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Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with “health inequity”. Governing power is impacting people's lives through laws, policies and professional decisions, and can be used intentionally to combat health inequity by addressing and changing people's living- and working conditions. Little attention is paid to how these ways of exercising governing power unintentionally can structure further conditions for health inequity. In this paper, the authors coin the term “governance determinants of health” (GDHs). The authors' discussion of GDHs potential impact on health inequity can help avoid the implementation of governing strategies with an adverse impact on health equality. This paper aims to discuss the aforementioned objective.

The authors identify Governance Determinants of Health, the GDHs. GDHs refer to governance strategies that structurally impact healthcare systems and health equality. The authors focus on the unintended, blind sides of GDHs that maintain or reinforce the effects of socioeconomic inequality on health.

The power to organize healthcare is manifested in distinct structural approaches such as juridification, politicalization, bureaucratization and medical standardization. The authors explore the links between different forms of governance and health inequalities.

The authors' discussion in this article is innovative as it seeks to develop a framework that targets power dynamics inherent in GHDs to help identify and avoid GDHs that may promote unequal access to healthcare and prompt health inequity. However, this framework has limitations as the real-world, blurred and intertwined aspects of governing instruments are simplified for analytical purposes. As such, it risks overestimating the boundaries between the separate instruments and reducing the complexity of how the GDHs work in practice. Consequently, this kind of theory-driven framework does not do justice to the myriad of peoples' complex empirical practices where GDHs may overlap and intertwine with each other. Nevertheless, this framework can still help assist governing authorities in imagining a direction for the impacts of GDHs on health equity, so they can take precautionary steps to avoid adverse impacts.

The authors develop and explore – and demonstrate – the relevance of a framework that can assist governing authorities in anticipating the impacts of GDHs on health inequity.

The increasing push towards centralisation and bureaucratisation in higher education, further exacerbated by the disruption caused by the COVID-19 pandemic, calls for a better understanding of the nature of collegiality in contemporary universities. We address this issue by looking into the necessary conditions and barriers to sustaining a collegiate environment. The empirical focus is on academics, academic leaders and professional support staff at Anonymous Business School (ABS), a department in a large civic UK university. We interviewed 32 participants across the school, ranging from early-career academics to experienced professors and members of department leadership teams. The findings suggest multiple emerging perspectives on collegiality, with features of horizontal collegiality perceived as key to successful academic responses to the crisis. The findings also indicate how sustaining a collegiate environment within the department requires both choice and effort from leadership and from staff, particularly when decision-making is primarily located at the centre of the university. The choice and effort made across different collegiate pockets contribute to the department becoming an ‘island of collegiality’ within the increasingly centralised and bureaucratised university hierarchy. In this sense, the actions of the department leadership to establish supporting mechanisms, and the actions of the staff to, in turn, embrace and build interpersonal relationships and professional identities, are key to sustaining a collegiate environment.

Recent changes in university systems, debates on academic freedom, and changing roles of knowledge in society all point to questions regarding how higher education and research should be governed and the role of scientists and faculty in this. Rationalizations of systems of higher education and research have been accompanied by the questioning and erosion of faculty authority and challenges to academic collegiality. In light of these developments, we see a need for a more conceptually precise discussion about what academic collegiality is, how it is practiced, how collegial forms of governance may be supported or challenged by other forms of governance, and finally, why collegial governance of higher education and research is important.

We see collegiality as an institution of self-governance that includes formal rules and structures for decision-making, normative and cognitive underpinnings of identities and purposes, and specific practices. Studies of collegiality then, need to capture structures and rules as well as identities, norms, purposes and practices. Distinguishing between vertical and horizontal collegiality, we show how they balance and support each other.

Universities are subject to mixed modes of governance related to the many tasks and missions that higher education and research is expected to fulfill. Mixed modes of governance also stem from reforms based on widely held ideals of governance and organization. We examine university reforms and challenges to collegiality through the lenses of three ideal types of governance – collegiality, bureaucracy and enterprise – and combinations thereof.

Collegiality is often discussed and analyzed as a challenged form of governance, a form of working that used to function well in universities prior to the emergence of contemporary and modern forms of governance. This seems to suggest that collegiality used to dominate, while other forms of governance are now taking over. The papers in volume 86 of this special issue support the notion of challenged collegiality, but also show that for the most part, nostalgic notions of “the good old days” are neither true nor helpful if we are to revitalize academic collegiality. After examining whether a golden age of collegiality ever existed, we discuss why collegiality matters. Exploring what are often described as limitations or “dark sides” of collegiality, we address four such “dark sides” related to slow decision-making, conflicts, parochialism, and diversity. This is followed by a discussion of how these limitations may be handled and what measures must be taken to maintain and develop collegiality. With a brief summary of the remaining papers under two headings, “Maintaining collegiality” and “Revitalizing collegiality,” we preview the rest of this volume.

This study aims to answer the research question of how a calculative regime for public universities is implemented, how and under which conditions its symbolic use emerges and what kind of unintended consequences occur over time.

The empirical material presented in the paper derives methodically from a longitudinal qualitative research approach analyzing higher education systems (HES)-reforms in Austria. To better understand the consequences of the organizational changes in line with the new legal framework, 2 series of qualitative interviews in 2011/2012 and 2016/2017 on the field level and the organizational level were conducted.

Identifying two enabling consequences from the tactical behaviors of resistance and symbolic use, i.e. new processes of communication and horizontal network building, allows for theory-building with a focus on the dynamics how accounting begins, then next becomes an established infrastructure, is then destabilized and re-elaborated before it becomes, again, an infrastructure which is different from before.

Although the findings are based on a national empirical context, they are linked to the international discourse on HES in transition and the role of calculative regimes including performance measurement and management attitudes and instruments. They are relevant for an international research community open-minded toward differentiated case studies in a longitudinal perspective on HES-reforms.

When reflecting on their own specific settings governing bodies and practitioners managing the transition of HES may find insights from longitudinal case studies inspiring. The dynamics initiated by new calculative regimes installed need a sensitive framework to handle dissent, resistance, tactical behaviors and changes in power relations between the field level and the organizational level.

This is a unique longitudinal case study of the Austrian HES and its public universities in transition.