ABSTRACT
Governments across the industrialized world are in the process of implementing wide-ranging reforms to rationalize their health systems, all of whose operations – economic, occupational, technical and social – are, as a result, undergoing major changes. This chapter examines the nature of these reforms undergone by French and Italian hospitals. It analyses these reforms have gone together with structural and shorter-term developments specific to their respective labour relations systems which are themselves changing. The main features of reform from an institutional point of view are the regionalization of systems, the increased autonomy and responsibility of health facilities and the establishment of new agencies responsible for evaluation. The reform to unify health care in Italy really started with the creation of the National Health Service under the terms of the law of 23 December 1978. Health reforms implemented in France and Italy reflect a long history of turbulence between the state and the unions.
