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The Legitimacy of Healthcare and Public HealthHealth Inequalities and Ethics of Responsibility: A Comparative Ethnography

The Legitimacy of Healthcare and Public Health: Health Inequalities and Ethics of Responsibility:... [This chapter develops comparative reflections on healthcare practices in Italy and the UK. Although they share a constitutionally declared goal of guaranteeing citizens’ welfare and wellbeing, these two countries embody significant variations in the “access” to healthcare and in the service provided. In Italy, the decentralisation of the national health service has produced significant regional variations in people’s wellbeing, life expectancy and finances. Here, proper healthcare too often depends on how health service personnel choose to perform their duties and on individuals’ means, and willingness, to “buy” private care. Traditionally, Britain has successfully implemented a welfare system in which national health service (NHS) is central. Over time, however, the quality of the NHS has declined following the privatisation of some services, health staff shortage and cuts in public funds. Here, too, devolution has produced territorially diversified services. The ethnography brings out the tension between legislative and performance legitimacy and the legitimacy deriving from shared values that link institutional responsibilities and work ethics to communities’ expectations. It ultimately shows that the legitimacy of the system is challenged when legislation and bureaucratic regulations, instead of facilitating common welfare, generate inequalities and increasingly jeopardise people’s wellbeing.] http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

The Legitimacy of Healthcare and Public HealthHealth Inequalities and Ethics of Responsibility: A Comparative Ethnography

Editors: Pardo, Italo; Prato, Giuliana B.

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Publisher
Springer International Publishing
Copyright
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023
ISBN
978-3-031-25591-5
Pages
19 –43
DOI
10.1007/978-3-031-25592-2_2
Publisher site
See Chapter on Publisher Site

Abstract

[This chapter develops comparative reflections on healthcare practices in Italy and the UK. Although they share a constitutionally declared goal of guaranteeing citizens’ welfare and wellbeing, these two countries embody significant variations in the “access” to healthcare and in the service provided. In Italy, the decentralisation of the national health service has produced significant regional variations in people’s wellbeing, life expectancy and finances. Here, proper healthcare too often depends on how health service personnel choose to perform their duties and on individuals’ means, and willingness, to “buy” private care. Traditionally, Britain has successfully implemented a welfare system in which national health service (NHS) is central. Over time, however, the quality of the NHS has declined following the privatisation of some services, health staff shortage and cuts in public funds. Here, too, devolution has produced territorially diversified services. The ethnography brings out the tension between legislative and performance legitimacy and the legitimacy deriving from shared values that link institutional responsibilities and work ethics to communities’ expectations. It ultimately shows that the legitimacy of the system is challenged when legislation and bureaucratic regulations, instead of facilitating common welfare, generate inequalities and increasingly jeopardise people’s wellbeing.]

Published: May 4, 2023

Keywords: Italy; UK; Legitimacy; Health inequalities; Ethics of responsibility; Charity; Privatisation

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