Downsizing in the public sector: Metro‐Toronto's hospitals Available to Purchase

This study has two objectives. First, to predict the outcomes of a public sector downsizing; second to measure effects of downsizing at organizational and inter‐organizational levels. Primary data to assess the organizational level effects was collected through interviews with senior executives at two of Metro‐Toronto's hospitals. Secondary data, to assess the inter‐organizational effects, was collected from government documents and media reports. Due to the exploratory nature of the study's objectives a case study method was employed. Most institutional downsizing practices aligned with successful outcomes. Procedures involved at the inter‐organizational level aligned with unsuccessful outcomes and negated organizational initiatives. This resulted in an overall alignment with unsuccessful procedures. The implication, based on private sector downsizings, is that the post‐downsized hospital system was more costly and less effective.