1st Edition

National Health Services of Western Europe Challenges, Reforms and Future Perspectives

Edited By Guido Giarelli, Mike Saks Copyright 2024
    340 Pages 16 B/W Illustrations
    by Routledge

    This book draws on research within neo-Weberian and neo-institutionalist perspectives to critically analyse National Health Services (NHSs) in Western Europe. Exploring the challenges posed by neo-liberal policies, it also looks at the impact of the role of the state, the medical profession, the public and the medical–industrial complex in their development.

    Bringing together a top-line range of expert international contributors, this book includes national studies from three European macro-regions: Britain, Scandinavia and the Mediterranean. In the first part, the NHSs of each country considered are examined historically and in a contemporary context in face of emerging challenges – from cost containment to governance. The second part looks across the macro-regions at the influence of the main actors involved in their evolution and sustainability. Comparing and contrasting the NHSs of Western Europe, the book ends with a discussion of future directions.

    This book makes a vital contribution at a time when health services globally have been under great pressure in the wake of the COVID-19 pandemic. It is written for academics and advanced students of healthcare, management, public policy, social policy and sociology – in addition to health professionals and policymakers.

    1 - Introduction: The national health services of Western Europe: A historical-comparative perspective

    Guido Giarelli and Mike Saks

    2 - England

    Rob Baggott

    3 - Wales and Scotland

    David Hughes

    4 - Sweden

    Paula Blomqvist and Ulrika Winblad

    5 - Denmark

    Karsten Vrangbæk

    6 - Norway

    Pål E. Martinussen and Jon Magnussen

    7 - Italy

    Giovanna Vicarelli

    8 - Spain

    Ana Marta Guillén and Sigita Doblytė

    9 - Portugal

    Joana Almeida

    10 - Greece

    Charalmbos Economou

    11 - The changing role of the state in a neo-liberal healthcare policy arena

    Guido Giarelli

    12 - The evolution of medical and health professions in the national health services

    Mike Saks

    13 - The participation of patients and the public in the national health services

    Mauro Serapioni

    14 - The role of the medical-industrial complex in the national health services

    Mike Dent

    15 - Conclusion: Challenges, reforms and future perspectives

    Guido Giarelli and Mike Saks


    Guido Giarelli is Professor of Sociology at the Magna Græcia University of Catanzaro, Italy.

    Mike Saks is Emeritus Professor at the University of Suffolk, UK, where he was previously Research Professor in Health Policy.

    “This timely collection by leading experts will be an excellent resource for academics and practitioners alike as the need to agree on criteria for establishing good healthcare becomes ever more urgent. Highly recommended.” – Graham Scambler, University College London, UK


    “At a time when national health services across Europe are facing huge pressures, there is an urgent need for a book which maps their changing features and considers how they can be sustained. This excellent edited collection provides a detailed understanding of these issues and the key actors involved and offers some proposals for their futures direction.” – Jon Gabe, Royal Holloway University London, UK


    “[This] is an example of solid scholarship, an excellent, illuminating and much needed book that students of comparative welfare, policy makers, health professionals and concerned citizens cannot afford to miss.” – Alberto Martinelli, University of Milan, Italy


    “Neo-liberalism is frequently offered as an explanation for many of the observed changes to healthcare systems and other dimensions of social or economic life; yet the concept is rarely unpacked or explicitly articulated. Thus it is refreshing to find a volume which provides this. The new book by Giarelli and Saks documents and investigates the varying ways in which neo-liberalism has impacted the National Health Service (NHS) styled healthcare systems of Western Europe. It offers an analysis of the contemporary healthcare field, and addresses the question that many of us have been asking. Has there been an overall convergence into a single 'type' of system, given that private medicine and the marketisation of services and facilities have been embraced and appear to now characterise many (or perhaps most) systems?” – Fran Collyer, Australian National University, Australia for Health Sociology Review


    “National Health Services of Western Europe makes a timely contribution to the comparative social policy literature at a critical juncture for the national health service (NHS) type across Europe...This volume is an excellent theoretical and empirical resource for scholars and students of comparative social policy which makes an important contribution to the discipline and will be a useful addition to comparative social policy reading lists.” – Tom Hoctor, University of Bedfordshire, UK for Social Policy & Administration