SHAPING HEALTH CARE
Since the middle of the twentieth century there has been a strong commitment in the Nordic countries to creating and enhancing welfare services. High-quality education, as well as health and social services, have been available to all citizens, free of charge. Costs are paid through taxes, which have traditionally been high. For the general public in these countries this has meant access to free education through university, and comprehensive quality health and social services. All of this has now begun to change. Nordic countries, like other western countries, are experiencing changes in the demography of the population and in an increased demand for services, which have, in combination, resulted in a considerable increase in financial pressure. As a result, attempts are now being made to lower costs by organizing the provision of healthcare services in different ways, limiting access and increasing public participation in the cost of care by introducing service fees. These changes have led to more emphasis on home care, increased participation of relatives as informal caregivers, and less access to institutional and formal services. Many policy-makers and politicians have a strong faith in market solutions and are encouraging increased outsourcing of services and the introduction of private companies in healthcare services.
These changes have created a healthcare system that is based on ideas and principles foreign both to the public and most healthcare workers. Although politicians still state that they are committed to maintaining the welfare state, the public is experiencing insecurity regarding some of their fundamental expectations. In light of decreased official support for health services, care of the sick and injured is no longer a certainty in Nordic countries, once renowned for their social services. These changes call for a forum for discussion regarding the development of healthcare services. This is the aim of the international, interdisciplinary ‘In Sickness and in Health’ conference to be held in Iceland in June 2004. It will be the second international conference addressing issues of power, practice and ethics in health-care, the first having been held in Melbourne, Australia, in 2002. The series was initiated by a group of nurses from different parts of the world who are interested in exploring the relationship between the state and the public as governmentality. The theme for the conference in Iceland is: ‘Shaping health care: Power and agency’. It will focus on ways in which healthcare workers and policy analysts can contribute to the creation of healthcare systems that successfully meet current needs of the population.
The main themes will include ethical issues in health-care in the twenty-first century; technologies and health-care for health promotion, diagnosis, treatment, rehabilitation, monitoring, communication and record-keeping; ideas of citizenship or governmentality applied to social, cultural, professional and political transformations in the organization of health services; the conduct of health professionals and individuals’ experience of illness; the framing of disease and health in the light of science and technology; and feminist perspectives on health, illness and health-care.
The conference will bring together scholars from diverse fields focusing on health and health services, such as nursing, medicine, allied health professionals, social scientists, historians, philosophers and geographers. The keynote speakers in Iceland this June will be: nursing scholar Mary Ellen Purkis from the University of Victoria in Canada; sociologist Alan Petersen from the University of Plymouth, United Kingdom; anthropologist Gisli Palsson, University of Iceland; and gender studies and sociologist Thorgerdur Einarsdóttir, University of Iceland.
‘In Sickness and in Health’ conferences provide a forum for international researchers, from a diverse range of disciplinary and professional backgrounds, to focus on critical scholarship pertaining to sickness and health in the twenty-first century. They provide the opportunity to examine the relationship between professional practices, policy-makers, and notions of health, treatment and the experience of illness. Out of this gathering we hope that new strategies will emerge to convince politicians and policy-makers of the importance of free and comprehensive healthcare services in the Nordic countries, and in the rest of the world.