Reorganising Hospital Medicine and Nursing in Europe

Abstract

It will not have escaped the notice of anybody who happens to be living in Europe at this time that the organisation of health care services has been and continues to be in a seemingly permanent state of flux. In some countries this is perhaps more noticeable than others, but no health system is free of the challenge of change. The dynamic for this process has been primarily, but not solely, one of controlling costs, but the modernising of health services delivery within Europe has proved to be not simply one of financial stringencies. Coping with the cost implications of the raised expectations of the citizenry and of new medical and related technologies at the same time as trying to control rising public expenditure levels generally has meant governments attempting to change the rules of the game and not only finding new ways of funding health care but also trying to reconfigure the social and cultural expectations of the users and the professionals. This first chapter sets the scene for the more elaborate analysis in Chapter 2 and the series of four comparative case studies to follow.