From reform to reality: governance mechanisms and social capital development in mandated healthcare networks

Mandated healthcare networks are introduced to achieve reform objectives through collaboration, yet imposed arrangements may not generate the social capital needed for collective action. We examine how governance mechanisms activate key sources of social capital (opportunity, ability, motivation) and shape its subsequent development. Using a longitudinal case study of a mandated hospital network governed by a Network Administrative Organization (NAO), we analyse 55 interviews along with documentary data. We find that while the NAO expanded opportunities for social capital development through network governance mechanisms, these were pseudo-opportunities that failed to enhance the ability and motivation of network members to collaborate. We contribute to theory by explaining how imposed governance can simultaneously appear to provide a key condition for social capital (interaction opportunities) and nevertheless inhibit successful collective action and generate disenchantment. The study highlights the need to distinguish between technical integration and meaningful collaboration in the implementation of governance mechanisms.