Science Space
Health Policy
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Michael Hill (1997) identified four ways of approaching the study and analysis of health policy: policy analysis; analysis for policy decision-making; analysis related to the results of health policies and, finally, the analysis of the political process. The approaches that are normally taken focus on organizations and structure of the National Health Service, and sometimes in relation to public health.
Many of the studies carried out have aggregate economic assessments that introduce standardized decision formulations. The scope of health policy analysis extends beyond the study and knowledge of formal health systems. Nowadays, environmental protection, sports promotion and participation, health and safety at work, food security, the health social system, protection initiatives, and social exclusion are considered to be an integral part of health policy analysis. The ideological debates that we have witnessed quite recently in the proposals advanced by the political parties for the new legislature are just one aspect of health policy.
Political activity and its analysis require a detailed and consistent study of power relations. Power is a conceptual instrument in any analysis of the development and implementation of health policies. The identification and exercise of formal and informal power reflect moral and political stances and are normally embodied in the specific concepts of the interests of groups or organizations.
Finally, a word for those involved in the conceptualization and implementation of health policies. Players have their own individual interests and are genetically different. National governments, local governments, health institutions, health professionals, payers, citizens/taxpayers/consumers have distinct situations, distinct timings and distinct evolutions. The analysis of the behaviour of players, both in global or more local terms, requires permanent monitoring of their interests and of the ideological debate that is underway at distinct times. The study of scenarios and their implications with regard to resource planning to ensure the possibility for choices when implementing health policies is of particular interest.
The National Health Plan is a public health planning tool which essentially lays down the priorities for political action. In other words, it is a document that states the priorities for public health intervention, associated to a political commitment to draw together the necessary resources to fulfil objectives and ensure the successful possibility of attaining the proposed goals, thus leading to gains in health, quality and efficiency.
The Institute has been offering an Open Access Course in Health Services Policy and Management for some years. This course has had a turnout that always goes over maximum student capacity. The course proposes a reflection on national and international health policies, and offers students the chance to visit and talk to health managers from public and private institutions. On the other hand, the teaching of Research in Health Sciences allows, in the areas of epidemiology, the creation of capacities to evaluate interventions based on political decisions.
Rui Portugal
Preventive Medicine Assistant
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Bibliography
Baggott, Rob (2007) Understanding Health Policy. Bristol: The Policy Press
Crinson, Ian. (2009) Health Policy. A critical perspective. London: SAGE publications.
Enthoven, A.C. and Tollen L.A. (2004) Toward a 21st Century Health System. San Francisco: John Wiley & Sons.
Hill, M. (1997) The Policy process in the Modern State (3rd ed). London: Prentice Hall.
McClughlin, Curtis P. and McLaughlin, Craig D. (2008) Health Policy Analysis: An Iterdisciplinary Approach. Sudbury, MA: Jones and Bartlett Publishers.
Ministério da Saúde. Plano Nacional de Saúde 2011-2016. Microsite: www.acs.min-saude.pt
Roberts, M.J. et al. (2004) Getting Health Reform Right. A guide to improving performance and equity. Oxford: Oxford University Press.
Stone, D. (2002) Policy Paradox. The art of political decision making (3rd ed). New York: W.W. Norton & Company.
Simões, J. (2004) Retrato Politico da Saúde. Coimbra: Almedina.
Walt, G. (1996) Health Policy. An introduction to process and power. (2nd ed). London: Zed Books.
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