T2a facing social reification in healthcare: lessons from organizational resilience

Abstract

We show through this piece of work the way by which performance management devices introduced by the prospective payment system and the so-called nouvelle Gouvernance reforms contribute to healthcare commodification that urges hospitals to develop activity with no increase of budget and we analyse the risks that such a situation induces for he healthcare public service as a whole, with a special attention granted to denying human dimensions. We propose a series of elements to nurture reflexion on possible tracks for solution: first we borrow from high reliability organizations which grant a high priority to safety and have developed an expertise from which we can learn; then we bring more theoretical inputs opening the way towards a paradigmatic reverse that leads to consider the healthcare public service system as a commons as defined and studied by elinor ostrom.