Bruce Rumbold, Mark Cobb and Christina Puchalski

in Oxford Textbook of Spirituality in Healthcare

Published on behalf of Oxford University Press

Published in print August 2012 | ISBN: 9780199571390
Published online August 2012 | e-ISBN: 9780199665037 | DOI:

Series: Oxford Textbook in Public Health


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  • Public Health and Epidemiology
  • Palliative Medicine


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This chapter outlines the development of spiritual care policy within the wider healthcare policy environments of the editors’ home countries. All three nations — UK, USA, and Australia — face similar challenges in delivering healthcare. These include an increasing proportion of aged citizens, increasing prevalence of chronic disease, the impact of new medical technologies, higher public expectations coupled with eroding public confidence, and increasing access to diverse health information through digital technologies. All three also share similar concerns about improving safety and quality in healthcare. The three nations however approach these challenges in markedly different ways. The UK has a nationalized, centrally-driven healthcare system (albeit devolved into four national networks). US healthcare, in contrast to this monolithic structure, uses a pluralistic, private-sector-driven, market-based approach that is implemented through a variety of healthcare systems, funded by varied insurance arrangements, and subject to differing regulation at state and federal levels. Australia’s healthcare stands between these approaches, combining an established universal access system with a market-driven private sector that accounts for one-third of health expenditure. Responsibilities for funding, regulating, and delivering healthcare overlap between federal and state governments.

Chapter.  6412 words. 

Subjects: Public Health and Epidemiology ; Palliative Medicine

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