Why we need multi-level health workforce governance: Case studies from nursing and medicine in Germany

Ellen Kuhlmann and Christa Larsen

Health Policy, 2015, vol. 119, issue 12, 1636-1644

Abstract: Health workforce needs have moved up on the reform agendas, but policymaking often remains ‘piece-meal work’ and does not respond to the complexity of health workforce challenges. This article argues for innovation in healthcare governance as a key to greater sustainability of health human resources. The aim is to develop a multi-level approach that helps to identify gaps in governance and improve policy interventions. Pilot research into nursing and medicine in Germany, carried out between 2013 and 2015 using a qualitative methodology, serves to illustrate systems-based governance weaknesses. Three explorative cases address major responses to health workforce shortages, comprising migration/mobility of nurses, reform of nursing education, and gender-sensitive work management of hospital doctors. The findings illustrate a lack of connections between transnational/EU and organizational governance, between national and local levels, occupational and sector governance, and organizations/hospital management and professional development. Consequently, innovations in the health workforce need a multi-level governance approach to get transformative potential and help closing the existing gaps in governance.

Keywords: Health workforce governance; Health human resources policy; Multi-level governance; Nurses and physicians; Germany (search for similar items in EconPapers)
Date: 2015
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Citations: View citations in EconPapers (7)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:119:y:2015:i:12:p:1636-1644

DOI: 10.1016/j.healthpol.2015.08.004

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