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Health care governance and gender relations within the health services of Germany and Italy

Health care governance and gender relations within the health services of Germany and Italy Purpose – The paper addresses the question of the contribution made by health service institutions towards the perpetuation of gender inequality within health occupations. Design/methodology/approach – Institutions that enable the medical profession to exercise influence over the working, training and examination practices of other health occupations will be looked at in their role as sustaining the dominance of the medical profession over all other health services. Statistically analysing the proportions of women and men in health occupations the paper examines whether this is a gender‐specific form of dominance. Using an institutionalist actor‐centred approach it will be examined whether the stability of the subordination of the allied occupations depends on whether the medical profession is also a corporate actor allotted a central steering function in the governance of the health system. A comparison is made between Germany and Italy. Findings – In Germany and Italy physicians fulfil the criteria for professional dominance. It is shown that in both countries there exists a gender‐specific segregation across the health occupations, women being under‐represented in the profession of physician, and greatly over‐represented in the subordinate occupations. Therefore, the dominance of the medical profession is gender‐specific. The dominance of the medical profession in Germany is reinforced by several institutions with the consequence of stagnation in the traditional relationship between physicians and allied health occupations. In Italy, more self‐determination of the allied health occupations in the areas of training and examination has become a distinct possibility. Originality/value – This is the first paper to assess the impact of health care institutions on gender inequality within the health services. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Sociology and Social Policy Emerald Publishing

Health care governance and gender relations within the health services of Germany and Italy

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References (24)

Publisher
Emerald Publishing
Copyright
Copyright © 2006 Emerald Group Publishing Limited. All rights reserved.
ISSN
0144-333X
DOI
10.1108/01443330610644443
Publisher site
See Article on Publisher Site

Abstract

Purpose – The paper addresses the question of the contribution made by health service institutions towards the perpetuation of gender inequality within health occupations. Design/methodology/approach – Institutions that enable the medical profession to exercise influence over the working, training and examination practices of other health occupations will be looked at in their role as sustaining the dominance of the medical profession over all other health services. Statistically analysing the proportions of women and men in health occupations the paper examines whether this is a gender‐specific form of dominance. Using an institutionalist actor‐centred approach it will be examined whether the stability of the subordination of the allied occupations depends on whether the medical profession is also a corporate actor allotted a central steering function in the governance of the health system. A comparison is made between Germany and Italy. Findings – In Germany and Italy physicians fulfil the criteria for professional dominance. It is shown that in both countries there exists a gender‐specific segregation across the health occupations, women being under‐represented in the profession of physician, and greatly over‐represented in the subordinate occupations. Therefore, the dominance of the medical profession is gender‐specific. The dominance of the medical profession in Germany is reinforced by several institutions with the consequence of stagnation in the traditional relationship between physicians and allied health occupations. In Italy, more self‐determination of the allied health occupations in the areas of training and examination has become a distinct possibility. Originality/value – This is the first paper to assess the impact of health care institutions on gender inequality within the health services.

Journal

International Journal of Sociology and Social Policy – Emerald Publishing

Published: Jan 1, 2006

Keywords: Medical care; Community health services; Sex and gender issues Germany; Italy

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