Corporate governance: up to date

Corporate governance is the system by which companies are directed and controlled. Boards of directors are responsible for the governance of their companies. Nonprofit governance is a political and organizational process involving multiple functions and engaging multiple stakeholders. The responsibilities of the board include setting the company’s strategic aims, providing the leadership to put them into effect, supervising the management of the business and reporting to shareholders and stakeholders on their stewardship and to ensure the mission fullfillment and overall accountability.

Having a knowledgeable and engaged board, a board that understands its fiduciary role, its managerial role and depending on the type of institution its fundraising role. is very important specially in public institutions and non for profit.

The Centre for Research in Health and Economics CRES from the Universitat Pompeu Fabra has published recently some policy papers related to  Corporate Governance. 

• Dalmau-Matarrodona, E.; "Bones pràctiques del govern de les organitzacions" Health Policy Papers Collection 2026-4_ED [Download]
• López-Casasnovas, G., Planas-Miret, I.; "La gobernanza de la colaboración público-privada en sanidad. El caso de Catalunya." Health Policy Papers Collection 2026-3_GL_IP [Download]
• Ortún, V.; "Gobierno y gestión de las organizaciones sanitarias" Health Policy Papers Collection 2026-2_VO [Download]
• López-Casasnovas, G.; "Anomalies organitzatives als consells de govern de les organitzacions públiques" Policy Papers Collection 2026-3_GL [Download]

Another interesting paper published in 2014 by Yvonne D. Harrison (University of Albany) and Vic Murray (University of Victoria): Guidelines for Improving the Effectiveness of Boards of Directors of Nonprofit Organizations

photo Jordi Soldevila. Màcula Malèvich de Sant Pau

______________________________________________________________________

Specialty choices among new generation of doctors - insights from a Polish survey study

Currently, healthcare systems around the world are facing serious labour crises, significant shortages, and unequal geographical distribution of doctors. One of the key issues in maintaining an adequate health workforce is young graduates’ choice of medical specialty. Their career choices substantially influence the future balance between different medical specialties. To better align the choices of young doctors with the needs of the healthcare system, we have to understand the differences between doctors who are already working and those who are only just starting. 

Three generations currently dominate the population of doctors in the workforce: the baby boomers (born 1945–1964), generation X (born 1965–1979), and generation Y (millennials: born 1980–1994). Each generation brings its characteristics to the medical profession. The baby boomers are known for working long hours and viewing medicine as a tireless vocation, while generations X and Y are more tech-savvy, value mobility, and prioritize work-life balance.

Doctors currently entering the healthcare labour market (generation Z) were born between the late 1990s and early 2010s. This generation, also known as‘Gen-Z’, differs significantly from older generations in many ways. Gen-Z individuals were born into a world of widespread access to information, largely due to the internet. They are proficient in using modern technologies, more focused on achieving a healthy work-life balance, and are more open to change in their lives compared to the generations of their parents and grandparentts. However, they do not accept the current state of workplace culture and working hours. They strongly desire a life-work balance, flexibility in working conditions, and collaboration in the workplace.

Although they have chosen a medical career, many young healthcare professionals report that their expectations are not being met, especially concerning non-clinical tasks, including the administrative burden. They understand that the success of future healthcare systems is closely linked to the implementation of new technologies, recognizing its potential to reduce administrative workload and work-related stress. Besides salary, autonomy, collaboration, and technology play a crucial role in selecting a workplace (hospital or practice). To attract and retain this younger generation, healthcare organisations need to focus on team collaboration, a friendly working atmosphere, and adapt their work organisation practices accordingly.

In Poland, many specialties are experiencing a ‘generation gap, which requires well-thought-out decisions to compensate for the forthcoming crisis that would become even more serious if doctors at retirement age were to stop working.

This article aimed to provide evidence on the factors that drive young doctors to choose their future specialties, presenting differences between those applying for non-surgical specialties and those applying for surgical ones.

Article: open acces and pdf

photo Jordi Soldevila. Màcules de Barcelona. Màcula simple del carrer Escorial

______________________________________________________________________

No health without peace. Nothing more to say.

The right to health was laid out in the Universal Declaration of Human Rights, reaffirmed in the Alma Ata declaration, and remains embedded in contemporary WHO priorities. There is no credible path to achieving it that can run through perpetual conflict. Responding to the health consequences of war is necessary, but it cannot substitute for the conditions required to build, protect, and sustain health systems. Ambitions for equity, resilience, preparedness, and universal access cannot be realised amid chronic insecurity. 

Peace is not adjacent to health—it is foundational.

The Lancet editorial (2026) (pdf Volume 407, Issue 10523, 1)

Photo Jordi Soldevila. Geometries de la injustícia. Desesperació.
_______________________________________________________________________

The future hospital in Global Health Systems

Future hospitals must be able to adapt in many ways to the changing demands on their roles and functions within evolving healthcare delivery infrastructures. These include changing population structures and needs, new models of healthcare provision, technological advances, and innovations in design, all while enhancing their environmental sustainability.

This article sets out the issues that those determining healthcare policy and designing future hospitals must consider if they are to become and remain fit for purpose within the wider health and social care system. It also examines the need for, and challenges to, strategic healthcare planning, creating future hospitals that are sustainable, net‐zero carbon organisations, and ensuring resilience in the face of a range of potential shocks.

Future hospitals play a crucial role in healthcare worldwide, regardless of the country's income level. Hospitals cannot be viewed without broader health system changes, infrastructure, community and cultural factors, staffing and other considerations. Future hospitals will enhance population health in all settings and support the move towards more consumer‐centric healthcare. The authors urge clinical and policy planners to consider the factors discussed carefully to maximise the benefits.

Article (2025) open access

Sebire NJ, Adams A, Celi L, Charlesworth A, Gorgens M, Gorsky M, Landeg O, Nagasawa Y, Nimako KT, Onoka C, Roder-DeWan S, Watts N, McKee M. The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System. Int J Health Plann Manage. 2025 May;40(3):741-751. doi: 10.1002/hpm.3891. Epub 2025 Jan 15. PMID: 39815953; PMCID: PMC12045726.

Photo Jordi Soldevila. Posidònies. Cicatriu 1

_______________________________________________________________________

The Great Resignation: Why women health workers are leaving

The ‘Great Resignation’ of women health workers is impacting women and health systems globally, with a concerning ‘Great Migration’ trend. This exodus exacerbates the existing health worker shortage crisis, affecting countries striving to achieve universal health coverage.The report published in October 2023 by Women in Global Health explores these issues in depth and calls for gender-transformative solutions to address workforce imbalances.

Countries competing for increasingly scarce trained health workers challenge the principles of global solidarity and ethical international recruitment, enshrined in global agreements like the WHO Code (WHO Code on the Practice of International Recruitment of Health Personnel)

"The WHO Code encourages all member states to act in solidarity, produce sufficient health workers domestically and invest in supporting countries with vulnerable health systems to strengthen their health workforce"

Health workers take years, sometimes over a decade to train, so lead times are long for producing the millions of new health workers needed to fill the gap. The urgent issue now is retaining trained health workers and reversing attrition from the sector.

Replacing domestic health workers with international recruits may just be putting new recruits into the same broken systems that caused the domestic health workers to leave. Coordinated action by governments is needed urgently to address health worker attrition in the short term and plan longer term to fill health worker shortages sustainably without reliance on unethical international recruitment.

The central role played by women health workers in the pandemic, along with the health and psychological impacts they endured in the course of their work, has placed a spotlight on their needs. Gender transformational change is needed to fix health workforce inequities and retain and attract back the women who are leaving. 

Women in the health workforce need a new social contract based on equal leadership, safe, decent and fairly paid work, to enable them to deliver health for all.

Report (pdf): 

Photo Jordi Soldevila. Els Monstres d'Ingres. IV

_______________________________________________________________________

When you see your neighbor's beard peeling, soak yours.

The NHS turns 77 this year 2025. Until recently, it has been widely regarded as the “crown jewel” of the British welfare state. Throughout its history, the NHS has achieved significant successes, including providing financial protection against the costs of ill health, incorporating formal assessments of new medical technologies, and delivering generally well-received care once accessed. Moreover, the NHS has been a driving force in medical research and innovation, pioneering advancements in treatments, healthcare delivery, and disease prevention. However, over a decade of austerity funding, compounded by the impact of the COVID-19 pandemic, has exposed its vulnerabilities. The NHS has shown limited resilience to external shocks and appears increasingly unsustainable in the face of growing demand.

Waiting lists are at an all-time high, population health outcomes in the UK are worsening, staff shortages and dissatisfaction remain persistent, and public confidence in the institution is wavering. In short, the NHS is in crisis.

The Labour government has increased NHS funding, but not to a level that several experts—including the LSE-Lancet Commission—deem sufficient to meet rising demands. The government has also announced a new 10-year plan. But will these measures be enough?

This event organized by the LSE last june explored the current state of the NHS, assessed whether the government's responses are adequate, and discussed whether more radical reforms are necessary. The discussion provided both critical reflection and potential solutions to address the crisis.

• Podcast to listen to.
• Video of the event to watch
• Slides and Speakers: to download here.

Photo Jordi Soldevila. Homenatge a Toni Catany Mandarina

_______________________________________________________________________

Doctors must live

Caroline Engen published in february 2025 the article: «Doctors must live»: a care ethics inquiry into physicians’ late modern suffering. Med Health Care and Philos 28, 275–290 (2025).

A good article to read (Free Acces) Article

Abstract: 

In 2023, thousands of young Norwegian physicians joined an online movement called #legermåleve (#doctorsmustlive) and shared stories of their own mental and somatic health issues, which they considered to be caused by unacceptable working conditions. 

This paper discusses this case as an extreme example of physicians’ and healthcare workers’ suffering in late modern societies, using Vosman and Niemeijer’s approach of rethinking care imaginaries by a structured process of thinking along, counter-thinking and rethinking, bringing to bear suffering as a heuristic device. 

1. Thinking along, taking the physicians’ stories and arguments literally, reveals an image of an unbearable workload. 
2. Counter-thinking resituates their suffering within the broader conditions of late modernity, suggesting that the root cause may lie not in the quantity of the workload itself but in its qualities and in its perceived threat to their integrity as caregivers through epistemic and moral injury and an inability to respond to this threat. 
3. In rethinking, the ambiguity of suffering– its dual potential as both a constraint and an opening– becomes central. 

Following the physicians’ own interpretations and the solutions emerging from this framing, both their suffering and that of their patients could paradoxically be exacerbated by further decentering physicians and reinforcing utilitarian, data-driven approaches. 

However, staying with their suffering and reinterpreting its causes opens possibilities to leverage critiques of medicalization at large and of their own suffering in particular, challenging the assumption that the weight of care must always grow heavier. 

From this reframing, I argue, it is possible to reclaim and reimagine care and the clinical space as a nexus of epistemic and moral privilege, recentering response-ability both relationally and socially.

Photo Jordi Soldevila. Els Monstres d'Ingres. III

_______________________________________________________________________