Health Sector Reform and the Regulation and Management of Health Professionals: A Case Study from Chile

This paper provides an overview of main issues facing the human resources function in the public sector health services in Chile in the late 1990’s. The paper examines the main characteristics of the Chilean health sector, from an HR perspective, and focuses on two key aspects of HR in health services-performance management and the regulation of the work of doctors and nurses. The paper provides a national level country case study of these two issues during health sector reform, placing the main HR related objectives of reform within the context of the key characteristics of the Chilean system. Health sector reform in Chile, as in many countries in 1990’s has focused on structural change, cost containment, the introduction of market mechanisms, and an increased emphasis on consumer involvement and choice. Whilst it is possible to identify common challenges in HR during health sector reform, it is also important to recognise that the country context, in terms of socio-economic, legal, political and cultural factors will play a fundamental role in determining what HR responses are viable and effective. The complexity, plurality and highly regulated nature of the Chilean system is highlighted in the paper. Any attempt to change HR policy and practice has to take account of the need to assess the impact and constraints of current legislation and regulation. Over the longer term it is likely that legislative change will be required to facilitate and to fully develop the flexibilities and local management capacity in HR required to best meet the health priorities set by the Chilean government.