Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-04T21:04:45.383Z Has data issue: false hasContentIssue false
  • English
  • Français

The complexities of negotiating governance change: introducing managerialism in Italy

Published online by Cambridge University Press:  01 July 2009

WILLEM TOUSIJN  and
VINCENZO MARIO BRUNO GIORGINO
WILLEM TOUSIJN*
Affiliation:
Professor of Sociology, Faculty of Economics, University of Torino, Torino, Italy
VINCENZO MARIO BRUNO GIORGINO
Affiliation:
Assistant Professor of Sociology and Labour Economics, University of Torino, Torino, Italy
*
*Correspondence to: Willem Tousijn, Professor of Sociology, Faculty of Economics, University of Torino, Corso Unione Sovietica 218 bis 10134 Torino, Italy. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Since the beginning of the 1990s, health policy in Italy has been characterised by continuous reform as reflected by the frequency of new measures. Importantly, the reforms have changed considerably many aspects of the health-care system, including the governance of medical performance. The new measures fall into two types: regionalisation and transformation of local providers into ‘health-care enterprises’. In relation to the governance of medical performance, more specifically, the reforms have entailed the introduction of budgeting and quality assurance, the creation of new managerial roles, and the transformation of existing roles, as well as the introduction of new mechanisms for evaluating medical performance. In terms of the specific forms of governance, the reforms have reinforced hierarchy-based forms of governing intermeshed with party governance, and have re-defined professional self-regulation by strengthening collective forms of professional self-regulation. The design and implementation of the reforms are subject to a complex process of negotiation, which involves a wide range of actors spread across different levels of governance and takes place in relation to all aspects of the governance of medical performance.

Type
Articles
Information
Health Economics, Policy and Law , Volume 4 , Issue 3: Governing Medical Performance: A Comparative Analysis of Pathways of Change , July 2009 , pp. 329 - 346
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anessi Pessina, E. and Cantù, E. (eds) (2006), L'aziendalizzazione della sanità in Italia. Rapporto Oasi, Milano: Università Bocconi.Google Scholar
Autorità Garante per la Concorrenza ed il Mercato (Authority for Competition and Market), Rapporti annuali (Annual Reports).Google Scholar
Bindi, R. (2005), La salute impaziente, Milano: Jaca Book.Google Scholar
Cergas, (2007), Rapporto Oasi, Milano: Università Bocconi.Google Scholar
Del Bufalo, P. and Turno, R. (2006), ‘Commissariamento scongiurato per le Regioni in deficit sanitario’, Il Sole 24 Ore, 1 June.Google Scholar
Dirindin, N. and Pagano, E. (eds) (2001), Governare il federalismo. Le sfide per la sanità, Roma: Il Pensiero Scientifico Editore.Google Scholar
EU Commission for Economic and Monetary Affairs (2006), Public Finance Annual Report, Commissioner Joaquin Almunia; Part V, Recent Developments and Medium-Term Prospects, Member State Developments, Italy: 236–239.Google Scholar
Ferrera, M. (1996), ‘La partitocrazia della salute’, in Cotta, M. and Isernia, P. (eds), Il gigante dai piedi di argilla’, Bologna: Il Mulino.Google Scholar
Filocamo, A., et al. (2003), ‘Il sistema dei controlli esterni sull'attività ospedaliera per acuti nel Lazio: organizzazione e risultati’, Tendenze Nuove, (6): 527–540.Google Scholar
Freidson, E. (1985), ‘The reorganization of the medical profession’, Medical Care Review, 42.CrossRefGoogle Scholar
Freidson, E. (1986), ‘The medical profession in transition’, in Aiken, L. H. and Mechanic, D. (eds), Applications of Social Science to Clinical Medicine and Health Policy, Rutgers University Press.Google Scholar
Krause, E. (1996), Death of the Guilds, New Haven: Yale University Press.Google Scholar
Maino, F. (2001), La politica sanitaria, Bologna: Il Mulino.Google Scholar
Malatesta, M. (2004), ‘Corpi e professioni tra passato e futuro:l'ordine dei medici’, Salute e Società 3.Google Scholar
Piperno, A. (1981) ‘Stato, Economia e Società nello sviluppo della sanità in Italia’, La ricerca sociale, (25).Google Scholar
Piperno, A. (1982), ‘Medici e Stato in Italia’, La ricerca sociale, (28).Google Scholar
Preti, D. (1984), ‘La questione ospedaliera nell'Italia fascista (1922–1940): un aspetto della ‘modernizzazione corporativa’, in Peruta, F. D. (ed), Storia d'Italia, Annali 7, Malattia e Medicina, Torino: Einaudi.Google Scholar
Salvi, C. and Villone, M. (2005), Il costo della democrazia, Milano: Mondadori.Google Scholar
Scott, W. R. (1982), ‘Managing professional work: three models of control for health organizations’, Health Services Research, 17: 213–240.Google ScholarPubMed
Secco, A. (1996), ‘La corporazione medica in età repubblicana’, in Storia d'Italia, I professionisti, Torino: Einaudi.Google Scholar
Soresina, M. (2003), Professioni e liberi professionisti in Italia dall'Unità alla Repubblica, Firenze: Le Monnier.Google Scholar
Tousijn, W. (2000), Il sistema delle occupazioni sanitarie in Italia, Bologna: Il Mulino.Google Scholar
Tousijn, W. (2006), ‘Beyond decline: consumerism, managerialism and the need for a new medical professionalism’, Health Sociology Review, 15: 469–480.CrossRefGoogle Scholar
Vicarelli, G. (2004), ‘Aziendalizzazione and management in the evolution of the Italian health care system’, Salute e Società, 3: 19–38.Google Scholar
Vicarelli, G. (ed) (2005), Il malessere del Welfare, Napoli: Liguori.Google Scholar
Vicarelli, G. (2006), Medicus omnium. La costruzione professionale del medico di medicina generale (1945–2005), in Cipolla, C.Corposanto, C. and Tousijn, W. (eds), I Medici di medicina generale in Italia, Milano: Franco Angeli.Google Scholar