Global challenges, global solutions? A cross-national comparison of primary health care in Britain, Norway and the Czech Republic

Abstract

Are current health policy changes leading to a greater degree of convergence in the health systems of European nations, or to a pattern of divergence? How can the degree of convergence/divergence be explained, and what can it tell us about local versus global impulses of change? The most common answer to these questions is that because the process of globalisation is driving different countries toward similar reform programs, their health systems converge at some common point. An alternative hypothesis is that each country has unique cultural, economic, political and historical traditions which are likely to override global changes, thus creating patterns of divergence. In this article, theories of globalisation and convergence are the theoretical foundation for a cross-national comparison of the development of primary health care in Europe. By comparing the development in three different countries between 1990 and 2005, converging and diverging paths are identified and explained.

Key Words:

• Primary health care
• health policy
• comparative sociology
• globalisation
• convergence
• Europe