9th Conference European Sociological Association

RN16 Sociology of Health and Illness

2009-09-04 09:00:00 2009-09-04 10:30:00 Friday, 4 September 09:00 - 10:30 Formal and Informal Health Care Organisation and Health Care Delivery in Europe I Building I, 1E2

Outsourced Services and Hierarchy in the Finnish Primary Health Care

This paper is concerned with the hierarchical changes in public health centres after outsourcing. We analyse the significances and connotations that the staff gives to the change of inter-employee relationships after outsourcing. The paper is a part of ongoing research about competitive practices in public health care.

The research data consists of group interviews of general practitioners and nurses conducted in three outsourced health centres. The interviewees have experience working on both private and public sector. The approaches used in analysing the data are sociological cultural studies and narrativity.

How does the low organisation structure of outsourced health care services influence the hierarchy between different groups of medical staff? The results indicate that there has been a change both in division of labour and in the hierarchy between nurses and doctors after the outsourcing. The professional borderline between nurses and doctors is less clear than before and there seems to be a growing tendency towards equal partnership. Our goal is to deepen the understanding of health centres´ transition to privately provided services from the employees´ viewpoint. This is done in the context of the changing organisational practices that lay behind the new order of hierarchy.