Health reforms in the last 25 years focused largely on structural change, cost containment and the introduction of market mechanisms, and the importance of the management of HR has often been overlooked. Pressures for efficiency and effectiveness are particularly pronounced in the hospital sector, which is the most resource-intensive component of the health care system. One important aspect of improving and maintaining service delivery in hospitals is to better manage the HR function. This paper highlights the importance and complexities of HRM in hospitals throughout the world.