Modernising health care

Reinventing professions, the state and the public

Ellen Kuhlmann

Modernising health care

Ellen Kuhlmann

Distributed for Bristol University Press

280 pages
Cloth $100.00 ISBN: 9781861348586 Published September 2006 For sale in North and South America only
Modernising health care: Reinventing professions, the state and the public is a crucial contribution to debates about the rapid modernisation of health care systems and the dynamics of changing modes of governance and citizenship. Structured around the role of the professions as mediators between state and citizens, and set against a background of tighter resources and growing demands for citizenship rights, Ellen Kuhlmann’s book offers a much-needed comparative analysis, using the German health care system as a case study. The German system, with its strongly self-regulatory medical profession, exemplifies both the capacity of professionalism to re-make itself, and the role of the state in response, highlighting the benefits and dangers of medical self-regulation, while demonstrating the potential for change beyond marketisation and managerialism. Kuhlmann critically reviews dominant models of provider control and user participation, and empirically investigates different sets of dynamics in health care, including tensions between global reform models and nation-specific conditions; interprofessional dynamics and changing gender arrangements; the role of the service-user as a new stakeholder in health care; and the rise of a new professionalism shaped by social inclusion. Modernising health care provides new approaches and a wealth of new empirical data for academics and students of health policy, medical sociology and sociology of professions, and for health policy makers and managers.


Towards 'citizen professonals': contextualising professions and the state

Part one: Mapping change in comparative perspective
Global models of restructuring health care: challenges of integration and coordination
Remodelling a corporatist health system: change and conservative forces
Drivers and enablers of change: exploring dynamics in Germany

Part two: Dynamics of new governance in the German health system
Hybrid regulation: the rise of networks and managerialsim
Transformations of professionalism: permeable boundaries in a contested terrain
New actors enter the stage: silent voices of consumers in the landscape of biomedicine

Part three: The rise of new professionalism in late modernity
Professions and trust: new technologies of building trust in medical services
The knowledge-power knot in professionalism: transforming the 'currency of competition'

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