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1948年英国医院国有化改革是英国政府制度化干预医院管理的开端,它确立了英国医疗服务的医疗公平原则。医院国有化改革反映了英工党政府、公共舆论与医学利益集团之间的互动关系。二战爆发后,民众对国家接管医院与免费医疗的关注度高涨,不仅为工党执政提供了重要支撑,也促成了支持医院国有化改革的舆论形成。医疗公平是公众舆论的核心诉求。工党政府作出回应将医疗改革提上日程。医学利益集团则利用自身在专业领域及人力资源上的优势施加政治压力,企图使政府的决策更倾向于集团利益。工党卫生大臣安奈林·比万被迫调整改革方案,最终实现了医疗公平与改革的利益平衡。这场改革既是工党政府对公共舆论的迎合和反映,也包含着其与医学利益集团的斗争与妥协,是各方博弈均衡的结果。
The nationalization reform of British hospitals in 1948 was the institutionalization of the British government to intervene the beginning of hospital management. It established the principle of medical fairness in British medical services. The nationalization of hospitals reflects the interaction between the British Labor government, public opinion and medical interest groups. After the outbreak of World War II, people’s concern about the state taking over the hospital and free medical treatment have not only provided important support for the Labor Party’s ruling party, but also contributed to the formation of public opinion in support of the nationalized reform of the hospital. Medical justice is the core appeal of public opinion. The Labor government responded by putting health care reform on the agenda. Medical interest groups exert political pressure by utilizing their advantages in professional fields and human resources in an attempt to make the government’s decision-making more inclined to the interests of the group. Labor Health Minister Annette Lynch was forced to adjust the reform program, eventually achieving the balance of interests between medical treatment and reform. This reform is both a cynical fit and reflection of the public opinion by the Labor government, as well as a struggle and compromise between the reform and the medical interests groups. It is the result of a balanced game between the parties.