Orchestrating public reforms through joint organizations: the case of a new remuneration policy in Belgian healthcare

Abstract

While remuneration policies in the public sector are a powerful lever for attracting and retaining qualified staff, they are known to be notoriously difficult to change. This paper sets out to unveil how remuneration reforms unfold by exploring the case of Belgian healthcare, in which a sectoral organization jointly managed by employers and labour unions implemented a new compensation framework. Two contributions emerged from this study. First, the paper emphasizes the strengths and challenges of joint organizations in orchestrating public reforms. Second, the tensions between political objectives, managerial rationalities, and workers’ expectations that arise when transforming remuneration policies are highlighted.

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