The crisis of the State-nation led to a consolidation of sub-national levels of government. This reinforcement has conditioned recent developments in the welfare state, and particularly in health policy. With reference to the Italian case, the article illustrates the main changes brought into force by the reforms of 1992-93 and of 1999 in terms of the «regionalization» of the health system, and outlines the main steps that led to fiscal federalism, enhancing regional financial autonomy. The closing paragraph takes into consideration possible implications of the process of European integration and, more specifically, the adoption of the Open method of co-ordination on the evolution of the regional health systems.only subscribers can see the full article

In the paper the author analyses the Italian Health spending in relation to public spending, and proposes a new accountability pact between central government and the regions, aimed at relaunching the National Health Service. Following an historical overview of the foundation of the Nhs and the reforms in the 70s and 90s, the relation between funding and spending from 1999 to 2004 is analysed in the light of documents produced by Institutions and Research Institutes, and compared with other European countries. The paper also presents a detailed analysis of health legislation concerning the regions adherence to the Stability Pact, the agreements signed at the State-Region Conference and the critical financial situations presently registered. Lastly, it examines article 119 of Title V of the Constitution and the new funding system of local authorities which it introduces.only subscribers can see the full article

The article gives an overview of some aspects of a Formez Research which is still underway, entitled «Emergent courses of integrated social and health planning». The paper examines the first part of the study that considers four regions in the centre-north: Toscana, Lombardia, Veneto, Emilia Romagna. Focus is placed on the analysis of strategies, objectives, courses, actors and tools provided for the realization of social-health integration. The aim is to provide a useful comparative framework of emergent trends from the experiences already conducted and form innovations underway to create shared know-how and common perspectives.only subscribers can see the full article

The article examines the emergence of new «spaces of social citizenship» at sub-national level in Italy with reference to welfare policies. In this sector, intermediate levels have traditionally had a major role since the Regions were first set up, and this has gradually extended to the attribution of exclusive responsibility in the matter, thanks to the recent reform of section V of the Constitution. After tracing the historical development of welfare policies in Italy, the article analyses the differences that exist at regional level in terms both of expenditure and of services offered. only subscribers can see the full article

The article analyses the theme of institutional accreditation in Italy, its implementation problems at the regional level in the framework provided in national legislation, and the experience of two regions, Emilia Romagna and Lombardia, which developed different accreditation models. In order to do this, national indications and the role assigned by the norm to the regions on accreditation are considered, together with the delays of the central level and those connected to the process of power devolution to the regions culminating in the modification of Title V of the Constitution. The analysis of some economic, cultural and political problems within the regions, which have influenced the modalities and start-up times of accreditation policies, introduces the accreditation models of Emilia Romagna and Lombardia, that are examined on the basis of different responses given to common critical aspects.only subscribers can see the full article