Governing public hospitals. Reform strategies and the movement towards institutional autonomy

Governance of public hospitals in Europe is changing. Individual hospitals have been given varying degrees of semi-autonomy within the public sector and empowered to make key strategic, financial, and clinical decisions themselves. This study explores the major developments and their implications for national and European health policy.

The study focuses on hospital-level decision-making and draws together both theoretical and practical evidence. It includes an in-depth assessment of eight different country models of semi-autonomy, in the Czech Republic, England, Estonia, Israel, the Netherlands, Norway, Portugal and Spain.

The evidence that emerges throws light on the shifting relationships between public-sector decision-making and hospital-level organizational behaviour and will be of real and practical value to those working with this increasingly important and complex mix of approaches.