Governance and the functions of boards: An empirical study of hospital boards in Norway

ObjectiveThis paper describes the implementation of hospital governance under the Norwegian hospital reforms 2001-2008.MethodsData are analysed from interviews with key decision makers in hospital boards and among hospital managers (N = 13), and a survey among a national sample of board members (N = 130). The analysis integrates findings from both the qualitative and quantitative data, which are analysed according to the theoretical framework.ResultsThe findings indicate a transition of the roles given to the hospital board from a model with professional and autonomous boards towards two different roles. These roles are a mixture between the tasks of a formal decision body and the behaviour of a body to secure the interests of different stakeholders.ConclusionsThe hospital boards have to act in contexts of ambiguity and uncertainty. In such situations, a wide decision space will face the boards with problems related to emotions and opportunism. Thus, the principals in the context of public sector hospitals have to balance among strong political influence, hierarchical modes of governance and discretion given to the boards.