Title: Internal labour market in the Spanish National Health Service: a critical appraisal

Authors: Begona Gonzalez-Busto, Begona Lopez

Addresses: Departamento de Administracion de Empresas y Contabilidad, Avda. del Cristo, s/n, 33071 Oviedo, Spain. Departamento de Administracion de Empresas y Contabilidad, Avda. del Cristo, s/n, 33071 Oviedo, Spain

Abstract: The aim of this study is to carry out a revision of the internal labour market in the Spanish NHS Secondary Care. New tendencies and reform proposals that are emerging are also analysed. First, the structure and organisational features of INSALUD and the centres associated with its healthcare network are set out. The conflicts between them, which hinder the design and establishment of an adequate incentive system, are highlighted. Subsequently, an analysis is made of the internal labour market in public hospitals, with special emphasis on the incentive system. In line with this, a distinction is made between the denominated high - and low - powered incentives, and consideration is given to their respective appropriateness in the case of public health. Furthermore, the benefits and drawbacks to promotion as the main incentive are analysed, as well as tenure. Finally, the new tendencies observed in medical personnel management are put forward, in light of the reform proposals for the Spanish NHS.

Keywords: Spanish NHS; incentive system; internal labour market; internal promotion; professional career; healthcare public foundations; tenure; Spain.

DOI: 10.1504/IJHTM.2001.001107

International Journal of Healthcare Technology and Management, 2001 Vol.3 No.1, pp.94-109

Available online: 15 Dec 2003

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