Over the past 25 years, governments that operate publicly-funded health care systems have endeavoured to modernize service delivery and to control health spending. This has occasioned high profile efforts to reform and restructure previously stable health systems. Health organizations are typically complex, labour intensive and unionized. Health reform has enormous consequences for management, workers and their unions. Long standing industrial relations practices, structures, workplace arrangements as well as workers' lives are disrupted. In this occupationally hierarchical industry, reform has different impacts upon the various employee groups and unions.This topical and timely comparative book examines the experiences of five jurisdictions, Great Britain, New Zealand, New South Wales, Saskatchewan and Alberta, each of which exercises powers in the areas of labour, health and fiscal policy throughout the restructuring process. While fiscal concerns drive each government, their ideologies determine the nature of reform initiatives and how management operates. These case studies include examples of neoliberal, social democratic and opportunistic administrations.