Convergent and divergent country trends in coordinated wage setting and collective bargaining in the public hospitals sector

Abstract

Drawing on the findings of research in the public hospitals sector in five European countries 1 -France, Germany, the Netherlands, Norway and the UK-this article assesses the character of change in wage setting and collective bargaining. It demonstrates the diversity of national arrangements by comparing key characteristics: (i) the bodies of collective representation (unions, professional associations and employer bodies); (ii) the degree of integration with the wider public sector framework; (iii) coordination (or competition) with the private hospitals sector; and (iv) the practice of à la carte provisions within individual hospitals. Despite national varieties of wage setting and collective bargaining, each country sector faces similar tensions-most notably the opposition between public (labour market) rules and health (product market) rules, and pressures to segment or integrate employment conditions by labour force group. By examining the nature of change in institutions for wage setting and collective bargaining in each country, the article contributes to our understanding of the extent of coordination and change of public sector wage setting and describes three scenarios: fragmentation (Germany); continuity (France and the Netherlands); and reconstruction (the UK and Norway). 1 This article draws on the detailed assessments of changes in industrial relations, pay and work organisation in the public sector hospitals of France (Méhaut et al., 2008), Germany (Jaerhling, 2008), the Netherlands (van der Meer, 2008) and the UK (Grimshaw and Carroll, 2008), listed in the bibliography. These four country reports were prepared as part of a European project funded by the Russell Sage Foundation on low-wage work. Each report considered two occupational groups in detail, the nurse assistant and the cleaner. Detailed information for Norway derives from research conducted independently by Nirit Shimron that explores changes in wage-setting institutions in three sectors (hospital, banking and metalworking) in Norway, Germany and the UK.

Sectors or countries? Typologies and levels of analysis in comparative industrial relations

“…The 'Liberal' cluster is a rather residual one, with the smallest number of cases (29) Yet we find here also German telecommunications and German hospitals, confirming researchers' findings about the distinctive disorganisation of these sectors in that country Grimshaw et al, 2007). This 'Mixed' or 'Empty' cluster is the only 'sector industrial relations' cluster that corresponds closely to the spatial distribution of European Commission's national typology.…”

The impact of public services outsourcing on work and employment conditions in different national regimes

“…A first major difference relates to the regulatory processes setting terms and conditions of employment in the public sector (Grimshaw et al, 2007). The degree of decisional autonomy by public employers over employment matters ranges from prominent to circumscribed.…”

“…The unique role played by the state as simultaneously employer, economic regulator, legislator and provider of public services has historically underpinned not only the national configurations, but also the distinctiveness of public services employment relations from the private sector (Grimshaw et al, 2007), being regulated by separate institutions and distinct rules (Bach and Bordogna, 2013). As a result, public sector employment relations were sheltered, operating in a relatively closed environment predominantly shaped by the regulatory power of the state and other domestic actors, while market pressures exercised only indirect and marginal influence (Della Rocca, 2013).…”

“…The nation-state regime remains pivotal in shaping the trajectories of reform in the public sector: 'a blend of the specific features of individual state traditions with their unique administrative cultures; the historical development of the welfare state, incorporating a particular post-war settlement between capital and labour; and the economic and political characteristics of each country have borne strongly on the evolution of public sector employment relations' (Bach, 1999: 2). Country-specific regimes of public sector governance are seen as buffers, mediating the repercussions of economic shocks and organizational restructuring on domestic public services employment relations (Grimshaw et al, 2007). Resilience and adaptability of national models explain institutional capacity to adapt flexibly to major changes along path-dependent trajectories (Pollitt and Bouckaert, 2011), absorbing shocks and resisting transformations potentially corrosive for national models (Ongaro, 2009).…”

International Recruitment of Health Workers

“…Changing boundaries between private and public health expenditure are the most visible example. In many European countries, there have been trends towards decentralization and marketization, with important implications for employment relations (4,5). For instance, reorganization in the UK increased managerial prerogatives and thereby employees' uncertainty with regard to their pay, job definitions and career progression (6).…”