British health systems and their values in the late 20th and early 21st century
What norms, values, and boundaries shape health systems and institutions in modern Britiain?
Join this event to hear new findings about the national-international borders of the English NHS, the history of the National Institute for Clinical Excellence and its ‘tragic choices’ on which health technologies to fund.
The Moral Making of the New 'Global' NHS - by Benjamin Hunter
Fair public healthcare systems are powerful tools for the promotion of the health of populations. But the pooling and spending of public resources needed to maintain such systems are highly contested processes and inevitably raise questions around institutional responsibilities and entitlements. This paper examines the disputed moral terrain for one public healthcare system – the English National Health Service (NHS) – and in particular the debates governing its national-international boundaries. How should a 'national' public institution approach issues of international knowledge transfer, recruitment and provision?
‘Tragic choices’: Which health care technologies should we fund and how should we decide? The National Institute for Clinical Excellence: a Contemporary History - by Paul Atkinson
This paper examines the history of the National Institute for Clinical Excellence (NICE)'s role in so-called tragic choices about which health care technologies will be funded by the NHS - examples famously include beta interferon, kidney cancer drugs, dementia drugs, and orkambi for cystic fibrosis. NICE has become a world leader in the application of health economics and in patient and public involvement in decision making. I will discuss why this activity has been delegated to an arm’s-length body, how NICE has sought to secure legitimacy (scientific and democratic) for its decisions, what challenges it has faced, and what NICE’s experience might show us about managing the moral dilemmas raised by the pursuit of cost-effective health care.
Benjamin Hunter, Lecturer in International Political Economy, Glasgow
Paul Atkinson, Senior Research Fellow, Institute of Population Health, University of Liverpool
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