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Medical Law and Health Care Reform in Tanzania

This paper examines the manner in which the tensions created by health care reforms in Tanzania were manifested in problems of law and professional regulation. The extensive privatisation of health provision and the introduction of user fees in the public sector rested upon a commodification of health care which was itself only possible through the deployment of contract models. Tort litigation was recommended as a channel of accountability but only resulted in a further skewing of resources towards the wealthy. The stresses created by the advertising of medical services and by doctors’ abandonment of altruistic goals were reflected in the disciplinary case load of the Medical Council in Tanzania. Professional ethics and privileges adopted during the colonial period were unable to withstand the pressures of the market. The paper attempts to locate these processes within the context of global liberalisation of health care services, whether through Structural Adjustment Programmes (SAPS), or the General Agreement on Trade in Services (GATS). As such the Tanzanian experience can illustrate some of the possible legal and regulatory consequences of the current restructuring of health care provision in Britain.