{"title":"New Public Management, Austerity, and the Alienation of the Medical Profession in France.","authors":"Daniel Simonet","doi":"10.2147/JHL.S463904","DOIUrl":null,"url":null,"abstract":"<p><p>In the last twenty years, France has gone through health policy changes that are perceived as paradigm shifts. After briefly describing the reforms driven by the new public management and the subsequent re-centralization of the French health system for budgetary purposes, it appears that those reforms had outcomes below expectations. The regrouping of policy decisions within the Regional Health Agencies and the rise of a French Welfare elite weakened the medical profession. Blame-shifting strategy, political dilution, and spatial inequality linger. The COVID-19 epidemic highlights those limitations. The negative societal and political impact of failed public reforms is increasingly evident.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11358241/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Healthcare Leadership","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/JHL.S463904","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
In the last twenty years, France has gone through health policy changes that are perceived as paradigm shifts. After briefly describing the reforms driven by the new public management and the subsequent re-centralization of the French health system for budgetary purposes, it appears that those reforms had outcomes below expectations. The regrouping of policy decisions within the Regional Health Agencies and the rise of a French Welfare elite weakened the medical profession. Blame-shifting strategy, political dilution, and spatial inequality linger. The COVID-19 epidemic highlights those limitations. The negative societal and political impact of failed public reforms is increasingly evident.
期刊介绍:
Efficient and successful modern healthcare depends on a growing group of professionals working together as an interdisciplinary team. However, many forces shape the delivery of healthcare; changes are being driven by the markets, transformations in concepts of health and wellbeing, technology and research and discovery. Dynamic leadership will guide these necessary transformations. The Journal of Healthcare Leadership is an international, peer-reviewed, open access journal focusing on leadership for the healthcare professions. The publication strives to amalgamate current and future healthcare professionals and managers by providing key insights into leadership progress and challenges to improve patient care. The journal aspires to inform key decision makers and those professionals with ambitions of leadership and management; it seeks to connect professionals who are engaged in similar endeavours and to provide wisdom from those working in other industries. Senior and trainee doctors, nurses and allied healthcare professionals, medical students, healthcare managers and allied leaders are invited to contribute to this publication