Hospitals and New Ways of Organising Medical Work in Europe: Standardisation of Medicine in the Public Sector and the Future of Medical Autonomy

Abstract

Citizens of all Western European countries have come to accept their right to ‘cradle’ to ‘grave’ health care provision. These ‘socialised’ arrangements contrast with the privatised arrangements that have characterised the US system. It is, therefore, somewhat paradoxical that in attempting to maintain citizens’ entitlements to health care services many European countries have looked to North America for new ways of organising their systems. The focus of the chapter will be on the implications of these organisational innovations for the work of hospital doctors within Europe, in particular Britain and the Netherlands. Both countries have well-established and organised medical professions and both have adopted the regulated or quasi-market model for health care delivery originally developed in the US. However, whereas the British reforms reflected a right-wing Thatcherite programme, in the Netherlands the reforms have been explicitly shaped by corporatist priorities and interests.