Archetype Transition in the German Health Service? The Attempted Modernization of Hospitals in a North German State

Abstract

In this paper, we argue that, rather than aiming at universal contingency relationships,
archetype theory needs to go down a path where ‘local variants’ can be discovered
and understood by relating them to their organizational and institutional
context(s). The case study of a public sector hospital group in a North German state
(Hamburg) is drawn on here to elaborate the argument. We found evidence for a
change from a Public Sector hospital archetype to a Public Hospital Corporation
archetype. Drawing on this model permits us to explore the impact of the introduction
of new forms of public management organization and the implications the managerial
ideology underpinning this may have for the professional organization. The
study explores the consequences of the innovations for professional/managerial
relations. We also suggest that the ‘archetype’ approach may be particularly useful
for the comparative study of organizations. This is particularly pertinent given the
different – corporatist – organization of the German health care system and its different
approach to public sector reform to that of the Anglo-American and Scandinavian
systems where the ‘archetypal’ approach has so far been applied.