Strengthening stakeholder involvement in health workforce governance: why we need to talk about power

Abstract

There is now widespread agreement on the benefits of an integrated, people-centred health workforce, but the implementation of new models is difficult. We argue that we need to think about stakeholders and power, if we want to ensure change in the health workforce. We discuss these issues from a governance perspective and suggest a critical approach to stakeholder involvement as an indicator of good governance. Three models of involving stakeholders in health workforce governance can be identified: corporatist professional involvement either in a continental European model of conservative corporatism or in a Nordic model of public corporatism; managerialist and market-centred involvement of professions as organizational agents; and a more inclusive, network-based involvement of plural professional experts at different levels of governance. The power relations embedded in these models of stakeholder involvement have different effects on capacity building for an integrated health workforce.

Keywords

healthcare governance health professions health workforce stakeholder involvement

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References

United Nations. High-Level Commission on Health Employment and Economic Growth. Working for health and growth: investing in the health workforce. New York: United Nations, 2016.

World Health Organization. Health Services Delivery Programme, Division of Health Systems and Public Health. The European Framework for action on integrated health services delivery: an overview. Copenhagen: WHO Regional Office for Europe, 2016.

World Health Organization. WHO global strategy on human resources for health: workforce 2030, Copenhagen: WHO Regional Office for Europe, 2016.

Greer SL, Wismar M, Figueras J, et al. Governance: a framework. In: Greer SL, Wismar M and Figueras J (eds.) Strengthening health system governance: better policies, stronger performance. Maidenhead: Open University Press, 2016, pp.27–55.

Greer, SL, Wismar M, Figueras J, et al. Policy lessons for health governance. In: Greer SL, Wismar M and Figueras J (eds.) Strengthening health system governance: better policies, stronger performance. Maidenhead: Open University Press, 2016, pp.105–125.

OECD. Health workforce policies in OECD countries: right jobs, right skills, right places. OECD Health Policy Studies. Paris: OECD Publishing, 2016.

Lorant

Rihoux

Nicaise

. Attitudes towards reforming primary care in Belgium: social network analysis in a pluralist context. J Health Serv Res Policy 2016; 21: 235–242.

McDermott

Checkland

Coleman

et al.

Engaging GPs in commissioning: realist evaluation of the early experiences of Clinical Commissioning Groups in the English NHS. J Health Serv Res Policy 2017; 22: 4–11.

Kuhlmann

Lauxen

Larsen

. Regional health workforce monitoring as governance innovation: a German model to coordinate sectoral demand, skill mix and mobility. Hum Resour Health 2016; 14: 71–71.

10.

Burau

Carstensen

Fleron

et al.

How occupational groups drive innovations in interprofessional working: the case of stroke rehabilitation in Denmark. Eur J Pub Health 2016; 26(Suppl 1): 165–165.