What difference does ("good") HRM make?

The importance of human resources management (HRM) to the success or failure of health system performance has, until recently, been generally overlooked. In recent years it has been increasingly recognised that getting HR policy and management "right" has to be at the core of any sustainable solution to health system performance. In comparison to the evidence base on health care reform-related issues of health system finance and appropriate purchaser/provider incentive structures, there is very limited information on the HRM dimension or its impact. Despite the limited, but growing, evidence base on the impact of HRM on organisational performance in other sectors, there have been relatively few attempts to assess the implications of this evidence for the health sector. This paper examines this broader evidence base on HRM in other sectors and examines some of the underlying issues related to "good" HRM in the health sector. The paper considers how human resource management (HRM) has been defined and evaluated in other sectors. Essentially there are two sub-themes: how have HRM interventions been defined? and how have the effects of these interventions been measured in order to identify which interventions are most effective? In other words, what is "good" HRM? The paper argues that it is not only the organisational context that differentiates the health sector from many other sectors, in terms of HRM. Many of the measures of organisational performance are also unique. "Performance" in the health sector can be fully assessed only by means of indicators that are sector-specific. These can focus on measures of clinical activity or workload (e.g. staff per occupied bed, or patient acuity measures), on measures of output (e.g. number of patients treated) or, less frequently, on measures of outcome (e.g. mortality rates or rate of post-surgery complications). The paper also stresses the need for a "fit" between the HRM approach and the organisational characteristics, context and priorities, and for recognition that so-called "bundles" of linked and coordinated HRM interventions will be more likely to achieve sustained improvements in organisational performance than single or uncoordinated interventions

Agency theory and performance appraisal: how bad theory damages learning and contributes to bad management practice

Performance appraisal interviews remain central to how employees are scrutinised, rewarded and sometimes penalised by managers. But they are also often castigated as ineffective, or even harmful, to both individuals and organisations. Exploring this paradox, we highlight the influence of agency theory on the (mal)practice of performance appraisal. The performative nature of human resource management increasingly reflects an economic approach within which its practices are aligned with agency theory. Such theory assumes that actors are motivated mainly or only by economic self-interest. Close surveillance is required to eliminate the risk of shirking and other deviant behaviours. It is a pessimistic mind-set about people that undermines the supportive, co-operative and developmental rhetoric with which appraisal interviews are usually accompanied. Consequently, managers often practice appraisal interviews while holding onto two contradictory mind-sets, a state of Orwellian Doublethink that damages individual learning and organisational performance. We encourage researchers to adopt a more radical critique of appraisal practices that foregrounds issues of power, control and conflicted interests between actors beyond the analyses offered to date

The UK gender pay gap 1997-2015: what is the role of the public sector?

The Labour Force Survey is used to examine the influence of sector on the UK gender pay gap 1997–2015. The assessment is twofold: first comparing gender pay gaps within sectors and second through identifying the contribution of the concentration of women in the public sector to the overall gender pay gap. The long‐term narrowing of the gender pay gap, which predominately reflects relative improvements in women's productivity‐related characteristics, is found to stall in 2010 within each sector. This is considered in the context of claims that public sector austerity represents a critical turning point in progress toward gender equality at work

Ethnicity and low wage traps: favouritism, homosocial reproduction and economic marginalization

This article analyses the relationship between cultural difference, social connections and opportunity structures using interview evidence from low-paid workers and managers in local government, the health service, facilities management and housing. Exploring the operation of homosocial reproduction it reveals the double-edged nature of informality and the role of favouritism in particular in perpetuating ethnic advantage and privilege. While demonstrating that uses of homosocial reproduction need to be sensitive to intersections of identities or categories of difference, the article adds further evidence of the persistent gap between equal opportunities policies and practice for ethnic minorities in the United Kingdom labour market. The article concludes that stronger forms of positive action, and even positive discrimination, are needed to address the low pay traps and restricted opportunities of ethnic minority workers

Flexible Working, Individual Performance and Employee Attitudes: Comparing Formal and Informal Arrangements

In the context of a wider trend to individualize HRM, this paper examines the relationship between flexible working arrangements and individual performance. Drawing on a range of theories, it examines potential indirect effects on employee performance via job satisfaction and organizational commitment and analyses whether these relationships vary according to whether the arrangement was set up through a formal process, or negotiated informally between the employee and their line manager. Extant research has tended to focus on formal arrangements, however, informal arrangements are widespread and may better accommodate work-life preferences, thereby potentially fostering more positive attitudes from employees. Survey data from 2617 employees in four large organizations with well-established flexible working policies are analysed. Results from structural equation models show average positive indirect effects from informal, but also negative direct effects, from formal flexible working. When two forms of flexible working amenable to being set up by both formal and informal means are examined separately: formal arrangements for flexibility over working hours are found to be negatively associated with performance, but also a source of greater job satisfaction; informal remote working arrangements have positive indirect effects via organizational commitment and job satisfaction on worker performance

An exploration of the influences on under-representation of male pre-registration nursing students

Background:- Worldwide, men are under-represented in the nursing profession. In Scotland less than 10% of pre-registration nursing students are male. Reasons for this imbalance need to be understood. Objectives:- To explore the views of male pre-registration nursing students, nursing lecturers and school teachers about this imbalance. Design:- Mixed methods study using focus groups and online survey. Settings:- Focus groups in four locations across Scotland. Online survey sent to teachers across Scotland. Participants and methods:- Eight focus groups with 33 male nursing students; four focus groups with 21 university and college nursing lecturers; 46 school teachers returned the online survey. Results:- Although nursing was considered a worthwhile career with job stability and many opportunities, it was also viewed as not being a career for men. Assumptions about the profession and femininity were challenging for men and use of the term ‘male nurse’ was felt to be anomalous. In some circumstances the provision of intimate care to particular patient groups caused difficulty. Positive encouragement from others, a positive role model or knowledge of nursing from significant others could be helpful. However concerns about low earning potential and negative media publicity about the NHS could be a disincentive. Being mature and having resilience were important to cope with being a male nursing student in a mainly female workplace. Some more ‘technical’ specialties were felt to be more attractive to men. Conclusions:- Nursing is viewed as a worthwhile career choice for men, but the gendered assumptions about the feminine nature of nursing can be a deterrent

Employers’ recruitment of disadvantaged groups: exploring the effect of active labour market programme agencies as labour market intermediaries

This article draws on an original comparative survey of employers in the UK and Denmark to analyse the role of active labour market programmes (ALMPs) in employers' recruitment of disadvantaged groups. Using the framework of Bonet et al. to conceptualise agencies delivering ALMPs as labour market intermediaries (LMIs), the effect of ALMPs on employers' recruitment was tested against organisational factors involving firm size and selection criteria. Although ALMPs marginally increased employers' probability of recruiting the long-term unemployed in both countries and lone parents in Denmark, their effect was negligible compared with firm size and employers' selection criteria. While ALMP agencies have the potential to increase employers' recruitment of disadvantaged groups, this is constrained when they act as basic ‘information provider’ LMIs. ALMP agencies' inability to act effectively as ‘matchmaker’ LMIs leads to a failure to overcome rigid intra-organisational barriers to such recruitment