Health systems in the western world face increasingly intense pressure to contain or reduce costs, while countries such as China and India move towards universal coverage. The contributors illustrate that radical gains in efficiency and innovative practice are required internationally in health care systems. They argue that the high proportion of health care system costs invested in staffing place the human resource function at the forefront of meeting this challenge. Sustained system change and productivity gains, more effective management of staff and work climate are essential elements of reform and are all covered in this book.