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RPS 1 2018

Il numero 1 2018 in uscita ad aprile, dedica la sezione monografica a genere e welfare, con un focus sull’Italia in prospettiva comparata.

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health and care system

Paolo Ferrero

Articolo scritto da:

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

Articolo scritto da:

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

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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?

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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

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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

Mimmo Lucà

Articolo scritto da:

As President of the Parliamentary Commission on Social Affairs I’d like to offer a few brief thoughts on the subjects introduced here and on which there has been a discussion, offering an institutional point of view on the path to follow. I refer in particular to the law on non-self-sufficiency, which is being discussed by the Commission I chair, and which comes from a failure in the previous Parliament. The Hon. Zanotti dealt with it in the last Parliament, and this time too, there is a risk of it finishing on the rocks of financial covering. This law is based on the setting up of the Fund for non-self-sufficiency, and it is clear that if this fund is not adequately financed with the necessary resources to guarantee an essential level of services, then the law cannot be approved.only subscribers can see the full article

Labour Market and Professionalization of the Care and Health System in Italy

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This article presents and discusses some characteristic features of welfare work in Italy, to try and understand better some of the challenges that the welfare system is facing today and, still more, will be facing in the near future. To deal with this subject synthetically, I propose to start from two central elements in the development of the Italian labour market in this field. The first, in the social field, is that of the unofficial «carers», that is, the private care work provided mainly by immigrant women to old people who are not self-sufficient and to the disabled. The second, in the health field, is that of the acceleration of the professionalisation process in the last ten years. These two phenomena will involve discussion of the labour market, regulation of the professions and professionalism. only subscribers can see the full article

Care for the Non-Self-Sufficient in the Context of the New Unfinished Regionalism

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Traditionally the creation of a welfare state has tended to centralise the powers and functions of central government in contemporary legal systems, as central government is regarded as offering better guarantees of stability and universal social services than more local bodies. This «centripetal» tendency of the policies connected with the creation of the welfare state has been noticed by constitutionalists since the 1980’s, particularly as regards federal systems, where egalitarian policies aimed at redistributing wealth have often set off processes centralising powers and functions in federal authorities, because of the need to guarantee uniform welfare standards nation-wide, in the interests of substantive equality. only subscribers can see the full article

Rare Diseases as an Example of Contrasting Marginality

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in the issue
Nhs
Rare diseases are an heterogeneous set of human pathologies whose common features are the low frequency rate in the population (under 5:10,000, according to European criteria) and serious social and health problems associated with such a low frequency. Their number involves a consistent part of the population (approx. 6,000). These pathologies are little known and studied, often chronic and crippling, for which social and health interventions must include support for life and work choices to persons affected. Important public health initiatives are underway at both the national and international levels.only subscribers can see the full article