Health Professions and the State

Health Planning & Management

Falkenbach

Neri

et al. 2022

Self Cite

Background The health workforce is a key component of any health system and the present crisis offers a unique opportunity to better understand its specific contribution to health system resilience. The literature acknowledges the importance of the health workforce, but there is little systematic knowledge about how the health workforce matters across different countries. Aims We aim to analyse the adaptive, absorptive and transformative capacities of the health workforce during the first wave of the COVID‐19 pandemic in Europe (January‐May/June 2020), and to assess how health systems prerequisites influence these capacities. Materials and Methods We selected countries according to different types of health systems and pandemic burdens. The analysis is based on short, descriptive country case studies, using written secondary and primary sources and expert information. Results and Discussion Our analysis shows that in our countries, the health workforce drew on a wide range of capacities during the first wave of the pandemic. However, health systems prerequisites seemed to have little influence on the health workforce's specific combinations of capacities. Conclusion This calls for a reconceptualisation of the institutional perquisites of health system resilience to fully grasp the health workforce contribution. Here, strengthening governance emerges as key to effective health system responses to the COVID‐19 crisis, as it integrates health professions as frontline workers and collective actors.

Section: Resultsmentioning

confidence: 70%

Section: Resultsmentioning

confidence: 99%

Health system resilience and health workforce capacities: Comparing health system responses during the COVID‐19 pandemic in six European countries

Health Planning & Management

Falkenbach

Neri

et al. 2022

Self Cite

“…Within the sociology of professions, comparative studies of profession-state relations are another example of macro level comparisons [ 18 ]. The focus is on analysing the professional project of medicine and in what ways states through their healthcare systems and health policies influence this project.…”

Section: Resultsmentioning

confidence: 99%

Comparing medicine and management: methodological issues

2016

BMC Health Serv Res

BackgroundIn the study of medicine and management, there is a strong interest in cross-country comparison. Across healthcare systems in industrialised countries, New Public Management has provided a similar reform template, but new governing arrangements exhibit significant national variations. The comparative perspective also offers a leverage to overcome the resistance focus of earlier studies. Comparison raises two overall questions: in what similar and different ways are relations between medicine and management changing across industrialised countries? Why is change occurring in different ways? The questions reflect exploration and explanation as the two basic rationales for comparison.MethodsThe aim was to provide a critical discussion of different approaches to comparing medicine and management across countries. The analysis was based on a narrative review of relevant studies from several bodies of literature.Results and discussionThe majority of studies exploring medicine and management adopt macro level approaches to comparison. Studies draw on a range of notions, including area specific ideal types of professionalism, professionalism as countervailing powers and governmentality. There are much fewer studies exploring relations between medicine and management at the meso level. Analyses treat comparison as a two-dimensional exercise looking across both countries and levels. The majority of studies draws on institutional explanations. These are variations of the path dependency argument and studies include both sector specific and broader political and administrative institutions. There is an emerging body of process-based explanations which connect macro level institutions to organisations and which promote more non-linear comparisons.ConclusionThe lack of meso level comparisons drawing on process explanations is problematic. Empirically, we need to know more about how relations between medicine and management are different across countries. Theoretically, we need to better understand how we can transpose analytical insights from institutional explanations at macro level to studies that are multi-level and also include the meso level of organisations. Methodologically, we need to address the challenges arising from more non-linear approaches to comparison, especially how to organise close international research collaboration over an extended period of time.

“…The relationship between the state and organized occupational groups is a salient issue in the sociology of professions (Burau, 2014;Macdonald, 1995). However, the face of the state has been changing considerably over recent decades following New Public Management reforms and moves towards decentralisation and marketization (Osborne, 2010).…”

mentioning

confidence: 99%

Pursuing Professional Interests at the Local Policy Level: A Comparative Case Study

Joensen

Kousgaard

2014

P&P

Self Cite

Abstract:The relationship between the state and organized occupational groups is a salient issue in the sociology of professions, but it has been changing considerably over recent decades. This paper revisits state-professions dynamics at the local level especially in relation to welfare service professions. The contribution is twofold: empirically, we investigate how welfare professionals attempt to influence local policies; theoretically, we adapt the notion of social closure introduced by the sociology of professions to local institutional contexts. The analysis is based on a comparative case study of two groups of welfare professionals in two Danish municipalities. Empirically, our study shows that welfare professionals actively consider the local institutional context when acting to promote the interests of their own professional groups. Theoretically, our study identifies three dimensions of local closure strategies; the strategies involve both administrative and practising professionals and within that offensive/defensive as well as direct/indirect means.