Suchergebnisse

The economic effects of the financial crisis in the eurozone have been much studied, but the impact of political and institutional changes made amidst crisis conditions have been less studied. This article examines the changes in the EU since 2008 through the lens of T.H. Marshall's concept of citizenship, gauging the effects of different changes in the EU polity on the citizenship rights of individuals. The key changes are in fiscal governance, which includes a new treaty as well as substantial legislation changing the balance of powers within and competencies of the EU institutions, the European Central Bank's role and the Troika arrangements for countries in crisis. We find that while the EU's contribution to civil citizenship in Europe is relatively intact, the development of its fiscal governance is bringing serious negative consequences for political and social citizenship in all member states. The EU is adopting policies that entrust more power to less democratically accountable institutions with the objective of fiscal rigour rather than social citizenship.

This article asks who works in Whitehall today. We argue that there are points of consensus about the nature of 'Whitehall', including generalism, internal labour markets, Oxbridge education, and lifetime careers. An analysis of 306 biographies of the top team of the UK civil service, which goes beyond existing published use of biographical data on the topic, allows us to compare the civil service with this model. We find that in every respect the descriptive usefulness of a Whitehall model is weak. Whitehall is no longer marked by internal labour markets, Oxbridge dominance, or lifetime careers, and there are signs of reduced generalism. Furthermore, many of the most politically salient departments appear to be leading the way towards a different public sector model premised on managerial, policy expertise rather than civil service generalism and loyalty.

Since devolution, the United Kingdom has evolved not only in terms of political representation but also in terms of the relationships between civil servants in each of its regions and nations. In this paper, we present an analysis of the distinct professional and educational backgrounds of elite civil servants in Scotland, Wales, and Northern Ireland. Using a new database of professional biographies of top officials across all four jurisdictions, we assess the extent to which devolved civil servants in these UK regions and nations are organizationally and professionally distinct from one another and from those in the UK-wide departments. We conclude that despite organizational change, the recruitment, demographics, and career structures of top officials in the four jurisdictions are actually quite similar. Comparing our findings to earlier studies by others, it seems that this is because the Cameron government appears to have overseen a resurgence of traditional civil servants.

US political debates often refer to the experience of "single-payer" systems such as those of Canada and the United Kingdom. We argue that single payer is not a very useful category in comparative health policy analysis but that the experiences of countries such as Canada, the United Kingdom, Spain, Sweden, and Australia provide useful lessons. In creating universal tax-financed systems, they teach the importance of strong, unified governments at critical junctures—most notably democratization. The United States seems politically hospitable to creating such a system. The process of creation, however, highlights the malleability of interests in the health care system, the opportunities for creative coalition building, and the problems caused by linking health care finance and reform. In maintaining these systems, keeping the middle class supportive is crucial to avoiding universal health care that is essentially a program for the poor. For a technical term from the 1970s, "single-payer health care" has proved to have remarkable political power and persistence. We argue it is not a very useful term but the lessons from such systems can be valuable for those contemplating movement toward universal health coverage in the United States.

AbstractVaccines against SARS‐CoV‐2 continue to be developed at an astonishingly quick speed and the early ones, like Pfizer and Moderna, have been shown to be more effective than many public health scientists had dared to hope. As COVID‐19 vaccine research continues to progress, the world's eyes are turning toward medicine regulators. COVID‐19 vaccines need to be authorized for use in each country in which the pharmaceutical industry intends to commercialize its product. This results in a patchwork of regulations that can influence the speed at which products are launched and the standards that govern them. In this research forum article, we discuss several key questions about COVID‐19 vaccine regulations that should shape research on the next stage of the pandemic response. We call for a research agenda that looks into the political economy of pharmaceutical regulation, particularly from a comparative perspective, including Global South countries.

The process of leaving the European Union (EU) will have profound consequences for health and the National Health Service (NHS) in the UK. In this paper, we use the WHO health system building blocks framework to assess the likely effects of three scenarios we term soft Brexit, hard Brexit, and failed Brexit. We conclude that each scenario poses substantial threats. The workforce of the NHS is heavily reliant on EU staff. Financing of health care for UK citizens in the EU and vice versa is threatened, as is access to some capital funds, while Brexit threatens overall economic performance. Access to pharmaceuticals, technology, blood, and organs for transplant is jeopardised. Information used for international comparisons is threatened, as is service delivery, especially in Northern Ireland. Governance concerns relate to public health, competition and trade law, and research. However, we identified a few potential opportunities for improvement in areas such as competition law and flexibility of training, should the UK Government take them. Overall, a soft version of Brexit would minimise health threats whereas failed Brexit would be the riskiest outcome. Effective parliamentary scrutiny of policy and legal changes will be essential, but the scale of the task risks overwhelming parliament and the civil service.