The Norwegian Hospital Reform - Balancing Political Control and Enterprise Autonomy

This paper focuses on the balance between superior governmental control and enterprise autonomy by examining the Norwegian Hospital Reform. We describe the enterprise model and give a description of the policy instruments that the government, as owner, has for exercising power and control vis-à-vis the health enterprises. How the trade-off between autonomy and control is experienced and practiced is analyzed by use of survey data collected among regional executive board members, and illustrative cases. The trade-off can be characterized as ambiguous and unstable and we ask if it is possible to achieve a plus-sum game between political control and autonomy