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Modernising health careReinventing professions, the state and the public$
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Ellen Kuhlmann

Print publication date: 2006

Print ISBN-13: 9781861348586

Published to Policy Press Scholarship Online: March 2012

DOI: 10.1332/policypress/9781861348586.001.0001

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Remodelling a corporatist health system: change and conservative forces

Remodelling a corporatist health system: change and conservative forces

Chapter:
(p.57) Three Remodelling a corporatist health system: change and conservative forces
Source:
Modernising health care
Author(s):

Ellen Kuhlmann

Publisher:
Policy Press
DOI:10.1332/policypress/9781861348586.003.0004

This chapter deals with restructuring in Germany's health system which was achieved by means of health policy, provider organisation and the occupational structures of physicians, physiotherapists and surgery receptionists. A number of issues are addressed: the changes which are implemented from the top down, and the translation of these into frontline changes in the provision of care; the roles health professions and occupations play in this scenario of change, and the strategies of professionalisation that they advance. This chapter aims to bring reflexivity to the analysis of change and to highlight the interplay of health policy, organisational change and occupational structure. The findings indicate the coexistence of innovation and conservatism. Corporatism is not replaced but ‘modernized’ through several elements from new governance. New governance brings the state into corporatist regulation, and at the same, the principle of delegating responsibility to the joint self-administration of stakeholders continues to exist.

Keywords:   conservatism, corporatism, Germany, health policy, organisational change

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