Review

Markets in common

HEALTH CARE AND THE COMMON MARKET
Medical World/International Association of Health Policy, 1993, £4.00

Conference proceedings rarely read well, but this publication is topical and timely. Gone are the days when partisans of the NHS could say that it was the envy of the world. As our health service slowly turns into a European-style medical market we shall need to understand what happens elsewhere in Europe’s health services, rather than keeping a lofty and ignorant distance.

This slim volume has heavyweight contributors, including an MEP, a director of city health services from Bremen and five professors. On the whole, they have managed to avoid academic stodginess and managerial jargon. Germany and the Scandinavian countries are well represented but the Mediterranean countries are notable by their absence, apart from Italy.

Britain belongs to the Scandinavian group in terms of health care, and the comparisons are fascinating. Arthur Keefe provides a summary of changes in health and welfare services that is succinct and considered. Finn Diderichsen of Sweden describes how health service managers there are importing British ideas about the internal market to ‘solve problems that we do not have’. Birger Forsberg’s analysis of the political context of market changes in Sweden’s welfare state is valuable for us in the UK.

Some of the papers are exotic. Knud Pedersen argues passionately against the idea of prostitution being recategorised as ‘sex work’, while Stipe Oreskovic from Bosnia communicates sadness and powerlessness in a paper that is probably the most tightly argued and difficult academic contribution.

There is an enormous amount of food for thought in this publication. The meeting which generated it must have been even better!