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Health systems governance

Health systems governance

Health systems governance contributes to better performing health systems. It affects the ability of markets, networks and public administrations to contribute to better health outcomes, more equitable distribution of financial burden, and an increase in responsiveness with regards to non-medical expectations of patients.

Health systems are full of markets, from the market for health services to the market for labour to the market for devices and medicines. For these markets to work, policies on outsourcing, contracting and competition need to be developed and implemented.  

Health systems are also full of networks that require coordination. The health system, for example, is highly dependent on the production of health professionals. In many countries, however, this is in the remit of the ministry responsible for education. Often, this responsibility sits with regional governments, which have their own political mandate and legitimacy and are not accountable to the ministry of health. To ensure that these networks function, tensions and multiple accountabilities need to be governed.

In many countries, health systems or parts of them are run directly by the government. Exposure to political influence can be unduly high. Alternatively, they can be too insulated from political oversight; and unlike dysfunctional firms in a market, they cannot simply fail and go out of business. 

The European Observatory’s work programme aims to synthesize evidence on how to govern markets, networks and public administration for better performance. 

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