SciELO - Scientific Electronic Library Online

vol.16 issue6New professionalism, medical education and healthcare systemsEvidence of the public-private mix in healthcare systems in countries with duplicated coverage: greater inequities and segmentation in National Health Systems author indexsubject indexarticles search
Home Page  

Ciência & Saúde Coletiva

Print version ISSN 1413-8123


FREIRE, José Manuel  and  REPULLO, Jose Ramon. Good governance of publicly-produced health services: ideas for moving forward. Ciênc. saúde coletiva [online]. 2011, vol.16, n.6, pp.2733-2742. ISSN 1413-8123.

The good performance of publicly-produced health services is of vital importance, well beyond the health sector. Taking into account the great complexity of the health services in the public sector due both to their public and professional nature, we identify seven Gordian Knots as being responsible for the most frequent problems of publicly produced health services in Spain and Latin America. From the concept of good governance we take its character as a normative and ethical benchmark and its potential to renew and invigorate the government of the public sector. From comparative analysis of publicly-produced health services in the best performing countries, we extract eight characteristics which contribute significantly to good performance. A final reflection is on the relevance of the importance of offsetting the potential hostility to a reformist impulse of the status-quo with alliances that strengthen public trust and the social contract between health professionals and citizens based on the values of public health systems.

Keywords : Good governance; Publicly-produced health services; Management; International comparisons; Contractual management; New public service.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )