This e-book aim to highlight the contingencies and dynamics of new governance approaches and the significance of contexts, thus redefining the universal discourse of managerialism. The findings highlight the significance of institutional configurations in relation to professional agency and importantly both at macro and at meso level: first, the regulatory structure and stakeholder arrangements of national healthcare states and second, the organisational settings of hospitals and other healthcare providers shape professional action. Consequently, a broadly similar trend towards new managerial regimes in healthcare plays out differently in the different institutional contexts.