Transforming hospital management à la francaise: The new role of clinical managers in French public hospitals

Abstract

Purpose

The perpose of this paper is to analyse recent changes in the management of French public hospitals, following a reform enacted in 2009 and aimed at bolstering the managerial roles of doctors.

Design/methodology/approach

The paper is exploratory and is based on both the analysis of French literature dealing with the results of the 2009 reform, and ten semi-directed interviews with clinical managers and top leaders in the public hospital sector.

Findings

The author reports on the major hospital management reforms of 2009 and analyse the implications for the medical profession and management. The author shows that the involvement of the classical clinical leaders has become less regulated as the units no longer have a clear legal basis. The governance of the newly introduced “medical poles” appears to be shaped by various factors: there is high correlation between centrality, prestige and “clan involvement”, which suggests that professionals holding new responsibilities obtain power and legitimacy by consolidating pre-existing networks. While it is often argued that high-quality clinical leadership is a key factor of organisational success, the findings suggest that the performance of clinical managers relies on this network and legitimacy acquired from it.

Originality/value

Drawing on the “sociology of translation” and actor-network theory (Callon and Latour, 1991), this paper provides a new conceptual framework for the analysis of the transformation of the role of clinical leaders, arguing that this transformation depends highly on their abilities to build and use networks. The findings challenge the French tradition of public management that presupposes a clear division of power between doctors and administrative staff.

Citation

Vinot, D. (2014), "Transforming hospital management à la francaise: The new role of clinical managers in French public hospitals", International Journal of Public Sector Management, Vol. 27 No. 5, pp. 406-416. https://doi.org/10.1108/IJPSM-06-2012-0067