An analysis of the consequences in which employment policies are derived from recognizing and incorporating a more realistic characterization of the professional performance within the public sector. To set out some guidelines for the reform of employment policies in this sector, the study highlights the question of the variety of public employment, as well as the effects of the design of the organization of a public activity. It also attempts to characterize the optimal level of elements in the organizational structure, after identifying the distribution of employees involved the activities to be carried out by the units. Healthcare constitutes the field of specific reflection of the research.