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