This article explores the relationship between HR practices and commitment to change in three health service organisations in Ireland. The research focuses on employee views of HR practices and resulting employee level consequences including commitment to change, perceptions of the industrial relations climate and the psychological contract, and work-life balance. The findings indicate that the practices valued by employees, and which are related to a range of employee-related consequences, are very different to the lists of sophisticated HR practices that appear in the high performance literature. The research suggests that organisations need to ensure that attention is still paid to the basics of the employment relationship and that these are not lost in the rush to introduce more sophisticated approaches to managing employees.