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The January OECD policy forum will address the future of healthcare with a focus on person-centred care (PCC) which is to be the “new normal” of tomorrow’s health systems. In addition, the Forum will consider ways in which healthcare spending can be improved by increasing efficiency and reducing waste. According to the OECD: “In a world of increasing complexity as well as opportunity, our healthcare systems simply must organize around the needs of the service user. A people-centred approach promises to raise quality, reduce waste and - most importantly – improve our health and well-being”.
PCC is a theme which has been taken up by numerous international agencies including the World Health Organisation (WHO). Underlying this shift to PCC is a change in focus from supply side of health systems to a greater emphasis on patient outcomes. In addition, patients themselves are required to “become better partners in ensuring they get the care they need” (OECD 2016a).
While such a move to greater coordination of health services and improved patient outcomes is highly desirable, this shift in health systems rhetoric needs to be set in the context of recent policy in practice. This Briefing Paper shows that, while there is considerable diversity across health systems, some common themes are emerging. In the past decade, public health systems across the world are facing extensive funding cuts. As part of current austerity programmes, health workers are under increasing pressure, with many enduring falling real wages as well as an increasing workload. Many countries have seen an increase in out-of-pocket payments for healthcare, and health sectors have been subject to extensive restructuring with a view to increasing market-like structures. Much of the restructuring has been to pave the way for increasing privatisation. In this wider context, the person-centred approach is at best largely peripheral to the major challenges facing intensely pressurised health systems and at worst, will shift greater responsibility on to individuals and households as well as private and voluntary health providers while public services are placed under greater strain.