Abstract in English


The "undetectable" link point between public and private sectors in Algeria. New objects in health in the field of health care privatisation

Mohamed Mebtoul

Maître de conférence au département de sociologie, faculté des sciences sociales, Université d'Oran et directeur du laboratoire de recherche en Anthropologie de la santé.

The question here is to show the relevance of constructing objets in health by starting from the way things work in the private sector, and especially in private clinics. The rapid increase in merchandisation of health care has led to structural changes in relationships between the public powers, hospital specialists and their private-sector counterparts. That results effectively in a modified configuration expressed by the emergence of new health "entrepreneurs" and the setting in place of new working relations between health personnel and the private clinic "chifs", sharply different from those in the hospital sphere. This is nevertheless the crux of the strengthening of the private sector. Here are shown the many points of interweaving between the health professionals of the two sectors, which are forming to the benefit of the private sector. The latter can easily capture hospital health personnel, and take over as dominant player a large number of patients, who become obliged to have their "complementary" examinations dispensed in that sector, because private structures are often the only ones that have technical equipment such as scanners. Emphasis is thus placed on the undetectable link-point between the public and private sectors. The latter in reality feeds on the malfunction of state health structures and on the public powers' working logic. These authorities are also going to contribute indirectly to reinfocement of the private sector, by legalising the complementary services the specialists provide. The private sector therefore has freedom of movement actively to mobilise hospital health care personnel in a network, while not hesitating to incorporate private-practice specialists who have the possibility to place their trust in the clinics to perform their partients' operations. This tacit alliance between clnic "chiefs" and private doctors gives the conditions for the private sector to extend its base.

Key-words : private care - merchandisation - public powers - physicians - mobilisation - interweaving - hospital - private clinics.