1. What are the advantages and disadvantages of works council and client council involvement at an early stage of a PE intervention from the top management perspective and the individual employee perspective? 

2. What kind of HR policies and practices can be applied to retain valuable employees during a process of a major organizational change? 

3. Why is it important that the two board members actively participate in a road show in which they personally explain the PE situation? 

4. What is the impact of a General Electric-inspired performance management system on nurses and medical specialists in a hospital? 

5. How does the new performance management affect organizational commitment, occupational commitment and team commitment of employees within the hospital? 

6. What is the impact of outsourcing disciplines on employees who are being outsourced and employees who may stay? 

7. What kind of competencies do HR professionals need for adding value to the organizational change process caused by a PE intervention? 

8. What kind of concrete HR practices can be applied to minimize the negative effects on a PE intervention on employee attitudes and perceptions? Explain why.

Aline Bos and Paul Boselie.

The aim of this case is to show how broad economic and societal developments can get translated into concrete organisational human resource practices. The lecturer may start discussing the case at a higher abstract level (new public management developments), going step by step to a more operational level and ending up with the role of the HR professional in the organisational change process caused by a private equity intervention. The questions help the student to reflect on the broader developments and their meaning for public organisations and concrete HR practices. 

Level 1: New public management (NPM) 

• Private equity in hospitals can be seen as a manifestation of NPM. Are students able to mention other examples of NPM interventions in the public sector (e.g. public and semipublic organisations)? 
• Why are these examples of NPM? What are their main characteristics? 

Level 2: Private equity The lecturer can give some more background information on the concept of private equity to illustrate the private equity intervention for students and its links with NPM developments. The following text can be used as a background. 

Level 3: The hospitals With the context of NPM and knowledge about private equity, the lecturer can now turn to the implications of private equity for hospitals as organisations delivering public services. Hospitals have to deal with multiple stakeholders and multiple – sometimes contradictory – logics: efficiency and effectiveness, fairness and accessibility, robustness and resilience (e.g. Hood, 1991). The discussion focuses on the following question: What will be the impact of a private equity intervention in hospitals on the individual, organisational and societal level? What level or dimension needs priority? 

 Individual level: for example, organisational trust, professional ethic, professional space. 

• Organisational level: for example, efficiency, organizational values, safety. 
• Societal level: for example, healthcare quality, costs/taxes, accessibility 

Refer to the case of the Rembrandt van Rijn hospital, but also stimulate students to think in other directions and possibilities of what will happen when a private equity firm gets a share in hospitals. There is a potential tension between the different logics. To put it simply, there are possibilities for tension between economic value in terms of efficiency and public/societal values, for example, reflected in the quality and safety of healthcare in hospitals.

Level 4: HR roles After debating on foregoing levels, the students now have to put themselves into the role of an HR professional in a hospital which is in the middle of a private equity intervention. The central question is: What kind of qualities and competencies do HR professionals need for adding value to the organizational change process caused by a private equity intervention? As a lecturer, you can position the quality of an HR professional as someone who is very good at handling ambiguity (Legge, 1995; Guest and King, 2004). Legge (1995) makes a distinction between two HR roles for having significant influence on strategic decision making: conformist innovator and deviant innovator. The conformist innovator speaks the business language and aligns HRM primarily with shareholder value (economic value), while the deviant innovator challenges a unitarist perspective. The deviant innovator has a high tolerance for ambiguities taking into account multiple logics and the interests of multiple stakeholders. Now, when students have to think as if they are an HR professional, ask them the following questions: 

• Which tasks have priority while managing the organizational change caused by a private equity intervention? 
• What competencies do you need to fulfill these tasks adequately? 

The lecturer can summarise the discussions on the different levels, showing how abstract changes may have concrete implications for organizations, often with contradictory and complex demands, and ask for specific competencies and practices of HR professionals in managing these specific changes.