英国购买式社区照顾服务模式的发展、改革及启示
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摘要
英国是当前福利国家中社区照顾历史最悠久的国家,迄今已逾六十年。英国社区照顾服务供给模式的建构深受新自由主义和新管理主义影响,这些意识形态主导了英国历届政府关于购买社区照顾服务的改革与完善。当前,我国正积极推进医养结合、长期照护政策,并确定社区为主的发展模式。本文在借鉴英国购买式社区照顾服务经验并结合中国国情的基础上,提出政府角色重新定位、积极扶持民间服务组织发展及完善购买式照顾服务法律体系等建议,以期减轻政府负担、增强照顾服务效率和提高照顾服务质量。
The United Kingdom is the longest-serving community in the welfare states,and has been serving for more than sixty years so far. The construction of community care service supply model in the United Kingdom is deeply influenced by the neo-liberalism and neo-managerialism,which dominated the reform and development of purchasing community care services. Presently,China is actively promoting the government to purchase pension services of public health care combined with the long-term care,especially policy and determination of community-based development of an elders' service model. Based on the purchased services experience of the United Kingdom combined with the situation in China,this paper puts forward some suggestions such as the repositioning the role of the government,actively supporting the development of civil service organizations and perfecting the legal system of care services to be purchased,supporting the development of proposals to reduce the burden on the government and enhance the efficiency of care services through improving their quality.
The United Kingdom is the longest-serving community in the welfare states,and has been serving for more than sixty years so far. The construction of community care service supply model in the United Kingdom is deeply influenced by the neo-liberalism and neo-managerialism,which dominated the reform and development of purchasing community care services. Presently,China is actively promoting the government to purchase pension services of public health care combined with the long-term care,especially policy and determination of community-based development of an elders' service model. Based on the purchased services experience of the United Kingdom combined with the situation in China,this paper puts forward some suggestions such as the repositioning the role of the government,actively supporting the development of civil service organizations and perfecting the legal system of care services to be purchased,supporting the development of proposals to reduce the burden on the government and enhance the efficiency of care services through improving their quality.
引文
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[16]顾江霞,罗观翠.试论政府购买社会服务项目的责信机制—基于H市政府购买社会服务项目实践的经验[J].华东理工大学学报:社会科学版,2010(4):108-116.
[2]佚名.全科医生小词典—社区照顾[J].中国全科医学,2014(34):3785-3785.
[3]Philippa H Tmobranski BSc MSc RGN RHV Cert Ed.Implementation of community care policy in the United Kingdom:will it be achieved?[J].Journal of Advanced Nursing,1995,21(5):988-995.
[4]Nachtnebel M,O'Mahony A,Pillai N,et al.Effectively engaging the private sector through vouchers and contracting-A case for analysing health governance and context[J].Social Science Medicine,2015,145:193-200.
[5]Le G,Julian.Quasi-Markets and Social Policy[M].Quasimarkets and social policy.Macmillan,1993:1256-1267.
[6]Johnson N.The Privatization of Welfare[J].Social Policy&Administration,1989,23(1):17-30.
[7]Waring J.Looking back(and forwards)at general management:30 years on from the Griffiths Report[J].Journal of Health Services Research&Policy,2013,18(4):249-250.
[8]王雯.英国撒切尔、卡梅伦政府两轮福利缩减改革比较[J].广西大学学报:哲学社会科学版,2013(6):77-82.
[9]Syrett K.A Technocratic Fix to the“Legitimacy Problem”?The Blair Government and Health Care Rationing in the United Kingdom[J].Journal of Health Politics Policy&Law,2003,28(4):715-746.
[10]Smith,Randall,Morbey,et al.From Community Care To Market Care?[M].2002.
[11]李菲雅,蒋若凡,邓翔.后危机时代的抉择:凯恩斯主义还是新自由主义[J].河北经贸大学学报,2013(6):21-25.
[12]Patulny R.Social rights and social capital:Welfare and cooperation in complex global society[J].Australian Review of Public Affairs,2005,6(1):59-75.
[13]Warren J,Wistow J,Bambra C.Applying qualitative comparative analysis(QCA)in public health:a case study of a health improvement service for long-term incapacity benefit recipients.[J].Journal of Public Health,2014,36(1):126-133.
[14]Geary C.Partnerships for Service Delivery Offer Local Governments Alternatives[J].Nations Cities Weekly,2010(43):4.
[15]陆春萍.我国政府购买公共服务的制度化进程分析[J].华东理工大学学报:社会科学版,2010(4):102-107,116.
[16]顾江霞,罗观翠.试论政府购买社会服务项目的责信机制—基于H市政府购买社会服务项目实践的经验[J].华东理工大学学报:社会科学版,2010(4):108-116.