Workforce flexibility – in defence of professional healthcare work

Wise, S; Duffield, C; Fry, M; Roche, M

Workforce flexibility – in defence of professional healthcare work

Wise, S

Duffield, C

Fry, M

Roche, M

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Publication Type:: Journal Article
Citation:: Journal of Health, Organisation and Management, 2017, 31 (4), pp. 503 - 516
Issue Date:: 2017-01-01

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Field	Value	Language
dc.contributor.author	Wise, S https://orcid.org/0000-0003-3513-3471	en_US
dc.contributor.author	Duffield, C https://orcid.org/0000-0001-6534-8743	en_US
dc.contributor.author	Fry, M https://orcid.org/0000-0003-1265-7096	en_US
dc.contributor.author	Roche, M https://orcid.org/0000-0002-3831-537X	en_US
dc.date.issued	2017-01-01	en_US
dc.identifier.citation	Journal of Health, Organisation and Management, 2017, 31 (4), pp. 503 - 516	en_US
dc.identifier.issn	1477-7266	en_US
dc.identifier.uri	http://hdl.handle.net/10453/123393
dc.description.abstract	© 2017, © Emerald Publishing Limited. 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.	en_US
dc.relation.ispartof	Journal of Health, Organisation and Management	en_US
dc.relation.isbasedon	10.1108/JHOM-01-2017-0009	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Health Personnel	en_US
dc.subject.mesh	Health Manpower	en_US
dc.subject.mesh	Delivery of Health Care	en_US
dc.subject.mesh	Health Workforce	en_US
dc.title	Workforce flexibility – in defence of professional healthcare work	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	31	en_US
utslib.for	1503 Business and Management	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	15 Commerce, Management, Tourism and Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	31	en_US

Abstract:

© 2017, © Emerald Publishing Limited. 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.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/123393