Convergent and divergent country trends in coordinated wage-setting and collective bargaining in the public hospitals sector

Drawing on the findings of research in the public hospitals sector in five European countries1—France, Germany, the Netherlands, Norway and the UK—this article assesses the character of change in wage setting and collective bargaining. It demonstrates the diversity of national arrangements by comparing key characteristics: (i) the bodies of collective representation (unions, professional associations and employer bodies); (ii) the degree of integration with the wider public sector framework; (iii) coordination (or competition) with the private hospitals sector; and (iv) the practice of à la carte provisions within individual hospitals. Despite national varieties of wage setting and collective bargaining, each country sector faces similar tensions—most notably the opposition between public (labour market) rules and health (product market) rules, and pressures to segment or integrate employment conditions by labour force group. By examining the nature of change in institutions for wage setting and collective bargaining in each country, the article contributes to our understanding of the extent of coordination and change of public sector wage setting and describes three scenarios: fragmentation (Germany); continuity (France and the Netherlands); and reconstruction (the UK and Norway).