A Comparative History of Health and Welfare in Europe

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Évora, 17 June 2002

Being a structural point of all societies, public welfare and attention to the poor and ill has always been a main problem for institutional power. The different ways in which every country tried to solve the problems related to well-being and people's health has varied over the years according to ideological contexts and financial resources. Yet, apart from the particularities from each State, there have been some moments in which all Europe has mobilised in search of answers for basically identical problems. For this reason, it is possible to individualise three great stages in European history that were, at the same time, moments of rupture of current social support systems and of modernisation of health and social solidarity structures. The first stage is the one of the decline of the feudal world and formation of Europe. The second one is the situation which arose from discoveries and economic globalisation. The third one occurred during the process of European industrialisation and ended up in the creation of the providence-State. The current collapse of the frontiers, the social problems arisen from the political de-structurization of Eastern Europe and the economic globalisation force us to rethink social policies nowadays. This means that Europe is living a new moment of rupture and transformation of both health and public welfare policies.

Demographic pressure in some countries, the lack of labour force in others, the existence of uncontrollable illegal migration, the urban chaos in almost all the big cities, the increasing number of outcasts, the social exclusion, the increasing criminality rate, specially among young people, the unemployment or poor working conditions, the increasing number of drug addicts and the catastrophic spread of aids, tuberculosis and hepatitis, show us that the whole world, and particularly Europe, is going through a period of civilizational metamorphose.

Although some of these problems are completely new, there are others which are endemic and have remained as a residual memory in some countries. What is new about this situation is that many of these problems have acquired an international projection due to market globalisation and the fall of the frontiers. Now, the only way to try to solve these problems – or at least take effective steps in order to avoid their spread and improve life conditions of those who have already been affected by disease, unemployment, poverty and exclusion – is one transnational collaboration. Still, in order to achieve this, it is necessary to rethink and radically transform the existing policies for social support. This effort will only be fruitful if it is based on an in-depth knowledge of the question so as to avoid the occurrence of isolated interventions of reduced range, oriented towards particular cases. Thus, there is a pressing need to carry out a minute analysis of the experience of each European country, examining its historical background, its structural problems at present and the different means that have been used in order to find a solution to such challenges, events and crises. It is also important to know the successes and the failures that they are having nowadays.