Hospital Autonomy Reforms in Pakistan and the politics of meanings

Abstract

This research attempts to understand how various stakeholders developed unique meaning of the phenomenon of autonomy and later got engaged in a political contest such that their meaning prevailed over that of others. Results show that meaning of different stakeholder prevailed at different stages of the implementation process; however, every time the stakeholder who was relatively more powerful than others was able to ensure its meaning dominated meanings of other stakeholders. The study concludes that in societies where rule of law is not well established, power becomes the coinage; hence the powerful actors reign supreme. Furthermore, in the implementation of different reforms, a political approach would be more suitable which takes into account the relative power of stakeholders and plans how to use it for one’s benefit or to neutralize it.

Key Words:         meaning, politics, stakeholders, Pakistan, power, Hospital autonomy reforms