No health without peace. Nothing more to say.

The right to health was laid out in the Universal Declaration of Human Rights, reaffirmed in the Alma Ata declaration, and remains embedded in contemporary WHO priorities. There is no credible path to achieving it that can run through perpetual conflict. Responding to the health consequences of war is necessary, but it cannot substitute for the conditions required to build, protect, and sustain health systems. Ambitions for equity, resilience, preparedness, and universal access cannot be realised amid chronic insecurity. 

Peace is not adjacent to health—it is foundational.

The Lancet editorial (2026) (pdf Volume 407, Issue 10523, 1)

Photo Jordi Soldevila. Geometries de la injustícia. Desesperació.
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The future hospital in Global Health Systems

Future hospitals must be able to adapt in many ways to the changing demands on their roles and functions within evolving healthcare delivery infrastructures. These include changing population structures and needs, new models of healthcare provision, technological advances, and innovations in design, all while enhancing their environmental sustainability.

This article sets out the issues that those determining healthcare policy and designing future hospitals must consider if they are to become and remain fit for purpose within the wider health and social care system. It also examines the need for, and challenges to, strategic healthcare planning, creating future hospitals that are sustainable, net‐zero carbon organisations, and ensuring resilience in the face of a range of potential shocks.

Future hospitals play a crucial role in healthcare worldwide, regardless of the country's income level. Hospitals cannot be viewed without broader health system changes, infrastructure, community and cultural factors, staffing and other considerations. Future hospitals will enhance population health in all settings and support the move towards more consumer‐centric healthcare. The authors urge clinical and policy planners to consider the factors discussed carefully to maximise the benefits.

Article (2025) open access

Sebire NJ, Adams A, Celi L, Charlesworth A, Gorgens M, Gorsky M, Landeg O, Nagasawa Y, Nimako KT, Onoka C, Roder-DeWan S, Watts N, McKee M. The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System. Int J Health Plann Manage. 2025 May;40(3):741-751. doi: 10.1002/hpm.3891. Epub 2025 Jan 15. PMID: 39815953; PMCID: PMC12045726.

Photo Jordi Soldevila. Posidònies. Cicatriu 1

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The Great Resignation: Why women health workers are leaving

The ‘Great Resignation’ of women health workers is impacting women and health systems globally, with a concerning ‘Great Migration’ trend. This exodus exacerbates the existing health worker shortage crisis, affecting countries striving to achieve universal health coverage.The report published in October 2023 by Women in Global Health explores these issues in depth and calls for gender-transformative solutions to address workforce imbalances.

Countries competing for increasingly scarce trained health workers challenge the principles of global solidarity and ethical international recruitment, enshrined in global agreements like the WHO Code (WHO Code on the Practice of International Recruitment of Health Personnel)

"The WHO Code encourages all member states to act in solidarity, produce sufficient health workers domestically and invest in supporting countries with vulnerable health systems to strengthen their health workforce"

Health workers take years, sometimes over a decade to train, so lead times are long for producing the millions of new health workers needed to fill the gap. The urgent issue now is retaining trained health workers and reversing attrition from the sector.

Replacing domestic health workers with international recruits may just be putting new recruits into the same broken systems that caused the domestic health workers to leave. Coordinated action by governments is needed urgently to address health worker attrition in the short term and plan longer term to fill health worker shortages sustainably without reliance on unethical international recruitment.

The central role played by women health workers in the pandemic, along with the health and psychological impacts they endured in the course of their work, has placed a spotlight on their needs. Gender transformational change is needed to fix health workforce inequities and retain and attract back the women who are leaving. 

Women in the health workforce need a new social contract based on equal leadership, safe, decent and fairly paid work, to enable them to deliver health for all.

Report (pdf): 

Photo Jordi Soldevila. Els Monstres d'Ingres. IV

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When you see your neighbor's beard peeling, soak yours.

The NHS turns 77 this year 2025. Until recently, it has been widely regarded as the “crown jewel” of the British welfare state. Throughout its history, the NHS has achieved significant successes, including providing financial protection against the costs of ill health, incorporating formal assessments of new medical technologies, and delivering generally well-received care once accessed. Moreover, the NHS has been a driving force in medical research and innovation, pioneering advancements in treatments, healthcare delivery, and disease prevention. However, over a decade of austerity funding, compounded by the impact of the COVID-19 pandemic, has exposed its vulnerabilities. The NHS has shown limited resilience to external shocks and appears increasingly unsustainable in the face of growing demand.

Waiting lists are at an all-time high, population health outcomes in the UK are worsening, staff shortages and dissatisfaction remain persistent, and public confidence in the institution is wavering. In short, the NHS is in crisis.

The Labour government has increased NHS funding, but not to a level that several experts—including the LSE-Lancet Commission—deem sufficient to meet rising demands. The government has also announced a new 10-year plan. But will these measures be enough?

This event organized by the LSE last june explored the current state of the NHS, assessed whether the government's responses are adequate, and discussed whether more radical reforms are necessary. The discussion provided both critical reflection and potential solutions to address the crisis.

• Podcast to listen to.
• Video of the event to watch
• Slides and Speakers: to download here.

Photo Jordi Soldevila. Homenatge a Toni Catany Mandarina

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Doctors must live

Caroline Engen published in february 2025 the article: «Doctors must live»: a care ethics inquiry into physicians’ late modern suffering. Med Health Care and Philos 28, 275–290 (2025).

A good article to read (Free Acces) Article

Abstract: 

In 2023, thousands of young Norwegian physicians joined an online movement called #legermåleve (#doctorsmustlive) and shared stories of their own mental and somatic health issues, which they considered to be caused by unacceptable working conditions. 

This paper discusses this case as an extreme example of physicians’ and healthcare workers’ suffering in late modern societies, using Vosman and Niemeijer’s approach of rethinking care imaginaries by a structured process of thinking along, counter-thinking and rethinking, bringing to bear suffering as a heuristic device. 

1. Thinking along, taking the physicians’ stories and arguments literally, reveals an image of an unbearable workload. 
2. Counter-thinking resituates their suffering within the broader conditions of late modernity, suggesting that the root cause may lie not in the quantity of the workload itself but in its qualities and in its perceived threat to their integrity as caregivers through epistemic and moral injury and an inability to respond to this threat. 
3. In rethinking, the ambiguity of suffering– its dual potential as both a constraint and an opening– becomes central. 

Following the physicians’ own interpretations and the solutions emerging from this framing, both their suffering and that of their patients could paradoxically be exacerbated by further decentering physicians and reinforcing utilitarian, data-driven approaches. 

However, staying with their suffering and reinterpreting its causes opens possibilities to leverage critiques of medicalization at large and of their own suffering in particular, challenging the assumption that the weight of care must always grow heavier. 

From this reframing, I argue, it is possible to reclaim and reimagine care and the clinical space as a nexus of epistemic and moral privilege, recentering response-ability both relationally and socially.

Photo Jordi Soldevila. Els Monstres d'Ingres. III

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Marmot places. An initiative that must be implemented in Catalonia

"Social Injustice is killing people on a grand scale’. (M.Marmot)

Health inequalities are the systematic differences in health between social groups. Where they are judged to be avoidable differences they are inequitable, unfair. 

Putting them right is a matter of social justice. Reducing these inequities requires actions to improve the social determinants of health – the social, economic, political, physical and cultural conditions that shape our lives and our behaviours.

 
The UCL Institute of Health Equity  established in 2011 and being led by Professor Sir Michael Marmot leads and collaborates on work that addresses the social determinants of health and improves health equity. The IHE created the concept of Marmot Places. 

A Marmot Place recognises that health and health inequalities are shaped by the social determinants of health (SDH) and takes action on these social determinants at a local level. 

Sometimes called the building blocks of health, these social determinants are the conditions in which people are born, grow, live, work and age, such as education, employment and housing, and lead to wide differences in people’s health and in their life expectancy. Many places across England and Wales have become Marmot Places putting health equity at the heart of their local strategies.

Becoming a Marmot Place: 

Marmot Places develop and deliver interventions and policies to improve health equity based on eight principles:

1. Give every child the best start in life. 
2. Enable all children, young people and adults to maximise their capabilities and have control over their lives. 
3. Create fair employment and good work for all. 
4. Ensure a healthy standard of living for all. 
5. Create and develop healthy and sustainable places and communities. 
6. Strengthen the role and impact of ill health prevention. 
7. Tackle racism, discrimination and their outcomes. 
8. Pursue environmental sustainability and health equity together.

Article: Public health and health inequalities: a half century of personal involvement Michael Marmot Journal of Public Health, 2022

LSE Health's Annual Lecture:: Social justice and health equity March 2025, M.Marmot

 

Photo Jordi Soldevila. Geometries de la injustícia II

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The generational differences: Health systems leaders need to modernize the workplace and workforce practices to reflect the values of younger health care workers.

Why new generations workers are leaving from healthcare sector?

Many younger workers cite toxic cultural dynamics, such as micromanagement, hierarchical structures, and lack of support from leadership, as significant contributors to dissatisfaction and burnout.

Younger health care workers (physicians, nurses, social care, data managers, economists, lawyers....,),  have different values than older health care workers like:

1. Work-Life Balance: Many new workers prioritize flexibility and mental health, yet the rigid schedules and high stress of healthcare roles often clash with these values.
2. Communication Challenges: New employees increasingly seek purpose-driven careers, and closing the loop on communication is crucial. Are new employees instructed on how to communicate?. The practice of medicine is based on human interaction and communication, as well as science. Balancing patient needs inside an environment of mutual respect is the goal. The deskless workforce in healthcare is high-touch, with patient and co-worker interaction at the center of service delivery. Knowing how to build trust and collaborate is key, across all generations.
3. Conflict with Traditional Structures: Many younger employees feel out of sync with the hierarchical and rigid structures common in healthcare organizations, preferring collaborative and innovative environments.

Health system leaders and administrators should consider new strategies to modernize the workplace and workforce practices to reflect the values of younger health care workers.

• Create an environment to report instances of discrimination, inequalities, and racism quickly and anonymously.
• Develop equity-centered hiring and retention practices. Including (DEI) practice: diversity, equity, and inclusion. Employees want to work at organizations that prioritize DEI practices.
• Design a healthy environment that prioritizes employee wellness. Early-career health care workers who began working during the COVID-19 pandemic endured unprecedented stress and pressure that likely influenced their outlook. Both early-career and longtime health care workers increasingly report feeling burnt out; health care leaders need to create work environments that support overall wellbeing and make workers feel heard and valued. 
• Promote empathy among the managers and leaders to understand the concerns, feelings, and thoughts of their teams.
• Provide employment opportunities for people with disabilities.
• Create a specific mentoring programms to increase awareness regarding gender, young and old, diversity, equity, and inclusion in an organization.
• Support its employees at every step in their career and promote also the accountability at every step: “Accountability breeds response-ability.”― Stephen R. Covey.

Source: 

1. Morenike Ayo-Vaughan and Laurie Zephyrin, “Young Health Care Workers See More Discrimination in the Workplace, Leading to Added Stress and Burnout,” To the Point (blog), Commonwealth Fund, May 29, 2024. Blog

2. Forbes 2024

Photo Jordi Soldevila. Seqüència Xostakòvitx. Quartet número núm  8,

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