that trade in the market in order to address one or more aspects of social vulnerability, particularly in local communities ( Galera and Borzaga, 2009 , Haugh, 2007 ) – have been the focus of particular attention, with a body of literature starting to emerge which considers the health and/or well-being impact of social enterprise-led activity.…”

Section: Introductionmentioning

confidence: 99%

Differentiating the effect of social enterprise activities on health

Macaulay

Mazzei

Roy

et al. 2018

Social Science & Medicine

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An emerging stream of literature has focused on the ways in which social enterprises might act on the social determinants of health. However, this previous work has not taken a sufficiently broad account of the wide range of stakeholders involved in social enterprises and has also tended to reduce and simplify a complex and heterogeneous set of organisations to a relatively homogenous social enterprise concept. In an attempt to address these gaps, we conducted an empirical investigation between August 2014 and October 2015 consisting of qualitative case studies involving in-depth semi-structured interviews and a focus group with a wide variety of stakeholders from three social enterprises in different regions of Scotland. We found that different forms of social enterprise impact on different dimensions of health in different ways, including through: engendering a feeling of ownership and control; improving environmental conditions (both physical and social); and providing or facilitating meaningful employment. In conclusion, we highlight areas for future research.

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Section: Introductionmentioning

confidence: 99%

Differentiating the effect of social enterprise activities on health

Macaulay

Mazzei

Roy

et al. 2018

Social Science & Medicine

View full text Add to dashboard Cite

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“…Outside of the obvious role that governments can play in addressing many of the social determinants of health (Bambra, 2013, McQueen et al., 2012, Wismar et al., 2013) there is also growing recognition of the public health role played by actors who are less obvious, operating outside of formal healthcare systems. Organisations and groups within civil society (Giarelli et al., 2014) often aim, implicitly or explicitly, to tackle aspects of social vulnerability (Galea et al., 2005) that we understand to be critical to health, but their work – at least in public health terms – can often go unrecognised, or at best under-recognised, by health service funders, researchers and policymakers. Furthermore, the actors themselves may not recognise the impact of their work in public health terms, since “their influence on health [is, rather,] a product of their primary intent” (Hanlon et al., 2012, p. 169).…”

Section: Introductionmentioning

confidence: 99%

Conceptualising the public health role of actors operating outside of formal health systems: The case of social enterprise

Roy

Baker

Kerr

2017

Social Science & Medicine

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This paper focuses on the role of actors that operate outside formal health systems, but nevertheless have a vital, if often under-recognised, role in supporting public health. The specific example used is the ‘social enterprise’, an organisation that seeks, through trading, to maximise social returns, rather than the distribution of profits to shareholders or owners. In this paper we advance empirical and theoretical understanding of the causal pathways at work in social enterprises, by considering them as a particularly complex form of public health ‘intervention’. Data were generated through qualitative, in depth, semi-structured interviews and a focus group discussion, with a purposive, maximum variation sample of social enterprise practitioners (n = 13) in an urban setting in the west of Scotland. A method of analysis inspired by critical realism – Causation Coding – enabled the identification of a range of explanatory mechanisms and potential pathways of causation between engagement in social enterprise-led activity and various outcomes, which have been grouped into physical health, mental health and social determinants. The findings then informed the construction of an empirically-informed conceptual model to act as a platform upon which to develop a future research agenda. The results of this work are considered to not only encourage a broader and more imaginative consideration of what actually constitutes a public health intervention, but also reinforces arguments that actors within the Third Sector have an important role to play in addressing contemporary and future public health challenges.

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“…The regulation of medical work in the UK has undergone a period of far reaching reform over the last decade as a result of external pressures broadly similar to those noted internationally in the US, European, Chinese, Indian and Australasian contexts (Bismark et al 2015, Pan et al 2015, Saks 2015, Toth 2015and Walton-Roberts 2015. Against the background of the fluxing conditions of the postrecession global political-economy, a growing tension between rising running costs and the advocacy of greater patient choice and rights of access, has led to state intervention to promote non-medical involvement in the delivery of health care services and their quality assurance (Giarelli, et al 2014Brown et al 2015.…”

Section: Risk-based Medical Regulationmentioning

confidence: 99%

Risk-based regulation and reforms to fitness to practise tribunals in the United Kingdom: Serving the public interest?

Chamberlain

2016

Health, Risk & Society

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In this paper I outline recent policy reforms to the General Medical Council and how these are designed to promote greater public confidence in its management of the patient complaint and fitness to practise tribunal process. I explore how in spite of a decade of reform, potential for bias remains in relation to how issues of race and ethnicity, disability, age, class, gender and English language proficiency, intersect with complaint making and case progression. I draw on reviews of and data from the General Medical Council to examine the key issues surrounding the representativeness of the medical tribunal process, in terms of members age, gender and race and ethnicity. I note that, as in other high-income countries, there is a tendency within the UK for the risk-focused regulatory system to focus its reforming agenda on the more effective performance management of cost and risk, rather than on inculcating a more diverse patient presence and biographical profile within the day-today operation of regulatory regimes. I argue that this might unintentionally lead to the promotion of an optimism bias within riskfocused regulatory systems, potentially leading to a failure to communicate realistic perceptions of medical risk to patients and their families, and in doing so perhaps serving to further exacerbate the situation when instances of medical error and negligence occur. I conclude that current regulatory reforms in the UK are unlikely as a result to as fully promote the public interest and patient safety as they intend.

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Introduction: The role of civil society in healthcare systems reforms

Cited by 11 publications

References 45 publications

Differentiating the effect of social enterprise activities on health

Differentiating the effect of social enterprise activities on health

Conceptualising the public health role of actors operating outside of formal health systems: The case of social enterprise

Risk-based regulation and reforms to fitness to practise tribunals in the United Kingdom: Serving the public interest?

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