NURSING, POLICY AND POLITICS IN TWENTIETH-CENTURY CHILE : reforming health, 1920s-1990s

This book offers the first in-depth account of healthcare policy in Chile across the twentieth century. It charts how nursing and nurses intersected with the political context of healthcare, with a focus on the country’s transition across welfare systems. Drawing on extensive archival research and interviews with nurses and governmental representatives, this book explores how the nursing profession implemented and challenged reform, while policies had an impact on nurses. It analyses nurses’ employment and mobility, and their lobbying through the press and through unions. The authors demonstrate that while Chilean health policy was influenced by US cultural politics, reform depended on the flexibility and willingness of nurses to carry through reforms. By examining the participation of the largest female professional group, the book offers new insights into the privatization of society on the pinnacle of industrial development and seeks to contribute to contemporary debates onChile’s welfare system. It is a vital read for scholars researching the history of public health. Preface Acknowledgments Contents List of Pictures Chapter 1: Background: The Struggle for Public Health and Equality 1 Introduction: Welfare State and the Public Health System 1.1 Processing a Vision: Healthcare for Everyone (1920–1964) 1.2 Sponsoring the Vision and Framing the Nursing Profession: Public Health from North America 1.3 One Step Forward and One Step Back: Gender Pay Gap and Healthcare in Times of Christian Democracy (1964–1970) 2 The Rise of the Modern Nursing Profession (1906–1970) 2.1 The Foundation of State Nursing (1906–1926) 2.2 Auxiliary to Health Work, an Appendix of History 2.3 The First Era of Public Health Nursing (1926–1941) 2.4 The Semblance of Equality: Women in a Cage 2.5 The Rockefeller Foundation and the Second Era of Public Health Nursing (1941–1952) 2.6 All Goals Achieved? The Nursing Law of 1953 2.7 The “Golden Age” of Nursing? 1960s Policy and Politics 3 Conclusion Chapter 2: Nursing in Times of Socialism (1970–1973) 1 Introduction 2 Politics Without Policies: The Popular Unity’s Vision of an Equal Healthcare Provision 3 Dependence on International Aid 4 Continuities in Nursing Practice and Standstill in Nursing Politics 5 The New Opposition in the Healthcare Sector 6 End of Negotiations: The 1972 Strike 7 The Hardened Fronts 8 The End of the Socialist Experiment: The 1973 Strike 9 Conclusion Chapter 3: Nursing Under the Civilian-Military Cooperation (1973–1979) 1 Introduction 2 The Establishment of the Civilian-Military Cooperation 3 The Labor Policy 4 The Healthcare Policy 5 The Origins of Resistance in the Healthcare System 6 Nursing in Times of Dictatorship 6.1 Privileged and Subordinated 6.2 Donors and Cooperators 6.3 Victims and Agents 6.4 Deceivers and Deceived 7 Conclusion Chapter 4: Nursing in Times of State Reforms (1980–1982) 1 Refounding the State1 1.1 Constitution: From the Façade of a Plebiscite to New Social Order 1.2 Pensions: From Public Cuts to Private Market 1.3 Professionals: From Collective Bargaining to Collective Downgrading 1.4 Professions: From Public Law Bodies to Private Associations 1.5 Administration: From Regionalization to Municipalization 1.6 Students: From University to Non-university 1.7 Auxiliaries: From Autodidact to Vocational 1.8 Healthcare: From Welfare to Business 1.9 Politics: From Cooperation to Resistance 1.10 Crises: From Economic Pressure to Political Dissatisfaction 2 Nursing the Welfare State 2.1 Poor Payment, Unemployment, and Struggling for Recognition 2.2 From Public to Private 2.3 The CECh Under Pressure 2.4 Dismantling Academically Trained Nursing 2.5 The Vocational Threat 3 Conclusion Chapter 5: Nursing in Times of Transition and Distinction (1982–1990) 1 Introduction 2 Crises, Political Conflicts, and Transition 2.1 The Rise of a New Female Resistance Movement 2.2 Universities and the Development of Political Diversity 2.3 State Problems and Private Solution 2.4 Physicians’ Fight, Female Health Professionals’ Inspiration 2.5 Team Players Still Missing: Healthcare in the 1990s 3 Nursing Becomes Political 3.1 The Distinction Continues: Professionals and Auxiliaries 3.2 The Left-Wing Nurses: On the Fast Lane From Victory to Imprisonment (1984–1986) 3.3 A New Spirit Under Old Circumstances (1986–1990) 3.4 Nursing After Dictatorship: Transition and Distinction 4 Conclusion Annex Index This book offers the first in-depth account of healthcare policy in Chile across the twentieth century. It charts how nursing and nurses intersected with the political context of healthcare, with a focus on the country's transition across welfare systems. Drawing on extensive archival research and interviews with nurses and governmental representatives, this book explores how the nursing profession implemented and challenged reform, while policies had an impact on nurses. It analyses nurses' employment and mobility, and their lobbying through the press and through unions. The authors demonstrate that while Chilean health policy was influenced by US cultural politics, reform depended on the flexibility and willingness of nurses to carry through reforms. By examining the participation of the largest female professional group, the book offers new insights into the privatization of society on the pinnacle of industrial development and seeks to contribute to contemporary debates on Chile's welfare system. It is a vital read for scholars researching the history of public health