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Workforce flexibility – in defence of professional healthcare work

Sarah Wise (Faculty of Health, University of Technology Sydney, Sydney, Australia)
Christine Duffield (Faculty of Health, University of Technology Sydney, Sydney, Australia)
Margaret Fry (Faculty of Health, University of Technology Sydney, Sydney, Australia)
Michael Roche (School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 19 June 2017

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Abstract

Purpose

The desirability of having a more flexible workforce is emphasised across many health systems yet this goal is as ambiguous as it is ubiquitous. In the absence of empirical studies in healthcare that have defined flexibility as an outcome, the purpose of this paper is to draw on classic management and sociological theory to reduce this ambiguity.

Design/methodology/approach

The paper uses the Weberian tool of “ideal types”. Key workforce reforms are held against Atkinson’s model of functional flexibility which aims to increase responsiveness and adaptability through multiskilling, autonomy and teams; and Taylorism which seeks stability and reduced costs through specialisation, fragmentation and management control.

Findings

Appeals to an amorphous goal of increasing workforce flexibility make an assumption that any reform will increase flexibility. However, this paper finds that the work of healthcare professionals already displays most of the essential features of functional flexibility but many widespread reforms are shifting healthcare work in a Taylorist direction. This contradiction is symptomatic of a failure to confront inevitable trade-offs in reform: between the benefits of specialisation and the costs of fragmentation; and between management control and professional autonomy.

Originality/value

The paper questions the conventional conception of “the problem” of workforce reform as primarily one of professional control over tasks. Holding reforms against the ideal types of Taylorism and functional flexibility is a simple, effective way the costs and benefits of workforce reform can be revealed.

Keywords

Citation

Wise, S., Duffield, C., Fry, M. and Roche, M. (2017), "Workforce flexibility – in defence of professional healthcare work", Journal of Health Organization and Management, Vol. 31 No. 4, pp. 503-516. https://doi.org/10.1108/JHOM-01-2017-0009

Publisher

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Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited

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