Change in the control of health care systems in Europe: implications for professional autonomy.

Major changes are taking place in European health care systems, especially those in the former communist countries. However, in Western European countries reorganization is also on its way, guided by the rhetoric of deregulation and competition. This might lead to a convergence in the institutional control of health care systems, although it appears that different paths have been chosen by Eastern European health care systems and Western national health services. It is argued that the implications of these changes for the professional autonomy of doctors differ and this is influenced by the way health care changes tie up clinical autonomy and economical autonomy. (aut.ref.)