ᖹ ᡂ 㸰 㸱 ᖺ ᗘ་ ⒪ ⤒ ῭ ◊ ✲ ᶵ ᵓ⮬ ୺ ◊ ✲ ஦ ᴗ࢖ࢠࣜࢫ་⒪ಖ㞀ไᗘ࡟㛵ࡍࡿㄪᰝ◊✲ሗ࿌᭩࠙2011 ᖺᗘ∧ࠚ࣭ ་⒪ಖ㞀ไᗘᴫせ࣭ ་⒪㛵㐃ࢹ࣮ࢱᖹᡂ㸰㸲ᖺ㸱᭶࢖ࢠࣜࢫ་⒪ಖ㞀ไᗘ࡟㛵ࡍࡿ◊✲఍⦅୍⯡㈈ᅋἲே ་⒪⤒῭◊✲࣭♫఍ಖ㝤⚟♴༠఍IHEP་⒪⤒῭◊✲ᶵᵓᧄ⺞ᩏ⎇ⓥߪ‫ߩࠬ࡝ࠡࠗޔ‬ㄭᐕߩක≮೙ᐲᡷ㕟ࠍ߼ߋࠆᦨᣂᖱႎߥࠄ߮ߦක≮଻㓚೙ᐲߦ㑐ߔࠆၮ␆࠺࡯࠲ࠍ෼㓸ߔࠆߎߣࠍ⋡⊛ߣߒߡታᣉߒߚ‫ᧄޕ‬ႎ๔ᦠߪ‫ ޔ‬ᐕ  ᦬⃻࿷߹ߢߦ෼㓸ߒߚᖱႎߦ৻ㇱᦝᣂࠍߒߡ޿ࠆ‫ޕ‬ࠗࠡ࡝ࠬ߅ࠃ߮ᣣᧄߩක≮೙ᐲߦ♖ㅢߒߚ᦭⼂⠪ߦࠃࠆᆔຬળࠍ⸳┙ߒ‫ࠬ࡝ࠡࠗޔ‬ක≮଻㓚೙ᐲߦ㑐ߔࠆ⎇ⓥ߿࠺࡯࠲ࠍ෼㓸࡮ᢛℂߒ‫ߩߘޔ‬ᚑᨐࠍᧄႎ๔ᦠߣߒߡ߹ߣ߼ߚ‫ޕ‬ᆔຬળߩ᭴ᚑߪએਅߩㅢࠅߢ޽ࠆ‫ޕ‬ࠗࠡ࡝ࠬක≮଻㓚೙ᐲߦ㑐ߔࠆ⎇ⓥળ㧔 ᐳ 㐳 㧕 ᳰ਄ ⋥Ꮖ 㧔ᘮᙥ⟵Ⴖᄢቇකቇㇱᢎ᝼㧕㧔 ᆔ ຬ 㧕 ᆌፒ ᱜᐔ 㧔ㄭ⇰ක≮⑔␩ᄢቇ␠ળ⑔␩ቇㇱ․છᢎ᝼㧕⨹੗ ↱⟤ሶ 㧔࿖┙㐳ኼක≮࠮ࡦ࠲࡯⎇ⓥᚲ㐳ኼ᡽╷⑼ቇ⎇ⓥㇱ㐳㧕৻࿧ శᒫ 㧔㑐⷏ᄢቇ᡽╷ഃㅧቇㇱᢎ᝼㧕੗਄ ᕡ↵ 㧔หᔒ␠ᄢቇᄢቇ㒮✚ว᡽╷⑼ቇ⎇ⓥ⑼ᢎ᝼㧕ㄭ⮮ సೣ㧔ᣣᧄ⑔␩ᄢቇ␠ળ⑔␩ቇㇱᢎ᝼㧕㧔ࠕ࠼ࡃࠗࠩ࡯㧕 ᄢ⷏ ⸽ผ 㧔ౝ㑑ቭᚱౝ㑑✚ോቭቶౝ㑑ෳ੐ቭ㧕ർ᧛ ᓆ  㧔೨ෘ↢ഭ௛⋭㓹↪ဋ╬࡮ఽ┬ኅᐸዪ㐳㧕ዊ಴ 㗼↢ 㧔⑔␩ක≮ᯏ᭴ ᐕ㊄⾉ઃㇱ㧕╣ሶ ቬ৻㇢㧔ෘ↢ഭ௛⋭ᄢ⤿ቭᚱ࿖㓙⺖⺖㐳⵬૒㧕㧔ᢘ⒓⇛‫ޔ‬੖ච㖸㗅㧕㧔੐ ോ ዪ㧕 ጤ੗ ൎᒄ 㧔ක≮⚻ᷣ⎇ⓥᯏ᭴ ⎇ⓥਥᐙ㧕⍹੗ ടઍሶ㧔ක≮⚻ᷣ⎇ⓥᯏ᭴ ਥછ⎇ⓥຬ㧕ᷡ᳓ ᴕ෹㉿㧔ක≮⚻ᷣ⎇ⓥᯏ᭴ ⎇ⓥຬ㧕⍫ญ ᕺ  㧔ක≮⚻ᷣ⎇ⓥᯏ᭴ ⎇ⓥຬ㧕                           ᚲዻߪ  ᐕ  ᦬⃻࿷ᧄႎ๔ᦠߩ৻ㇱ߹ߚߪోㇱࠍ໧ࠊߕ‫ޔ‬ήᢿᒁ↪‫ޔ‬ォタࠍ⑌ߕࠆࠗࠡ࡝ࠬක≮଻㓚೙ᐲߦ㑐ߔࠆ⺞ᩏ⎇ⓥႎ๔ᦠ‫ޣ‬2011 ᐕᐲ‫ޤ‬‫ ⋡ ޝ‬ᰴ ‫ޞ‬ࡍ࡯ࠫࠗࠡ࡝ࠬ࿖ౝߩᦨㄭߩേ߈ࠗࠡ࡝ࠬක≮଻㓚೙ᐲߩ᭎ⷐ‫ޣ‬2011 ᐕᐲ1‫ޤ‬

1. ࠗࠡ࡝ࠬක≮଻㓚೙ᐲߩၮᧄ⊛઀⚵ߺߣ․ᓽ
1-1.ࠗࠡ࡝ࠬක≮଻㓚೙ᐲߩ᭎ⷐ㧔ࠗࡦࠣ࡜ࡦ࠼㧕
1-2. NHS ᡷ㕟ߩേะ
1-3. NHS ߩ⾰ࠍ⏕଻ߔࠆߚ߼ߩࡈ࡟࡯ࡓࡢ࡯ࠢߣࠬ࠻࡜࠹ࠫ࡯
1-4. ක≮ߦ㑐ㅪߔࠆઁߩ଻㓚೙ᐲ
2. ක≮ឭଏ૕೙
2-1. ੱ⊛⾗Ḯߩలታ
2-2.ࡊ࡜ࠗࡑ࡝࡯࡮ࠤࠕ㧔৻ᰴක≮㧕
2-3.࠮ࠞࡦ࠳࡝࡯࡮ࠤࠕ㧔ੑᰴක≮㧕
2-4. ⺞೷ಣᣇ㧔⺞೷⮎ዪ㧕
2-5. ᱤ⑼2-6. ␠ળࠨ࡯ࡆࠬ‫ޔ‬㜞㦂⠪ࠤࠕߥߤ2-7. ⚳ᧃᦼࠤࠕ㧔End of Life Care㧕
2-8. ஜᐽߠߊࠅኻ╷2-9. ஜᐽߩਇᐔ╬߳ߩኻ╷
3. ⽷Ḯ㧔Source of Finance㧕ߣᖚ⠪⽶ᜂ
3-1. ක≮⽷Ḯߣᡰ಴
3-2. NHS ߩ⽷Ḯߣᡰ಴
3-3. ᳃㑆ක≮଻㒾ߩ⽷Ḯߣᡰ಴
4. ᡰᛄᣇᑼ4-1.ࡊ࡜ࠗࡑ࡝࡯࡮ࠤࠕ㧔৻ᰴක≮㧕
4-2.࠮ࠞࡦ࠳࡝࡯࡮ࠤࠕ㧔ੑᰴක≮㧕
4-3.ߘߩઁߩࠤࠕ࡮ࠨ࡯ࡆࠬ㧔ᱤ⑼࡮⺞೷㧕
4-4. ᳃㑆ක≮଻㒾ࠨ࡯ࡆࠬ
4-5. ᷙว⸻≮ߦߟ޿ߡ
5. ෳ⠨ᒁ↪ᢥ₂৻ⷩ㧔Bibliography㧕
6. ⇛⺆⴫㧔Abbreviation㧕

5642

72788790ࠗࠡ࡝ࠬක≮㑐ㅪ࠺࡯࠲‫ޣ‬2011 ᐕᐲ‫ޤ‬

1. ੱญ࡮ੱญേᘒ

93
93

1-1㧕࿾ᣇ೎ੱญផ⒖ߣ዁᧪ផ⸘ੱญ .................................................................................................................... 94
1-2㧕ᐕ㦂㓏⚖೎ዬ૑⠪ੱญ㧔ㅪว₺࿖㧕 ............................................................................................................ 96
1-3㧕ᐕ㦂㓏⚖೎ዬ૑⠪ੱญ㧔ࠗࡦࠣ࡜ࡦ࠼㧕 .................................................................................................... 98
1-4㧕࿾ᣇ೎↢๮⴫࡮ᐔဋ૛๮㧔2008㨪2010 ᐕᱫ੢₸ߦࠃࠆផ⸘㧕.............................................................. 100
1-5㧕↵ᅚ೎ 0 ᱦᐔဋ૛๮ផ⒖㧔ㅪว₺࿖㧕 ...................................................................................................... 101
1-6㧕ᐔဋ૛๮ᐕᰴផ⒖㧔ࠗࡦࠣ࡜ࡦ࠼߅ࠃ߮࠙ࠚ࡯࡞࠭㧕........................................................................... 102
1-7㧕ᐔဋ૛๮ផ⒖㧔ࠗࡦࠣ࡜ࡦ࠼㧕 .................................................................................................................. 104
1-8㧕಴↢ᢙ‫ޔ‬಴↢₸‫ޔ‬ᱫ↥ផ⒖㧔ᐕᐔဋ߽ߒߊߪᥲᐕว⸘㧧ㅪว₺࿖࡮ࠗࡦࠣ࡜ࡦ࠼߅ࠃ߮࠙ࠚ࡯࡞࠭㧕 .............................................. 106
1-9㧕ᕈ࡮ᐕ㦂೎ᱫ੢ᢙផ⒖㧔ㅪว₺࿖㧕 .......................................................................................................... 108
1-10㧕 ᱫ࿃೎ᱫ੢ᢙ㧔࿖㓙∔∛்ኂᱫ࿃⛔⸘ಽ㘃╙ 102. ⚻ᷣᜰᮡ

㧔2001㧕
㧕 ........................................................... 110

117

2-1㧕࿖ౝ✚↢↥㧦㔛ⷐ㗄⋡೎㧔ㅪว₺࿖㧧2001㨪2009 ᐕ㧕.......................................................................... 118
2-2㧕ᕈ߅ࠃ߮ᐕ㦂೎ᄬᬺ₸㧔ㅪว₺࿖㧕 .......................................................................................................... 119
2-3㧕⒅⒢ߣ⛎ઃߦࠃࠆᚲᓧߩౣಽ㈩㧔ㅪว₺࿖㧧2003㨪2009 ᐕᐲ㧕.......................................................... 120

3. ᡽ᐭᡰ಴࡮ක≮⾌

125

3-1㧕ࠨ࡯ࡆࠬ㗄⋡೎ ౏౒ㇱ㐷ߩᡰ಴ 1996㧙2010 ᐕᐲ 㧔ㅪว₺࿖............................................................. 126
3-2㧕࿖᳃଻ஜࠨ࡯ࡆࠬߦ㑐ߔࠆ᡽ᐭᡰ಴㧔ㅪว₺࿖㧧3 ᦬ 31 ᣣ⚳ੌᐕᐲ㧕 .............................................. 127
3-3㧕␠ળ଻㓚⛎ઃߦ㑐ߔࠆ᡽ᐭᡰ಴㧔ㅪว₺࿖㧧3 ᦬ 31 ᣣ⚳ੌᐕᐲ㧕...................................................... 128
3-4㧕࿖᳃଻ஜࠨ࡯ࡆࠬ✚ᡰ಴㗄⋡೎⾌↪ഀวផ⒖㧔ㅪว₺࿖㧕................................................................... 129
3-5㧕࿖᳃଻ஜࠨ࡯ࡆࠬ㧔NHS㧕ߩ⽷Ḯ㧔ㅪว₺࿖㧧1949㨪2009㧕............................................................... 130
3-6㧕ഭ௛ਇ⢻ߦ㑐ߔࠆ⛎ઃ 㧔ࠣ࡟࡯࠻ࡉ࡝࠹ࡦ㧕 ........................................................................................ 132
3-7㧕∔∛߽ߒߊߪ்ኂߦࠃࠆഭ௛ਇ⢻ߩේ࿃೎⏕ቯઙᢙ㧔ࠣ࡟࡯࠻ࡉ࡝࠹ࡦ㧕 ....................................... 133
3-8㧕✚ක≮ᡰ಴ផ⒖㧔ㅪว₺࿖㧕 ...................................................................................................................... 134

ࡍ࡯ࠫ

4. ක≮ឭଏ૕೙135

4-1㧕∛㒮߅ࠃ߮ኅᐸ଻ஜࠨ࡯ࡆࠬ㧔ࠗࡦࠣ࡜ࡦ࠼߅ࠃ߮࠙ࠚ࡯࡞࠭㧕....................................................... 136
4-2㧕∛㒮߅ࠃ߮ࡊ࡜ࠗࡑ࡝ࠤࠕࠨ࡯ࡆࠬ㧔ࠬࠦ࠶࠻࡜ࡦ࠼㧕 ...................................................................... 140
4-3㧕∛㒮߅ࠃ߮৻⥸଻ஜࠨ࡯ࡆࠬ㧔ർࠕࠗ࡞࡜ࡦ࠼㧕 .................................................................................. 142
4-4㧕଻ஜක≮ߥࠄ߮ߦኻੱ␠ળࠨ࡯ࡆࠬᓥ੐⠪ᢙផ⒖ 㧔ࠗࡦࠣ࡜ࡦ࠼㧕................................................. 145
4-5㧕∛㒮߅ࠃ߮࿾ၞ଻ஜࠨ࡯ࡆࠬߦ߅ߌࠆකᏧߣᱤ⑼කᏧᢙផ⒖㧔ࠗࡦࠣ࡜ࡦ࠼㧕............................... 148
4-6㧕଻ஜක≮ᓥ੐⠪ᢙផ⒖㧔ࠗࡦࠣ࡜ࡦ࠼㧧ฦᐕ 9 ᦬ 30 ᣣ⃻࿷㧕............................................................. 149
4-7㧕ᬌ⌒჻ᢙ㧔ࠗࡦࠣ࡜ࡦ࠼㧧ฦᐕ 12 ᦬ 31 ᣣ⃻࿷㧕 .................................................................................. 150
4-8㧕ࡄ࡯࠻࠽࡯ࠪ࠶ࡊߩⷙᮨ೎ߩ⸻≮ᤨ㑆ߦ೙㒢ߩߥ޿৻⥸කᢙ 㧔ࠗࡦࠣ࡜ࡦ࠼㧕............................. 151
4-9㧕৻⥸කߩᢙߣ㐿ᬺᒻᘒ㧔ࠗࡦࠣ࡜ࡦ࠼㧧2000㨪2010㧕 .......................................................................... 152
4-10㧕↵ᅚ೎৻⥸කᢙߩផ⒖㧔ࠗࡦࠣ࡜ࡦ࠼㧧2000㨪2010㧕 ........................................................................ 153
4-11㧕↵ᅚ೎∛㒮╬කᏧᢙផ⒖(ᱤ⑼කᏧ฽߻)㧔ࠗࡦࠣ࡜ࡦ࠼㧧ฦᐕ 9 ᦬ 30 ᣣ⃻࿷㧕 ............................ 154
4-12㧕කᏧ఺⸵ขᓧ࿖೎ ∛㒮╬කᏧᢙ㧔ࠗࡦࠣ࡜ࡦ࠼㧧ฦᐕ 9 ᦬ 30 ᣣ⃻࿷㧕......................................... 155
4-13㧕∛㒮කᏧ࡮∛㒮ᱤ⑼කᏧߩႎ㈽㧔ࠗࡦࠣ࡜ࡦ࠼㧕 ................................................................................ 157
4-14㧕∛ᐥ⒳㘃೎∛ᐥᢙ‫ⴕ≮⸻ޔ‬ὑᜰᮡ㧔∛㒮㧦ࠗࡦࠣ࡜ࡦ࠼㧕 ................................................................ 158

5. ක≮ߦ㑐ߔࠆ⻉ᜰᮡ

159

5-1㧕࿖᳃଻ஜࠨ࡯ࡆࠬ㧔౉㒮㧧ࠗࡦࠣ࡜ࡦ࠼㧕 .............................................................................................. 160
5-2㧕࿖᳃଻ஜࠨ࡯ࡆࠬ㧔੐᡿߅ࠃ߮ᢇᕆ㧧ࠗࡦࠣ࡜ࡦ࠼㧕 .......................................................................... 160
5-3㧕NHS ∛㒮ߦ߅ߌࠆ⸻≮⑼೎౉㒮ᖚ⠪৻ੱ৻ᣣᒰߚࠅᐔဋ⾌↪ 㧔ࠗࡦࠣ࡜ࡦ࠼㧕 ............................ 161
5-4㧕ਥ࿃೎∛㒮ᴦ≮ቢੌઙᢙ㧔ࠗࡦࠣ࡜ࡦ࠼㧕 .............................................................................................. 162
5-5㧕ਥ࿃೎∛㒮౉㒮ઙᢙ㧔ࠗࡦࠣ࡜ࡦ࠼㧕 ...................................................................................................... 163
5-6㧕ਥ࿃೎࠺ࠗࠤ࡯ࠬ౉㒮ઙᢙ㧔ࠗࡦࠣ࡜ࡦ࠼㧕 .......................................................................................... 164
5-7㧕ਥ࿃೎∛㒮ㅢᏱ౉㒮࿷㒮ᦼ㑆㧔ࠗࡦࠣ࡜ࡦ࠼㧕 ...................................................................................... 165
5-8㧕ਥ࿃೎∛㒮ㅢᏱ౉㒮ᑧߴ∛ᐥᢙ㧔ࠗࡦࠣ࡜ࡦ࠼㧕 .................................................................................. 166
5-9㧕ᕈ࡮ᐕ㦂೎⥄Ꮖ↳๔ߦࠃࠆ᦭∛₸ 㧔1972㨪2009 ᐕ㧧ࠣ࡟࡯࠻ࡉ࡝࠹ࡦ㧕........................................ 167
5-10㧕౉㒮ᓙᯏᖚ⠪ᢙ㧔∛㒮ႎ๔ಽ㧕㧔2005 ᐕ 3 ᦬㨪2009 ᐕ 3 ᦬㧧ࠗࡦࠣ࡜ࡦ࠼㧕 ................................. 1695-11㧕࿖᳃଻ஜࠨ࡯ࡆࠬ㐿ᬺකߦኻߔࠆ৻ੱᒰߚࠅᐕ㑆ᐔဋฃ⸻࿁ᢙ
㧔1972㨪2009 ᐕ㧧ࠣ࡟࡯࠻ࡉ࡝࠹ࡦ㧕 .............................................................................................................. 169
5-12㧕∛㒮ߥࠄ߮ߦ࿾ၞ଻ஜࠨ࡯ࡆࠬߦኻߔࠆ⹏ଔ㧔ࠣ࡟࡯࠻ࡉ࡝࠹ࡦ㧕................................................. 170
5-13㧕‫ޟ‬ᢇᕆએᄖߩᚻⴚߢߩ㗅⇟ᓙߜ‫⹏ߩߡ޿ߟߦޠ‬ଔ㧔ࠣ࡟࡯࠻ࡉ࡝࠹ࡦ㧕........................................... 170

6. ⮎೷

171

6-1㧕⮎೷ࠨ࡯ࡆࠬ㧦∛㒮એᄖߢ⺞೷ߐࠇࠆಣᣇຠ⋡ᢙ㧔ࠗࡦࠣ࡜ࡦ࠼㧕................................................... 172
6-2㧕⮎ല⟲೎ಣᣇຠ⋡ᢙ߅ࠃ߮ᱜ๧⮎೷⾌↪㧔ࠗࡦࠣ࡜ࡦ࠼㧧1999㨪2009㧕........................................... 173

7. ෳ⠨ ಴ౖర⛔⸘ᦠߩ᭎ⷐߣ⸥ภߩᗧ๧

174

8. ࠺࡯࠲ᦝᣂ⁁ᴫ߅ࠃ߮಴ౖ৻ⷩ

177