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Purpose -- This paper aims to present an empirical study of the effect of high performance work practices on commitment and citizenship behaviour in the health care sector. The theory suggests that individual employees are willing "to go the extra mile" when they are given the opportunity to develop their abilities and to participate, and when they are motivated. Design/methodology/approach -- The data were gathered in a Dutch general hospital using employee questionnaires. Medical specialists were not included in the study. Findings -- The results of the study suggest that employee development (e.g. skills training, general training, and task enrichment) and employee involvement (e.g. job autonomy, participation in decision making) are important HR practices in creating a high performance work climate in a health care organisation. Research limitations/implications -- The data come from one hospital and the analysis is cross-sectional. However, the importance of the study lies in its focus on the individual employee perspective rather than the organisational level analyses which currently predominate in the HRM and performance debate. Practical implications -- The training and development of health care employees can increase their affective commitment. Increasing employee involvement can also help stimulate citizenship behaviour. Originality/value -- The paper looks at the non-profit sector, whereas the majority of previous HR research has focused on multinational companies. [ABSTRACT FROM AUTHOR]