Monday, March 21, 2011

[EQ] Decentralization as a governance tool in health care

Decentralization as a governance tool in health care

The European Observatory on Health Systems and Policies, March 2011

The new Spring issue of Euro Observer looks at decentralization as a governance tool in health care.
Spring 2011 Volume 13, Number 1

Case studies on Norway, Spain and the United Kingdom highlight how decentralized arrangements work in practice in these countries.

Full text available for download PDF [12p.] at:

“…..A common challenge across the majority of countries in Europe is finding the appropriate level for the making and implementation of policy and administration, particularly in health care. Many countries have decentralized, recentralized and then decentralized again in an ongoing cycle, searching the right balance of efficiency and responsiveness in their health care system.


Looking at the arguments for and against, in many cases the same reasons are used to justify movement in opposite directions. So is decentralization purely a politically driven phenomenon or is it the wrong instrument used for the right objective?......” Jeni Bremner, Director, European Health Management Association, Brussels.



The complexities of decentralization

Centralizing England and decentralizing the United Kingdom:

The paradox of power in British health services

Health system decentralization in Spain: a complex balance

Recentralization 10 years later – success or failurein Norway?


The Observatory is a partnership between the World Health Organization Regional Office for Europe, the Governments of Belgium, Finland, Ireland, the Netherlands, Norway, Slovenia, Spain, Sweden, and the Veneto Region of Italy, The European Commission, the European Investment Bank, the World Bank, UNCAM (French National Union of Health Insurance Funds), the London School of Economics and Political Science (LSE), and the London School of Hygiene & Tropical Medicine (LSHTM).

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