Working paper
Collective bargaining and the changing governance of hospitals: a comparison between the UK, Italy and France
Projet GUSTO
GALETTO Manuela - Industrial Relations Research Unit, Organisation & HRM (Auteur)
MARGINSON Paul - Industrial Relations Research Unit, Organisation & HRM (Auteur)
SPIESER Catherine - Centre d'études de l'emploi (Auteur)
Projet GUSTO : WP6
Mots clés
Hospital governance, Hospital organisation, Managerialisation, Corporatisation
In the face of growing budgetary pressures and changes in demand for both the volume and quality of the health care, public authorities across Europe have moved to reform the organisation and governance of publicly-provided care through hospitals. In all countries these reforms have been strongly influenced by the doctrine of ‘new public management’. The paper identifies four key processes shaping the direction of these reforms. One is managerialisation, or the adoption of private sector management techniques, in place of professional control; a second is marketisation, involving the introduction of mechanisms of market competition in the provision of health; a third process is the corporatisation of hospital organisations, that is giving them a more autonomous status intended to resemble that of a private company; the final one is privatisation, as private providers undertake more public healthcare provision and public organisations are transformed into private ones. To what extent and how have these trajectories of reform affected well-established arrangements for the governance of the health sector workforce?