anita stenta vili territorio:
chrith creasing pressure to contain public spending, a tightening of controls is looming in Spain, where the financing of the health service is most reminiscent of the British NHS before Labour imposed cash limits in 1976.
The Spanish health service is financed 70% from taxation and 30% from social security, with overspends covered by the general state budget.
It is generally recognised that initial budgets set for the year are inadequate and that more will be spent. On average the overspend amounts to some 10%: this would be the equivalent of a £3 billion annual overspend in the British NHS!
The result in Spain has been a cumulative health service deficit of £3.4 billion.
Perhaps the most open-ended commitment to spending on health is that in Italy, where the state-run health service was modelled on the structure of the 1974 NHS, and where the government is also aping Tory changes in hospital management, including the opting out of hospitals to form the equivalent of Trusts.
Budgets are allocated to regions by central government, but widely dismissed as 'unrealistic', giving regions a pretext for substantial over-spending.
Private
In addition, the system stipulates that if a patient has to wait more than four days for out-patient care, they are entitled to use a contracted private hospital, and the health service will foot the bill.
In the case of high-tech medicine, patients forced to wait more than a 'reasonable time' can even travel abroad to find treatment, with the bill paid by the state. The longest 'reasonable time' is defined as 120 days.
It is clear that Britain's waiting lists, like unemployment, are not fixed facts of life, but the outcome of political decisions and a capitalist system that is in FEATURE deep crisis.
As the Tory government sets about tightening the screws still further on NHS funding, forcing a new wave of hospital closures hitting almost every major city, their example will be closely watched by governments and employers throughout Europe.
A fightback that defeats this attack on the most popular of the services would strengthen the fight against all austerity policies across the continent.