Abstract
During the 20th century, Greece was confronted with serious problems and challenges in the health sector that - given the particular social, economic and sanitary conditions of that period - made necessary the Greek state to plan and implement integrated and evidence based reforms and regulatory changes in order to improve the health system's performance and the health of the population as well as to deal with the malfunctions of the health services. In these circumstances, an important role was played by academic specialists and health experts who, with their scientific knowledge and experience in different areas of health policy, supported the work of the development and modernisation of health services, through the preparation and drafting of special reports and studies on health issues that were of particular concern and priority at a national level. These expert's reports aimed to gather reliable information and data on the situation and problems of the Greek health system as well ...
During the 20th century, Greece was confronted with serious problems and challenges in the health sector that - given the particular social, economic and sanitary conditions of that period - made necessary the Greek state to plan and implement integrated and evidence based reforms and regulatory changes in order to improve the health system's performance and the health of the population as well as to deal with the malfunctions of the health services. In these circumstances, an important role was played by academic specialists and health experts who, with their scientific knowledge and experience in different areas of health policy, supported the work of the development and modernisation of health services, through the preparation and drafting of special reports and studies on health issues that were of particular concern and priority at a national level. These expert's reports aimed to gather reliable information and data on the situation and problems of the Greek health system as well as to prepare positions, proposals and recommendations for evidence-based policy-making that could contribute to the effective organisational and operational restructuring of health services and to the improvement of the quality of delivered care.Moreover, the reports aimed to provide the appropriate interpretative and diagnostic preparation for the institutionalisation and implementation of the changes and interventions that the health system needed, taking into account the health needs of the population, the available resources and the socio-political factors that influenced, in each period, the decision-making process in the health field.In this context, the research made in the present PhD thesis entitled "Expert reports on health policy in Greece (1920-2004): social conditions and political reality of reforms", aims to critically examine the trajectory of health reforms in Greece during the 20th century and to analyse the most important expert's reports on health policy issues with ultimate goal to be identified the degree of contribution of these reports to the formation of the national health policy, to evaluate the systematicity of preparation and drafting process of the reports, and to highlight the major policy areas and priorities for the reorganisation of the health system and services, based on the experts' proposals and findings.In the theoretical part of this thesis, an overview of the interpretative approaches and theoretical paradigms for the organisation and operation of health systems, as well as for the administration, financing and delivery of health services is undertaken, while particular emphasis is given to the directions and objectives of reforms, in the light of the contemporary challenges facing health systems and services. As far as the research part is concerned, an attempt is made to describe the health policies that have been implemented in Greece since the establishment of the Greek state, followed by a detailed study and analysis of the expert reports that were prepared during the period 1920-2000 to support the process of reforming the Greek health system, which concludes with the presentation and discussion - as a special case study - of the report of the Health Organization of the League of Nations (1929) for the sanitary reorganisation of Greece.The findings and conclusions that emerge in the context of this thesis, highlight the duration and intensity of reflection on the major problems of health policy in Greece throughout the 20th century, while at the same time reveal the contribution of expert reports in promoting the necessary reform initiatives for the reorganization of the health system and in supporting evidence-based decision making process in the context of national health policy.
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