Trade Union Responses to a Marketized Hospital Sector: A Comparison of Germany and England

The public sector is in a phase of reform and transition and thus many thousands of workers are experiencing change. New public management reform processes changed public administration structures with respect to finance, personnel and organizational management towards greater output orientation and performance management. The extent and implementation of new public management (NPM) reforms has been studied extensively in a comparative perspective, while the impact of the reforms on employees’ representations remained widely neglected.

This project attempts to contribute to filling this gap by conducting a comparative analysis of the effect of NPM reforms on trade unions’ strategic choice in Germany and England.

The focus will lie on performance management, namely, on one of the most profound organizational and financial changes in the hospital sector: The introduction of diagnosis-related groups (DRGs), which led to increased work pressure and competition in the hospital sector. The matter of this analysis is to gain insights into unions’ usage of changed opportunity structures in an ever increasing marketization of the hospital sector. The responses of public sector trade unions will constitute the core of this paper which aims at answering two main questions: What were the determinants of trade unions’ strategic choices to prevent further marketization or moderate its negative effects? And against the background of a common directionality of marketization reforms in the hospital sectors: Are these determinants becoming more similar in Germany and England?

These questions will be addressed drawing on an empirical qualitative analysis of conflict cases reported in magazines published by the hospital sector trade unions between 2001 and today, as well as on preliminary findings from semi-structured interviews.