The Concept of Social Responsibility Applied to the Health Care Sector: The Case of Portugal.

This paper aims to show that the concept of Social Responsibility (SR) has been fundamental to consolidating, reformulating and implementing the changes of socio-economic rules of hospitals in a period of social controversy around health care. For instance, elaboration and divulgation of sustainability reports, communication on social responsibility programs through hospital´s websites, implementation of certification ISO 9001 and ISO 140001, application of internal and external audits systems and stakeholder´s management models.

The research shows that SR practices grew up when Portuguese healthcare sector was undergoing a period of intense criticism from the public-private partnerships consolidated with the Portuguese State. The study showed that at the same time the period of controversy has been fruitful to implementation of SR in healthcare because it generated “social immunities” so that the hospitals could adopt behavior, symbols and languages to legitimate the new public management (NPM) models in healthcare.

The concept of Social Responsibility seemed to be a new way through which healthcare organizations and professionals could achieve the social license that they needed to operate their NPM systems.

One of the motives that also contributed to hospital mobilization was the necessity to achieve the equilibrium between the demands of universal access to healthcare and the demands of economic efficiency within the new public management decisions taken by managers and clinicians. Undoubtedly, SR contributed to this equilibrium. But Social Responsibility found institutional and cognitive barriers that make difficult its introduction and expansion. To overcome these barriers, hospitals developed a network of partnerships and negotiation models in very different modes as well as creating new social regimes, for instance, increased transparency and democratic participation within decision process. Case studies (of public, public-private, and private hospitals) provide empirical support for the analyses and conclusions presented in the paper.