Mass layoffs in health: the irrationality of business reason in the public

Mr. Director,
The favorable present of the pandemic has brought consequences. One of them is the massive process of disengagement of health officials that, in the words of the Undersecretary of Healthcare Networks, Alberto Dougnac, is justified because “in the conditions of now they are not necessarily useful and we must adapt.” Beyond the insensitivity of the explanation, this is a measure as worrying as it is revealing.
It is worrying because, despite the positive progress of vaccination and the low positivity rate, the possibility of facing increases in infections has not disappeared. In addition, as the viral threat subsides, health services will have to resume postponed care, so it seems unwise to reduce medical personnel.
The latter connects us with the unveiling character of the measure. This logic of moving resources and people as if they were inventory stocks responds to the managerial way of managing the public known as New Public Management. [New Public Management]. Under this mode of administration, popularized worldwide in the 1980s, public services are organized according to the model of private enterprise, that is, the public is subject to the requirements of efficiency, productivity, cost reduction, among other issues. By the way, this has not been inocuous. As the report “When the market becomes deadly” (2021) by the Corporate Europe Observatory (CEO) shows, the decisive progress of the privatization of European health systems, with the consequent application of managerial logics to its administration, was co-responsible for the systemic inability to face the pandemic, since the cuts to the budget and the management of “zero stock” (that is, the policy of minimizing stocks to reduce costs) prevented proper preparation. Of course, the dynamic denounced by CEO is not a European exclusivity, but has been deployed throughout the world.
By conforming to this corporate way of approaching the public, the ministerial decision to drastically reduce the number of health personnel reveals the limited learning that the authorities have gained from the catastrophe. The evidence shows us eloquence that building robust public health systems is a state imperative and, for this to happen, the public must be oblivious to the impositions of business reason because they advance in opposite directions. Reflecting on the place that corresponds to the public in society will make the difference between effectively overcoming the crisis or just overcoming it under the latent risk of a new collapse.
Alvaro Muñoz Ferrer
PhD student in Philosophy, Universidad de Chile

Original source in Spanish