The lesson for Europe

The relevance of the attempted French reforms for European governments is that healthcare and social reform can be risky stuff.

Right across Europe, governments are engaged in re-engineering their health sectors. In Britain, Foundation Hospitals are not some modish Blairite exercise in creating an NHS "third way", but — as the government said when it introduced the measures — the NHS's last chance to get it right. The billions of pounds Gordon Brown has thrown at the NHS over the last few years have concealed that message. But the underlying Government threat is still there: the NHS in its current form is unacceptable. Yet if the Government pushes too hard with reform, it could find it an even more unpopular issue that the Iraq war. But distrust of the Tories on key issues like the health service also helped the Government keep its own voters in line, despite misgivings on foreign policy.

Ireland, Italy, Switzerland, Denmark, the Netherlands, are also engaged in wholesale reform of their health services.

The third member of the Euro-3, Germany, is also grappling with health and social welfare reform. As is normal in Germany, this is being piloted in a particular state before being rolled out nationwide. The state in question is the governing SPD stronghold of Nordrhein-Westfalen (NRW). Well, SPD stronghold no longer. Because in last month's state election, the NRW electors threw out the SPD and installed a CDU administration for the first time in generations: a shockwave that has prompted German Chancellor Schröder to call a general election a year early.

The lesson for Europe's governments is that health and welfare reform may be essential, but they'll have to tread carefully and recruit public opinion to the cause — something Europe's governments have not been too good at. It's time to starting asking the frogs.


Healthcare reform helped French No vote

French public spending policy in crisis

France's national disease coding

DMP: the French EPR

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