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RPS 1 2017

Sono online i free text relativi al Tema del n. 1/2017: Servizio Sociale e welfare.

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health and care system

Editor’s note

Articolo scritto da:

Following a still recent custom, this issue of «Rps» reprints the contributions to the journal’s second annual Forum. It is a discussion that took place in November 2006 on the subject of various aspects of the Italian health-care system, and reprinting it was a complex matter: we did not want a mechanical reproduction of the original talk, but something rethought and rewritten by the speakers as much as possible. Not the least of the complications for this edition was our desire to publish the whole material in English too, convinced as we are that reflection on the social situation in Italy has a vital need of contributions from abroad. only subscribers can see the full article

Betty Leone

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I welcome the decision to devote a session of the seminar on health and welfare policies to issues related to a proper definition of informative system aimed to transferring knowledge among health workers, and from them to the general public, and vice versa. The debate is not new. On the contrary, it characterized the ’70’s and ’80’s in the period of health service reform and it was later taken up again during the discussions that led to the law (no. 328/2000) on welfare reform. Indeed, it is clear that this subject meets various needs. The first is that of identifying the needs to which we are to respond: this is an essential function if the services are not to fall into a merely self-referential logic rather than responding to the need to meet the general public’s requirements effectively. only subscribers can see the full article

The Integration that We Lack, and that We Need

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I want first of all to concentrate on one important aim that has guided Rps in organising this Forum on welfare integration: placing the accent on the concept of «integration» rather than on that of «social-health», understood as a system of services, and this aim is particularly important for me. We can talk about welfare integration in various ways, meaning aspects that are also very different and potentially in conflict with each other. On the one hand, we hear talk of social-health integration as if it were the more or less official name for a sector, a synonym of the social-health sector, that accompanies the health and the care sectors. only subscribers can see the full article

Data Policy in the Social and Health Sector. A Focus on Municipal Expenditure

Articolo scritto da:

Returning to the thoughts in earlier essays on the difficulties for the functioning of the health and social services caused by an ongoing lack of information, this article considers the question of data policy in the welfare sector. This aspect is one of the enabling conditions for integration in both welfare policies and social policy in general, and is the basis for an effective and efficient functioning of the health and social system, understood as all those services and interventions that include care and social integration, treatment, prevention and protection. only subscribers can see the full article

Paolo Ferrero

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First of all I’d like to thank you for your invitation to contribute to this Forum. Various problems seem to have emerged, and I’d like to try and talk about them. Apart from some criticisms relating to questions of organisation, I particularly want to draw attention to a specific problem, that of the essential levels of care, with special reference to the question of non-self-sufficiency. I want to talk about it in cultural as well as political terms, though in this latter sense our policy on this should start to be implemented in the next few months. I start from one element for evaluating the present situation. It seems to me obvious that — and here I agree with the judgments given — the social sector is much less protected in the constitution than the health sector. Traditionally there has always been a strong difference in the level of services in our country.only subscribers can see the full article

The Application of the Principles of Good Management to Health. Role of the Health Units and Centrality of Local Systems

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Integration in welfare policies, like the management of the processes of change in our welfare system are often dealt with and analysed from the perspective of the policy maker. In our country this is a response to a deficit in implementing and evaluating public policy and, still more, to the need for a more pragmatic approach to reform in the various areas of state intervention. This perspective becomes indispensable in the health sector, in particular, where the eternal debate on the public-private relation, on the costs of the national health service, or on the inadequacy of our services in relation to continually evolving health needs and demand, almost inevitably lead to large-scale questioning of the reforms carried out, starting from law 833/78, without there being any careful evaluation of the impact and the real effects of these interventions. only subscribers can see the full article

Essential Levels of Welfare: Cash Benefits and Services

Articolo scritto da:

When we talk about health, social and welfare services it is useful to refer to health and wellbeing. They are two concepts that significantly overlap and mutually interfere with each other, and are difficult to separate out even in our own lives. Health influences wellbeing and vice versa, and we do not know where health ends and wellbeing begins. Legally, politically and administratively, in organising and providing services, the distinction and the separating out is a necessary phase. However, when they have been separated out, they need to be brought back together again. The first separation of the two is in the Constitution, where protecting the right to health is different, more precise and detailed, while the protection of social rights is weaker. This formulation is linked to a work logic, a logic that has been important in history, but is now reductive in terms of universalism.only subscribers can see the full article

Sandro Del Fattore

Articolo scritto da:

I want first of all to consider a question: what made Cgil decide to take up the subject of integrated policies? We came to that point trying above all to understand what were the most critical features of the traditional welfare system compared with present innovations in this economic and social context. We set off in this direction because we were convinced that welfare is best defended if its critical features are rationally identified and new proposals put forward. Let us analyse some of its characteristics. First, we all know about the extraordinary changes in technology and production that have revolutionised the modern world, starting from the field of computers and communications. We also know about the potential of technology to provide greater autonomy, planning capacity for the workers themselves, and opportunities for a qualified job or a job that is deliberately chosen.only subscribers can see the full article

Social Policies: Governing through Fragments?

Articolo scritto da:

I’d like to continue in the same direction as the other papers, analysing what we are trying to define as a welfare system. It’s a very particular system, incomplete, and which at the moment can at least be rebuilt theoretically. In fact, in considering social and health policies, we come up against the difficulty of having fragments rather than a real system: something that actually is more like a nebula, an archipelago or a system of archipelagos. Much has been written on whether social policies make up a system or not, and there are in-depth analyses and case histories; despite the lack of useful information, particularly as regards databases, for making decisions and evaluating results, there is an overall survey of these policies in the literature. The thoughts advanced in this debate too suggest that we actually know quite a lot about this «system».only subscribers can see the full article

Apocalyptic Scenarios and Integrated Policies: Reasons and Problems of a Fund for the Non-Self-Sufficient

Articolo scritto da:

A response to the problems of the elderly who are no longer self-sufficient is today the point where we can most immediately assess our capacity to draw up innovative public policies and develop techniques and instruments for integrating the social services and the health service. The institutional, financial, organisational and professional innovations that now appear necessary for running both the health service and the social services need to offer practical solutions to the specific problem of the aging of the population, but also have a high symbolic value in relation to the role of the public sector in solving collective problems and empirically verifying the capacity of both these systems to radically renew themselves. only subscribers can see the full article