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This study is a considered interpretation of the National Registration and Accreditation Scheme for the health professions, which commenced operations in Australia in 2010. The development of the Scheme and its operational elements (namely the Australian Health Practitioner Regulation Agency and 14 profession-specific national Boards) are positioned within the context of regulatory capitalism. Regulatory capitalism merges the experience of neoliberalism with an attentiveness to risk, particularly by the State. Nationally consistent legislation put in place a new set of arrangements that enabled the continuity of governments’ role in health workforce governance. The new arrangements resulted in an entity which is neither exclusively subservient to nor independent of the State, but rather “quasi-independent.” In exploring this arrangement, specific consideration is given to how the regulatory response matched the existing reality of a global (and national) health workforce market. This study considers this activity by the State as one of consolidation, as opposed to fracturing, against a backdrop of purposeful regulatory reform.

This chapter explores the ethics of a critical vulnerability suffered by migrant health professionals (MHPs): the problem of ‘pathways to nowhere’. This problem arises from dynamic change in the processes, practices and policies governing how migrant professionals achieve accreditation, training and employment in destination countries, whereby established pathways to professional practice are unexpectedly altered or removed. The authors detail the significance of this phenomenon in Australian and Canadian contexts. Drawing on the literature on legitimate expectations and the rule of law, the authors outline the ethical stakes and responsibilities that attach to states creating and then disappointing people’s legitimate expectations, and discuss how these considerations apply to destination countries’ treatment of MHPs.

The hospital–physician relationship (HPR) has been the focus of many scholars given the potential impact of this relationship on hospitals’ ability to achieve socially and organizationally desirable health care outcomes. Hospitals are dominated by professionals and share many commonalities with professional service firms (PSFs). In this chapter, we explore an alternative HPR based on the governance models prevalent in PSFs.

We summarize the issues presented by current HPRs and discuss the governance models dominant in PSFs.

We identify the non-equity partnership model as a governance archetype for hospitals; this model accounts for both the professional dominance in health care decisions and the increasing demand for higher accountability and efficiency.

There should be careful consideration of existing regulations such as the Stark law and the antikickback statue before the proposed governance model and the compensation structure for physician partners is adopted.

While our governance archetype is based on a review of the literature on HPRs and PSFs, further research is needed to test our model.

Given the dominance of not-for-profit (NFP) ownership in the hospital industry, we believe the non-equity partnership model can help align physician incentives with those of the hospital, and strengthen HPRs to meet the demands of the changing health care environment.

This is the first chapter to explore an alternative hospital–physician integration strategy by examining the governance models in PSFs, which similar to hospitals have a high reliance on a predominantly professional staff.

In 2013, the National Mutual Acceptance (NMA) of single ethical review was introduced into the Australian public health sector to address the timeliness of multisite clinical trials. A clinical trial is usually designed to test the effects of an experimental therapeutic product. While all research involving humans must comply with ethical guidelines, clinical trials testing products in Australia are also subject to stringent regulatory controls making the need to meet trial milestones critically import. Commercial clinical trials offer participating research sites substantial financial and clinical advantages. Concerns that bureaucratic processes have impeded commercial investment have influenced countries, including Australia, to introduce single ethical review, where one ethics review is accepted at multiple sites participating in the same research project. Although a central tenet of the NMA is the standardization of the behaviors and procedures of research review, concerns of inconsistency remain. This raises the question of whether the NMA does lead public healthcare agencies to adopt similar research governance practices.

A questionnaire survey was undertaken to explore the current experiences (n = 149) of the NMA in Victorian public health agencies, and 21 semi-structured interviews were conducted to explore expectations of the future of the NMA. The findings indicated that, while there was conformity to many of the process requirements of the NMA, a persistent focus on the needs of each individual healthcare agency rather than on complying with the national system weakened pressure on agencies to adopt standardization.

The NMA has the capacity to be a powerful tool in delivering quality clinical trial outcomes, maximize research resources and create dependable performance metrics if consistent policies and governance are followed.

Voluntary non-financial reporting aims at fairly reporting a firm’s non-financial performance. In particular, integrated reporting (IR) displays in a single report the contribution of different forms of capital to the firm’s value creation. Drawing on both legitimacy and voluntary disclosure theory, the main purpose of this study is to examine the extent to which a company’s environmental, social, and governance (ESG) performance affects the content and semantic properties of intellectual capital disclosure (ICD) found in IRs.

To test theoretical hypotheses, content and tone analysis is used to assess the disclosure strategy associated with ICD, whereas a regression analysis tests the variation in semantic properties of ICD according to firms’ ESG performance. A total of 79 reports by European listed firms from 2011 to 2016 were downloaded via the Integrated Reporting Emerging Practice Examples Database and analyzed.

Results show that ESG performance contributing more to optimistic ICD tone is governance, although in mixed ways. Integrating vision and strategy positively contributes to ICD tone, whereas information on poor treatment of shareholders’ rights tends to be manipulated and associated with an optimistic tone of the ICD. Moreover, eco-efficient product innovation and healthy and safe job conditions play a positive role in enhancing optimistic ICD tone.

This chapter contributes to the current literature on voluntary disclosure by introducing new evidence on the disclosure strategy in IR. By analyzing the effect of the single dimensions of ESG performance on ICD tone, this study extends respectively ESG literature.

In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.