Gender and the Public Sector: Professionals and Managerial Change

By Jim Barry; Mike Dent et al. | Go to book overview

4

Gender, welfare regimes and the medical profession in France and Greece

Clientelism, étatism and the 'Mediterranean rim'

Mike Dent

Introduction
In this chapter I compare the work and organisation of hospital doctors in France and Greece in the broader context of the state and gender. First, this chapter is an exploration of two variants of the 'Beveridge' and 'Bismarckian' systems within Europe: France, because it is, perhaps paradoxically, an étatist variant of a 'Bismarckian' system; Greece, because it is an unusual variant of the Beveridge model. The examination of these two countries' health systems is carried out initially in terms of Esping-Andersen's (1990) welfare state regimes. This provides a useful framework within which to raise questions of the relationship between gender, family and health care provision, in particular the work of the medical profession. Part of the argument here is that professional jurisdiction (Abbott 1988) and autonomy - in the more loosely coupled sense of individual practitioner's discretion - is partly shaped by the officially defined role(s) of women in society (Lewis 1992; O'Connor 1993; 1996; Orloff 1993; Sainsbury 1994; Williams 1994). The chapter will discuss four sets of issues and examine their inter-relationship:
1 the organisation and funding of the two health care systems and the public/private sector boundaries;
2 gender and welfare state regimes;
3 governmentality and state/profession relations;
4 the family and the issue of co-payments - official and unofficial.

The first, concerning the organisation and funding of the two systems, is largely descriptive and it is the relationship among the remaining three that is the focus of the analysis here.


Health services organisation and funding and public/ private sector boundaries

The funding of the health services in both countries is based on social insurance (sickness funds) with the state taking an active interest.

-65-

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Gender and the Public Sector: Professionals and Managerial Change
Table of contents

Table of contents

  • Title Page v
  • Contents vii
  • Acknowledgements xvi
  • Introduction 1
  • Part I - Contexts and Networks 13
  • 1 - New Labour, Governance and the Politics of Diversity 15
  • Notes 25
  • 2 - Gendered States, Critical Engagements 27
  • 3 - Managing Transformation? 44
  • 4 - Gender, Welfare Regimes and the Medical Profession in France and Greece 65
  • Notes 80
  • Part II - Managing Professional Work 83
  • 5 - Identifying the Professional 'Man'Ager 85
  • 6 - Women's Positioning in a Bureaucratic Environment 104
  • 7 - Plural Frames of Work in Public Sector Organisations 120
  • Note 133
  • 8 - On the Front Line 136
  • 9 - Hard Nosed or Pink and Fluffy? 154
  • References 168
  • 10 - Ministering Angels and the Virtuous Profession 170
  • References 184
  • Part III - Identity and Biography 187
  • 11 - Gendered Narratives of the Management of Residential Care Homes 189
  • 12 - The Problematic Professional 205
  • References 216
  • Index 218
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