This book engages theoretically and empirically with the unprecedented wave of public management reforms in public hospitals in Europe in the past 25 years. It provides a useful overview of these reforms and studies the way in which they have influenced the ability of national policy-making institutions to co-ordinate the system of public hospitals as a whole. Using a comparative structure, as well as original empirical data collected by the author, the book examines case studies on which little has so far been published for an international audience in English.