Austerity or Xenophobia? The Causes and Costs of the "Hostile Environment" in the NHS
Austerity or Xenophobia? The Causes and Costs of the "Hostile Environment" in the NHS
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DOI：
10.1007/s10728-019-00374-w
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发表时间：
2019-09-01
影响因子：
1.9
通讯作者：
Shahvisi, Arianne
中科院分区：
文献类型：
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作者：
Shahvisi, Arianne
在财政紧缩时期，英国政府以公平和节俭为理由，逐步限制向海外游客提供免费医疗服务。尽管新系统所需的额外官僚机构的成本和公共卫生后果预计将超过节省的资金，但这一数字仍在增长。在这篇文章中，我探讨了紧缩和仇外心理的话语之间的相互作用，因为它们与移民获得医疗保健有关。通过对现有数据的研究和对各种道德论点的评判，我对当前收费规定具有成本效益和公平性的说法表示怀疑。相反，我认为，如果英国想要经营一种经济上可持续、道德上站得住脚的医疗服务，就必须欢迎移民，无论是作为工作人员还是作为患者。最后，我认为，仇外心理促成了保健服务的变化，这些变化不符合所声称的紧缩方式，而是故意为移民创造了一个敌对的环境，尽管这很可能造成经济损失。
During the age of austerity the UK government has progressively limited free health services for overseas visitors on the grounds of fairness and frugality. This is despite the fact that the cost of the additional bureaucracy required by the new system and the public health consequences are expected to exceed the sums saved. In this article I explore the interaction between the discourses of austerity and xenophobia as they relate to migrants' access to healthcare. By examining the available data and adjudicating various moral arguments, I cast doubt on the claim that the current charging regulations are cost-effective and fair. I instead contend that if the UK is concerned with running a health service that is economically-sustainable and morally-defensible, it is critical that migrants are welcomed, both as staff and as patients. I conclude by arguing that xenophobia has precipitated changes to the health service which do not qualify as austerity in the way that is claimed, but rather deliberately produce a hostile environment for migrants, despite this very likely generating economic losses.