The changes experienced by health organizations in France since the 1970s, reveal increasing tensions between markets and public interest. Funding and management are the most concerned in hospitals. As the example of transplant departments at the Assistance Publique-Hôpitaux de Paris illustrates, profitability is not the only aim of the managerial adaptations. Safety and ethical principles also drive the modifications of hospital management and both physicians and managers share such concerns. An analysis of the reforms projected and achieved at the end of the 1980s and in the early1990s at the AP-HP highlights what is changing in health activities in France at this moment.
By Sophie Chauveau