Viola Burau

Healthcare governance, professions and populism: Is there a relationship? An explorative comparison of five European countries

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  • Emmanuele Pavolini, Department of Political Science, Communication and International Relations, University of Macerata, Via Don Minzoni, 22, 62100, Macerata, Italy. Electronic address:, Italy
  • Ellen Kuhlmann, Institute of Epidemiology, Social Medicine and Health Systems Research, Medical School Hannover, OE 5410, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Medical Management Centre, Karolinska Institutet, Stockholm, Sweden. Electronic address:, Germany
  • Tuba I Agartan, Takemi Fellow in International Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, Room 1210A, Boston, MA, 02115, United States; Health Policy and Management Program, Providence College, 1 Cunningham Square, Providence, RI, 02918, United States. Electronic address:, United States
  • Viola Burau
  • Russell Mannion, Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Birmingham B15 2RT, UK. Electronic address:, United Kingdom
  • Ewen Speed, School of Health and Social Care, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK. Electronic address:, United Kingdom

A new wave of support for populist parties and movements represents a serious threat to universal healthcare coverage in traditional liberal democracies and beyond. This article aims to contribute empirical material on the relationships between healthcare governance, professions and populism. It applies an explanatory cross-country comparative approach and uses mixed methods, including micro-level data garnered from international comparative databases and documents. Denmark, England, Germany, Italy and Turkey have been selected for comparison, reflecting different types of healthcare systems and populist movements. The results reveal variety in the ways populist discourses impact in healthcare. Abundant economic resources, network-based governance, high levels of trust in healthcare providers and doctors participating as insiders in the policy process seem to work as a bulwark against populist attacks on healthcare and professional expertise. On the other hand, poorly resourced NHS systems with doctors as outsiders in the policy process and major NPM reforms together with low to medium levels of trust in healthcare providers may be fertile ground for populist discourse to flourish. Our explanatory data provide hints of correlations, which may inform further studies to investigate causality. Yet the research highlights that healthcare governance and professions matter, and brings into view capacity for counteracting populist attacks on universal healthcare and professional knowledge.

Original languageEnglish
JournalHealth Policy
Pages (from-to)1140-48
Number of pages9
Publication statusPublished - Oct 2018

    Research areas

  • health policy, health professions, healthcare governance, populism, new public management reforms, European comparison

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