HR’s role in the public sector: understanding constraints and enablers in the hospital context

НазваHR’s role in the public sector: understanding constraints and enablers in the hospital context
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Ciara Elston

Brian Harney

The Learning, Innovation and Knowledge (LInK) Research Centre

Dublin City University

Business School

Dublin 9


Phone: 700 6957



Submitted to

Irish Academy of Management Conference

National University of Ireland, Maynooth

6th-7th September, 2012



Literature in the field of SHRM widely recognises the potential for HR to act as a credible strategic partner, most notably during times of change. Several researchers have worked towards defining particular roles for HR with the objective of enhancing the perceived legitimacy of this function. However, much of this research neglects the myriad of contextual factors that are highly influential in determining the capacity for HR to adopt a particular role. In a similar vein HR research has typically sampled private sector organisations thereby offering limited understanding of the type of role that HR may adopt in the public sector. In overcoming these deficiencies this research explores the role of HR in a hospital context via in-depth qualitative interviews with a diverse range of HR stakeholders.

The findings indicate that strategic HR in the hospital increased significantly as a result of the introduction of the new HR strategy. Nonetheless HRM was hindered in its capacity to adopt either a strategic or employee focus during change, owing to the impact of contextual factors outlined in this study. Evidence of a potential coordinator role for HR is still notably in the early stages of development but indicates a prominent role opportunity for HR to adopt during change. This work consequently illustrates the danger in attempting to predefine a role for HR within a turbulent public hospital setting.

Key Words: SHRM; Change; Employee; Constraints and Enablers; Context; HR Role


In recent years the public sector has faced intense pressure to become more professional, accountable and adaptable (Rhys et al., 2008). Concepts such as New Public Management (NPM) neatly capture the emphasis on greater transparency, user-choice and administrative reform (cf Hood, 1991). Public sector organisations also face significant environmental influences and requirements to appease multiple stakeholder groups (Lynn, 2001). Successfully managing change is therefore one of the key challenges facing HR professionals in the public sector. Nonetheless, prior empirical studies in this domain remain ‘relatively scarce’ (Alfes, Truss and Gill., 2010 p.123).

The importance of HR and the challenge of managing change is said to be particularly acute in the healthcare sector (Anson, 2000). Kabene et al. (2006) illuminate the significance of sufficient HR management in a context where all services are delivered by people. Townsend and Wilkinson (2010) discuss the pressure of managing human resources within the hospital setting where the vitality of efficiency and effectiveness are paramount. Likewise, Khatri et al. (2006) identify the HR function as a key factor that impacts both performance outcomes and levels of patient care. In spite of this, the HR function is often overlooked in hospitals, particularly in relation to organisational change processes (Khatri et al. 2006; Truss 2009).

In order to redress this imbalance the current study examines perceptions of HR’s role during a change initiative. The context is a large public sector hospital which was in the midst of developing a more strategic HR role, exemplified by the recent introduction of its first HR strategy. Caldwell (2003) notes how the complexity of role conflict is highly influenced by on-going organisational change. This has the capacity to alter the type and nature of the role adopted by HR. Furthermore, Eichinger and Ulrich (1996) suggest that not all HR professionals have successfully adapted to the role of change agent or change maker on an organisational level. By contrast, Truss (2009) provides extensive research on changing HR functional forms in the public sector indicating that the role of HR has the potential to become more strategic, especially during times of change. However, Van Buren et al. (2011) highlight that an increased focus on SHRM can result in decreased levels of employee focus and engagement, a finding echoed by Hope-Hailey et al., (2005). In order to make sense of such contradictory evidence this study explores both managerial and employee perceptions of the HR function during change (Conway and Monks, 2008). The paper proceeds as follows. The next section will outline key debates on the role of HR in organisational change processes culminating in a framework of various HR change roles. Informed by this framework the research methodology is outlined. The findings are then presented prior to discussion and implications for practice and further research.


The management of change is said to be a critical challenge for HR professionals in the private and public sector alike (Stace and Dunphy, 1991). Anson (2000) captures the rapid nature of change in healthcare, and in particular the power exerted by external agents. With the evolution of the HR function ranging from an administrative capacity to one that is more strategic in nature, HR professionals must now adjust their priorities in line with corporate strategy and stakeholder expectations. This concept is explored in the work of Caldwell (2003) who builds on the previous work of Ulrich (1997) in assessing the extent to which HR has assumed a more strategic organisational role. Rees and Johari (2010) explore the role of HRM as change agent, suggesting that all forms of organisational development are inextricably linked with the management of human capital and therefore are fostered by activities within the HR function. Bamford and Daniel (2005) in turn stress the need for effective management of both transformational and incremental change within the public sector in order to avoid negative implications or potential disruption of vital services. Furthermore, the role of HRM in organisational change processes is said to have become more prevalent as the boundaries between people management activities and change management activities become increasingly blurred (Ellis 2000).

In consideration of SHRM and the alignment of business and employee interests, Wright et al. (1998) examine the significance of the HR function during strategic organisational change from a variety of stakeholder perspectives. Their findings indicate that line manager’s perception of the role of HR was less positive than that of HR managers. This suggests that assessments of the role played by HR in organisational change should investigate multiple stakeholder perceptions of this role. Indeed, there is increasing evidence of the importance of designing HR practices that support a positive disposition to change and foster employee commitment in this context (Herold, Fedor and Caldwell 2007; Conway and Monks, 2008). Stanton et al. (2010), for example, find that the manner in which HR messages are translated across different levels of management in the organisation greatly impacts both implementation and employee perception of the HRM system. This issue will be explored empirically in the hospital context. However, in order to fully understand the complexity of HR’s role in the hospital sector, it is useful to examine the determinants that surround the transition of HR from an administrative capacity.


The work of Truss (2009) indicates that the transfer from traditionally administrative HR roles in the public sector has not been seamless. The central control over resources in this context frequently inhibits the scope of strategic input and managerial discretion afforded to the HR function (Truss 2008). Additional problems arise due to the large and varied level of stakeholders that HR professionals in the public sector are required to contend with (Procter and Currie 1999; Ring and Perry, 1985). Evidently careful strategic planning, decision making and execution of HR activities is framed, and occasionally undermined, by the conflicting demands of employer and employee interests (Legge, 1995). Klinger (1993) explores the difficulties experienced by HR in evolving from a predominantly administrative capacity to one that is strategically focused and aligned with business strategy. The author indicates that issues centre on the problematic nature of competing values in an organisational setting. Such values require HR to appropriately balance efficiency and responsiveness with employee rights and equity while moving towards a framework where cost and accountability are the primary focus (Francis and Keegan, 2006).

Another key element of HR’s role in this context is to explicitly recognise the impact of change on those most affected, that is the employees (Farquharson and Baum, 2002). This issue is further elaborated in the work of Doorewaard and Benschop (2003) who note that employee fears over the aftermath of change processes must be addressed due their potential to greatly influence the effectiveness of HRM change initiatives, especially those that require active employee participation. In terms of emotional ambiguity the term change can encompass different meanings for different employees resulting in both positive and negative effects on the change outcome (ibid.). This therefore requires HR to contend with the challenge of reducing emotional ambiguity during change initiatives in order to reduce the prospect of resistance to change. Conway and Monks (2008) and Iverson (1996) stress that one of the key challenges for HR during organisational change processes is securing the commitment of employees through the provision of employee centred HR practices. Additionally, the authors note that employees are more likely to comply with change initiatives if they feel their employer has complied with their employment obligations and this can be achieved through high levels of employee engagement

Although potentially restricted by central government decisions in terms of maintaining an employee or strategic focus, Truss (2009) notes that there is opportunity for innovation at local level and this is something that needs to be incorporated into strategic management. Another potential barrier to transformation of the HR role is an ongoing adherence to professional norms that has the capacity to inhibit the development of SHRM (Caldwell 2003 and Truss 2009). If innovation is to evolve at local and higher level and transformation of the HR function is to occur, then HR needs to be open to altering entrenched structures before it can begin making changes elsewhere. This effectively corroborates the work of Anson (2000) who recognises the internal factors that impact the implementation of new public management. This current study therefore seeks to build on previous findings by examining the role of HR in the public hospital context along the following three dimensions:

Strategic Focus: A strategic role for HR during change has already been advocated by several authors (Ulrich 1997; Alfes, Truss and Gill 2010; Kotter, 2007; Caldwell, 2001). According to Van Buren, Greenwood and Sheehan (2011) increasing the credibility of the HR function is a key motivator in the adoption of dominant organisational strategies. However, the duality of HR's role in balancing business and employee interests can serve to heighten the complexity of adopting a strategic focus during change. As such, the viability of the above findings will be explored in the current study.

Employee Focus: According to Van Buren, Greenwood and Sheehan (2011) an "increasing focus on strategy in HRM has been at the expense of employee focus" (p.217). Although the need for change in the public sector is largely driven by a desire to adopt principles of corporate management and structures (Nutley 2000; Boyne et al., 2004 cited in Truss, 2009), the welfare role of HR, according to Truss (2009), has not diminished and is instead an ongoing feature of the new strategic focus in HR. Building on such previous work, the current study seeks to examine any potential decline in employee focus during change.

Coordinator Role: This role involves liaising with employees, senior management, line management and external agents to achieve common strategic goals by putting in place the necessary resources to ensure successful implementation of the change process. Resources include training and development and knowledge and support for those involved in the change initiative. The model provided by Caldwell (2001) illustrates the collaborative nature of the HR function during change processes in its liaison with line managers, external agents and senior managers. Acting as a central logistics element of the change process in this manner gives rise to a new role for HR as coordinator that extends beyond an administrative capacity. Such a role centres on two key areas, communication and employee voice. The possibility of this role will be explored in the context of HR in the hospital.


In order to provide exploratory richness and stakeholder insight the study pursued an in-depth single case study method (Yin, 1984). While access was secured via personal contacts the case was something of an ‘exemplary’ case in that preliminary discussion with the HR Director revealed that the hospital had recently introduced a new HR strategy. 1 Conducting an exploratory interview with the hospital’s HR Director was designed to leverage information on the organisational context and the key issues faced by the hospital at that time. Such an approach meant that the research itself would be both more context-specific and practically relevant (Van de Ven, 2005). This approach is similar to the method used by Sackmann (1992) who used open interviewing to focus on a number of issues which over the course of several interviews resulted in the emergence of a theoretical understanding of the topic.

The Hospital has a workforce of some 3,500 employees and is structured around several clinical directorates. Due to the economic downturn the hospital is managing with less resources, reduced finances and a smaller workforce while striving to implement this new HR strategy. The biggest anticipated challenge faced by HR is in implementing and overcoming resistance to these changes. HR will therefore have to assume a number of diverse roles to ensure effective introduction of this strategy.

As previously outlined in this work, this research aims to explore the focus of the HR role in the hospital context along three dimensions. Objective 1 seeks to investigate employee and management perceptions on the extent to which HR adopts a strategic focus during change initiatives. Objective 2 seeks to investigate employee and management perceptions on the extent to which HR adopts an employee focus during change initiatives. Finally, Objective 3 examines employee and management perceptions on the possibility of a coordinator role for HR during change initiatives.

A total of twelve semi-structured interviews involving a mixed demographic of participants (see Fig. 1) were conducted using a flexible interview schedule that allowed for further probing questions where necessary. Insights were gained from both within and outside the HR function in order to establish an organisational wide consensus on the role of HR and the effectiveness of the HR system (Bowen and Ostroff, 2004). Examining management and employee’s perceptions facilitated the identification of discrepancies between intended and actual HR practices (Conway and Monks, 2008) while also enabling the analysis to compare and contrast the perceptions of those who implement organisational change and those who are impacted by it. Interviews were recorded with a dictaphone and consent for recording was sought from participants beforehand. Interviews were initially sought for the duration of one hour but due to work demands in the hospital, they instead ranged from 30-70 minutes.

Fig. 1 Demographic of Participants

Management Participants

Employee Participants

Relationship Manager HR

Catering Assistant

Employment Control Manager

Endoscopy Technician

Learning and Development Manager

Medical Directorate Supervisor

Chief Physicist

Medical Administrator

Directorate Nurse Manager


Previous studies in this field have adopted a similar approach, although many have not explored employee and management interests concurrently. Bamford and Daniel (2005) explore the effectiveness of change management in the UK NHS by examining the perceptions of those most impacted by these changes, the employees. Similarly, Rees and Johari (2010) explore senior management perceptions of the HR function during change initiatives. As such, this current study utilises a similar approach in determining the type of role adopted by HR in the hospital context. However, it differentiates itself from previous work by exploring both management and employee perceptions collectively in order to facilitate comparative analysis along the three dimensions outlined in this study.

Significantly, it must be noted that emergent data highlighted the importance of the contextual environment that HR in the hospital is operating in. Consequently, the approach adopted allowed the researcher to gain a more in-depth understanding of the role of HR by examining the contextual factors that either constrained or enabled HR to adopt a particular focus. It is anticipated that such an approach will provide more credibility in understanding HR’s role in both the hospital context and the wider public sector. As such, the research findings will be analysed along the three dimensions previously outlined in this work. However, these findings will also be further analysed in light of the emergent contextual factors which will facilitate a more comprehensive understanding of the HR role in the public hospital sector.


In addition to the potential for subjectivity and personal bias, generalisation presents an issue in this instance as findings from qualitative studies are context dependent and therefore not directly applicable in all settings (Bryman and Bell, 2007). This inevitably impacts external validity. However, Yin (1999) provides a series of analytical strategies designed to enhance the quality of case studies in health services research, making them highly appropriate for the current study. These strategies were used to enhance the validity of the findings particularly through recommended data triangulation. The current study was able to draw upon company documents such as the HR strategy and company newsletters in addition to rudimentary observations during interview visits.



When asked if strategic change is a positive thing for the hospital four out of six managers were fully in support of the new HR strategy, viewing it as a positive step in delivering value and incorporating the HR function into the wider hospital. This supports the work of Khatri et al. (2006) who illustrate the need for senior management support in developing SHRM and even more importantly during change.

I think it’s a good idea to have a HR strategy, I think we all have to have some kind of plan to work with and work towards …. traditionally HR was kind of over there and they’re bringing it more into the realm of the employee which is better

(Learning and Development Manager)

In the wider context it’s about HR being more integrated into the hospital as a whole and it feeding into clinical areas cause that’s what we’re about, the vision of the hospital is to provide care so HR shouldn't be out on a limb, it should be very much inclusive

(Directorate Nurse Manager)

In contrast three out of five employees were unaware that there was a HR strategy. The remaining two employees were positive about the HR strategy and viewed it as a means of improving service in the hospital:

I would imagine that once it has been implemented and it’s flowing, it would be beneficial to the hospital and I think it is good for the line managers and for the different specialities to take more of an active role in HR and to look after some of the aspects of it themselves, because that’s what separates different departments within the hospital

(Medical Administrator)

If HR in the hospital are to achieve the desired level of engagement, management need to take more responsibility for transmitting messages on the significance of the HR strategy and the impact that it will have on employee's working life (Bowen and Ostroff, 2004; Niishi, Lepak and Schneider, 2008). According to Caldwell (2003), the role adopted by HR during change processes is subject to a heightened sense of role ambiguity owing to the conflicting demands associated with balancing business and employee interests. Evidence of this role ambiguity was identified by HR in the hospital, particularly in respect of the economic climate that the hospital is operating in:

We have the employee assistance programme, for people that have run into hardship, people that have been down, looking for loans because they’re in arrears with their mortgage and I mean that’s not the facility, the hospital has very limited funds for that, so I mean I could advise people to go to MABS, that’s not really my job (laughs) ya know, I'm a financial advisor?

(Employment Relationship Manager)

Significantly, four out of five employees were able to explain how their role contributes to their perception of organisational goals. This is an important finding in respect of developing SHRM in the hospital as employees already recognise the impact their role is having on the hospital's strategic priorities:

If this didn't happen you’re talking about a clinic being cancelled, a longer waiting list, ya know, that’s the kind of impact me not doing my job would have on the long term goals of the hospital

(Medical Directorate Supervisor)

In relation to resistance, some concerns were expressed in respect of the downturn in the economic climate as strategic change in the hospital has blurred with unanticipated changes outside of the hospital or HR's control. Guest (1992) suggests a prominent role for HR as change agent and to an extent this research provides evidence of this role. However, this study also acknowledges that the potential for HR to act as change agent in the hospital is inevitably constrained by external government control:

A lot of people would be resistant to change but I think it’s more of a confidence building thing and the whole idea is engaging people, engage people with the change before it actually happens and get them on board beforehand and introduce them to the change and this is what the strategy is

(Employment Relationship Manager)

I think it’s probably coming at a bad time, people's morale are low with the moratorium going on, with pay cuts and people really aren't interested

(Employment Control Manager)

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