Centralisation and decentralisation in a crisis: How credit and blame shape governance

The COVID-19 pandemic led to unprecedented challengesand political creativity worldwide. In governance, this often led to unexpected centralisation and decentralisation in response to case surges. Changes in the distribution of power and responsibility throughout governments changed quickly as the pandemic progressed. Centralisation and decentralisation occurred within governments and between governments, as power shifted. The main explanation for the patterns of centralisation and decentralisation is the politics of credit and blame. Politicians at all levels seek to centralise when there is credit to be had from forceful action and decentralise when there are unpopular policies or bad news coming.

It’s the governance, stupid! TAPIC: a governance framework to strengthen decision making and implementation

This policy brief’s key messages are: governance is a broad and complex topic with many overlapping definitions, frameworks and recommendations, but governance concepts and ideas found in the literature can broadly be grouped into five key domains: Transparency, Accountability, Participation, Integrity and Capacity (TAPIC); governance is crucial to successful policy-making and implementation. It affects the likelihood that workable policies are adopted, that they are implemented, and that they produce intended results. At the same time, governance may be the cause of policy problems. But it is only one potential cause of problems, alongside other causes of failure such as inadequate finance.; each of the five domains of the TAPIC framework contains many different techniques for policy and procedural change. Rigorous and context-sensitive analysis is required to work out which domains contain governance problems and what those problems might be.

Everything you always wanted to know about European Union health policies but were afraid to ask

What does the European Union (EU) mean for health? What can it mean for health? This comprehensively revised second edition answers these questions. It provides a broad review and analysis of EU public health policies to mid-2019. It begins by explaining the basic politics of European integration and European policy-making in health, including the basic question of how the EU came to have a health policy and what that policy does. Thereafter, it moves on to the three faces of EU health policy. The first face is explicit health policy, both public health policy and policies to strengthen health services and systems in areas such as cancer, and communicable diseases. The second face is internal market building policies, which are often more consequential for health services, but are not made with health as a core objective. These include professional and patient mobility, regulation of insurers and health care providers, and competition in health care. They also include some of the policies through which the EU has had dramatic and positive health effects, namely environmental regulation, consumer protection and labour law. The third face is fiscal governance, in which the EU institutions police member state decisions, including relating to health. Each face has different politics, law, policy and health effects. The book provides a synthesis of the different faces and the different ways in which they have been used to strengthen or weaken public health and health systems in Europe. It shows the many, often unappreciated, ways that the EU has worked for health, as well as the opportunities to further strengthen the EU's positive impact on health. This book is aimed at policy-makers and students of health systems in the EU who seek to understand how the influence of the EU on health policy affects those systems and their patients. To ensure that the EU’s impact on health is wholly positive, the wider health community must understand and engage with the EU in the future – something this book aims to encourage.

Everything you always wanted to know about European Union health policies but were afraid to ask

What does the European Union mean for health and health systems? More than one would think. The EU’s health mandate allows for a comprehensive set of public health actions. And there are other EU policies, though not health related, which have important consequences for governing, financing, staffing and delivering health services. In other words: EU actions affect the health of Europe’s population and the performance of health systems. Given how important health systems are, we need an informed debate on the role of the EU and its contribution. But this is not easy because EU health policy is difficult to comprehend. There is no single strategy with a neat body of legislation implementing it; rather, there are many different objectives and instruments, some of which appear in unlikely places. Understanding the EU role in health is especially important now, when health systems have to deal with a plethora of challenges, the European social model is confronted by the threat posed by the financial crisis, and the EU is facing increasing euro-scepticism in politics. This short book makes EU health policy in its entirety (and complexity) accessible to political and technical debate. To this end the volume focuses on four aspects of EU health policy: the EU institutions, processes and powers related to health; the EU action taken on the basis of this health mandate; the non-health action affecting health and health systems; and, because of its growing importance, financial governance and what it means for European health systems. This book is aimed at policy-makers and students of public health and health systems in the EU who want to understand how the EU can add value in their quest for improving population health and the performance of health systems in Member States.