scholarly journals Repositioning the boundaries between public and private healthcare providers in the English NHS

2019 ◽  
Vol 33 (7/8) ◽  
pp. 776-790 ◽  
Author(s):  
Rod Sheaff ◽  
Joyce Halliday ◽  
Mark Exworthy ◽  
Alex Gibson ◽  
Pauline W. Allen ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Organisational Change ◽  
Governance Structures ◽  
Qualitative Comparison ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Service Production ◽  
Organisational Research

Purpose Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons? Design/methodology/approach An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above. Findings The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways. Research limitations/implications This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations. Practical implications Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary. Originality/value Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.

Uncoupling innovation and entrepreneurship to improve undergraduate education

2019 ◽  
Vol 26 (6/7) ◽  
pp. 783-796 ◽  
Author(s):  
Nick Swayne ◽  
Benjamin Selznick ◽  
Seán McCarthy ◽  
Kimberly A. Fisher
Keyword(s):  
Undergraduate Education ◽  
Public And Private ◽  
Teaching Innovation ◽  
Undergraduate Level ◽  
Content Type ◽  
The Public ◽  
Curricular Practices ◽  
Institutional Contexts ◽  
Innovation And Entrepreneurship

Purpose When it comes to undergraduate education, the terms “innovation” and “entrepreneurship” are often used interchangeably with respect to curricular practices and their associated learning and developmental outcomes. The purpose of this paper is to chart a course through the vast and growing multidisciplinary literature covering both topics to argue that innovation and entrepreneurship are not only different concepts, but they also play out in postsecondary institutional contexts in different and important ways. Design/methodology/approach Based on these differences, the authors propose that developing innovators must precede teaching future entrepreneurs and that the home of innovation education is not necessarily in the business school at all. Ideally, the authors believe innovation should be taught separately from any one disciplinary context. To illustrate the concept, the authors point to an existing program where professors and students from different disciplines work together on actual problems provided by external clients from both the public and private sectors. Findings Based on the authors’ rationale and approach, the authors propose an agenda that would allow for a deep analysis of the interaction between organizational behaviors and student outcomes, providing insight into effective practices and strategies for mobilizing institutional efforts aimed at teaching innovation and better aligning innovation with entrepreneurship education. Originality/value The authors provide a clear rationale for separating innovation and entrepreneurship pedagogy in higher education, terms that have been conflated in literature and in practice for nearly a century. The authors do this in an original way by pairing a theoretical framework with a short case study of an education program that has developed innovation pedagogy at the undergraduate level.

Tax avoidance: the 21st century employment conundrum

2015 ◽  
Vol 14 (6) ◽  
pp. 234-236
Author(s):  
Barry Moseley
Keyword(s):  
21St Century ◽  
Design Methodology ◽  
Government Regulation ◽  
Tax Avoidance ◽  
Private Companies ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Public And Private Sector

Purpose – The purpose of this paper is to explore the importance of being aware of current tax regulations for both the public and private sector. Design/methodology/approach – This paper uses some of the recent news around large corporations and their tax systems to support the argument for more awareness of tax avoidance. Whilst using the recent UK regulations into reporting of non PAYE workers as a case study. Findings – More needs to be done to ensure businesses are aware and comply to the regulations around non-PAYE employees. Originality/value – Entirely original content, citing examples from government regulation and private companies experience.

Relationship between CSR motivations and corporate social performance: a study in the power industry in India

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Moumita Acharyya ◽  
Tanuja Agarwala
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Corporate Social Performance ◽  
Social Performance ◽  
Power Sector ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Self Interest ◽  
Public And Private Sector

PurposeThe paper aims to understand the different motivations / reasons for engaging in CSR initiatives by the organizations. In addition, the study also examines the relationship between CSR motivations and corporate social performance (CSP).Design/methodology/approachThe data were collected from two power sector organizations: one was a private sector firm and the other was a public sector firm. A comparative analysis of the variables with respect to private and public sector organizations was conducted. A questionnaire survey was administered among 370 employees working in the power sector, with 199 executives from public sector and 171 from private sector.Findings“Philanthropic” motivation emerged as the most dominant CSR motivation among both the public and private sector firms. The private sector firm was found to be significantly higher with respect to “philanthropic”, “enlightened self-interest” and “normative” CSR motivations when compared with the public sector firms. Findings suggest that public and private sector firms differed significantly on four CSR motivations, namely, “philanthropic”, “enlightened self-interest”, “normative” and “coercive”. The CSP score was significantly different among the two power sector firms of public and private sectors. The private sector firm had a higher CSP level than the public sector undertaking.Research limitations/implicationsFurther studies in the domain need to address differences in CSR motivations and CSP across other sectors to understand the role of industry characteristics in influencing social development targets of organizations. Research also needs to focus on demonstrating the relationship between CSP and financial performance of the firms. Further, the HR outcomes of CSR initiatives and measurement of CSP indicators, such as attracting and retaining talent, employee commitment and organizational climate factors, need to be assessed.Originality/valueThe social issues are now directly linked with the business model to ensure consistency and community development. The results reveal a need for “enlightened self-interest” which is the second dominant CSR motivation among the organizations. The study makes a novel contribution by determining that competitive and coercive motivations are not functional as part of organizational CSR strategy. CSR can never be forced as the very idea is to do social good. Eventually, the CSR approach demands a commitment from within. The organizations need to emphasize more voluntary engagement of employees and go beyond statutory requirements for realizing the true CSR benefits.

scholarly journals Public and private sectors collective response to combat COVID-19 in Malaysia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ching Siang Tan ◽  
Saim Lokman ◽  
Yao Rao ◽  
Szu Hua Kok ◽  
Long Chiau Ming
Keyword(s):  
Insurance Coverage ◽  
Healthcare Providers ◽  
Screening Tests ◽  
Public Healthcare ◽  
Private Hospitals ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare ◽  
Care Services ◽  
Challenges And Opportunities

AbstractOver the last year, the dangerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly around the world. Malaysia has not been excluded from this COVID-19 pandemic. The resurgence of COVID-19 cases has overwhelmed the public healthcare system and overloaded the healthcare resources. Ministry of Health (MOH) Malaysia has adopted an Emergency Ordinance (EO) to instruct private hospitals to receive both COVID-19 and non-COVID-19 patients to reduce the strain on public facilities. The treatment of COVID-19 patients at private hospitals could help to boost the bed and critical care occupancy. However, with the absence of insurance coverage because COVID-19 is categorised as pandemic-related diseases, there are some challenges and opportunities posed by the treatment fees management. Another major issue in the collaboration between public and private hospitals is the willingness of private medical consultants to participate in the management of COVID-19 patients, because medical consultants in private hospitals in Malaysia are not hospital employees, but what are termed “private contractors” who provide patient care services to the hospitals. Other collaborative measures with private healthcare providers, e.g. tele-conferencing by private medical clinics to monitor COVID-19 patients and the rollout of national vaccination programme. The public and private healthcare partnership must be enhanced, and continue to find effective ways to collaborate further to combat the pandemic. The MOH, private healthcare sectors and insurance providers need to have a synergistic COVID-19 treatment plans to ensure public as well as insurance policy holders have equal opportunities for COVID-19 screening tests, vaccinations and treatment.

Mapping public value processes

2014 ◽  
Vol 27 (4) ◽  
pp. 334-352 ◽  
Author(s):  
John Alford ◽  
Sophie Yates
Keyword(s):  
Public Sector ◽  
Child Nutrition ◽  
Process Mapping ◽  
Public Value ◽  
Public And Private ◽  
Content Type ◽  
The Public ◽  
Public Managers ◽  
Big Picture ◽  
Comprehensive Framework

Purpose – The purpose of this paper is to add to the analytic toolkit of public sector practitioners by outlining a framework called Public Value Process Mapping (PVPM). This approach is designed to be more comprehensive than extant frameworks in either the private or public sectors, encapsulating multiple dimensions of productive processes. Design/methodology/approach – This paper explores the public administration and management literature to identify the major frameworks for visualising complex systems or processes, and a series of dimensions against which they can be compared. It then puts forward a more comprehensive framework – PVPM – and demonstrates its possible use with the example of Indigenous child nutrition in remote Australia. The benefits and limitations of the technique are then considered. Findings – First, extant process mapping frameworks each have some but not all of the features necessary to encompass certain dimensions of generic or public sector processes, such as: service-dominant logic; external as well internal providers; public and private value; and state coercive power. Second, PVPM can encompass the various dimensions more comprehensively, enabling visualisation of both the big picture and the fine detail of public value-creating processes. Third, PVPM has benefits – such as helping unearth opportunities or culprits affecting processes – as well as limitations – such as demonstrating causation and delineating the boundaries of maps. Practical implications – PVPM has a number of uses for policy analysts and public managers: it keeps the focus on outcomes; it can unearth a variety of processes and actors, some of them not immediately obvious; it can help to identify key processes and actors; it can help to identify the “real” culprits behind negative outcomes; and it highlights situations where multiple causes are at work. Originality/value – This approach, which draws on a number of precursors but constitutes a novel technique in the public sector context, enables the identification and to some extent the comprehension of a broader range of causal factors and actors. This heightens the possibility of imagining innovative solutions to difficult public policy issues, and alternative ways of delivering public services.

scholarly journals Innovation and cross-functional teams

2018 ◽  
Vol 24 (1/2) ◽  
pp. 84-105 ◽  
Author(s):  
Daniel Marasquini Stipp ◽  
Márcio Lopes Pimenta ◽  
Daniel Jugend
Keyword(s):  
Single Case ◽  
Field Research ◽  
Incremental Innovation ◽  
Future Research ◽  
Content Type ◽  
The Public ◽  
Tax Management ◽  
Functional Teams ◽  
Practical Implications

Purpose The aim of this paper is to characterize how innovation may happen through cross-functional teams (CFT) in an organization of the public sector. Design/methodology/approach A case study helped to characterize several behavior patterns, team structures and respective links with generating innovation in internal processes and public answering contexts. Findings The results highlight that formal-temporary teams present a higher capacity to generate incremental innovation in products, whereas permanent-informal teams have a higher capacity to generate innovation in the internal processes and public answering contexts. Research limitations/implications The limitations of this research relate to the fact that this is a single case study, and although it is an important case to examine innovation and CFTs, by its very nature, it is not possible to extend and generalize the obtained data to other organizations. The evaluation of its propositions was merely qualitative, and future research is needed to validate its characteristics. Practical implications Several settings of CFTs are presented, as well as their ability to generate different types of innovation, such as the computerization of documents, petitions and papers, which decreases the time to answer the taxpayer. Moreover, CFTs can help to create products, such as computer programs that can be used not only locally but also in several public organizations related to tax management. Originality/value The field research provides the perceptions of the respondents regarding CFT characteristics that can lead to specific types of innovation, as well as the types of products or services that can be generated by these processes.

New perspective on the black box of internal auditing and organisational change

2016 ◽  
Vol 31 (8/9) ◽  
pp. 804-820 ◽  
Author(s):  
Aviv Kidron ◽  
Yuval Ofek ◽  
Herztel Cohen
Keyword(s):  
Public Sector ◽  
Quantitative Methods ◽  
Internal Audit ◽  
Organisational Change ◽  
Internal Auditing ◽  
Content Type ◽  
Internal Auditors ◽  
The Public ◽  
Innovative Model ◽  
Audit Information

Purpose The shift from the traditional audit towards performance audit implies that internal auditors in the public sector function as change agents who underpin the fundamental change process. This paper aims to propose a model that identifies the determinants of organisational change in the public sector that result from internal auditing and the way internal auditors facilitate it. Design/methodology/approach The conceptual discussion of this paper is based on a review of relevant literature, both practical and academic. Findings This paper develops an innovative model that describes the factors leading to auditees’ change readiness after undergoing internal audit processes. The independent variable is audit information quality and the dependent variable, organisational change. Auditees’ perceptions is the mediator variable, and accessibility to audit information is the moderator variable. Practical implications The proposed model suggests the advantages that can be gained by audit-related services, which in turn will add value to the organisation. The relationships between the variables inform practitioners on how to support effective audits as a means of increasing performance and influencing organisational change. Originality/value As the paper offers an innovative model, it may open up new research areas in internal auditing that can be studied by using both qualitative and quantitative methods.

Satisfaction of tuberculosis patients with health services in Ghana

2017 ◽  
Vol 30 (6) ◽  
pp. 545-553 ◽  
Author(s):  
Frank Bonsu ◽  
Felix Afutu ◽  
Nii Nortey Hanson-Nortey ◽  
Mary-Anne Ahiabu ◽  
Joshua Amo-Adjei
Keyword(s):  
Client Satisfaction ◽  
Service Providers ◽  
Healthcare Providers ◽  
Large Body ◽  
Service Users ◽  
Content Type ◽  
Sputum Production ◽  
Interview Guide

Purpose Within human services, client satisfaction is highly prioritised and considered a mark of responsiveness in service delivery. A large body of research has examined the concept of satisfaction from the perspective of service users. However, not much is known about how service providers construct client satisfaction. The purpose of this paper is to throw light on healthcare professionals’ perspectives on patient satisfaction, using tuberculosis (TB) clinics as a case study. Design/methodology/approach In-depth interviews were conducted with 35 TB clinic supervisors purposively sampled from six out of the ten regions of Ghana. An unstructured interview guide was employed. The recorded IDIs were transcribed, edited and entered into QSR NVivo 10.0 and analysed inductively. Findings Respondents defined service satisfaction as involving education/counselling (on drugs, nature of condition, sputum production, caregivers and contacts of patients), patient follow-up, assignment of reliable treatment supporters as well as being attentive and receptive to patients, service availability (e.g. punctuality at work, availability of commodities), positive assurances about disease prognosis and respect for patients. Practical implications Complementing opinions of health service users with those of providers can offer key performance improvement areas for health managers. Originality/value To the best of the authors’ knowledge, this is a first study that has examined healthcare providers’ views on what makes their clients satisfied with the services they provide.

Communicate belonging? Duoethnography of an organisational change study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ivana Crestani ◽  
Jill Fenton Taylor
Keyword(s):  
Change Management ◽  
Sense Of Belonging ◽  
Management Practices ◽  
Organisational Change ◽  
Change Initiatives ◽  
Content Type ◽  
Inclusive Language ◽  
Employee Resistance ◽  
Practical Implications

PurposeThis duoethnography explores feelings of belonging that emerged as being relevant to the participants of a doctoral organisational change study. It challenges the prolific change management models that inadvertently encourage anti-belonging.Design/methodology/approachA change management practitioner and her doctoral supervisor share their dialogic reflections and reflexivity on the case study to open new conversations and raise questions about how communicating belonging enhances practice. They draw on Ubuntu philosophy (Tutu, 1999) to enrich Pinar's currere (1975) for understandings of belonging, interconnectedness, humanity and transformation.FindingsThe authors show how dialogic practice in giving employees a voice, communicating honestly, using inclusive language and affirmation contribute to a stronger sense of belonging. Suppressing the need for belonging can deepen a communication shadow and create employee resistance and alienation. Sharing in each other's personal transformation, the authors assist others in better understanding the feelings of belonging in organisational change.Practical implicationsPractitioners will need to challenge change initiatives that ignore belonging. This requires thinking of people as relationships, rather than as numbers or costs, communicating dialogically, taking care with language in communicating changes and facilitating employees to be active participants where they feel supported.Originality/valueFor both practice and academy, this duoethnography highlights a need for greater humanity in change management practices. This requires increasing the awareness and understanding of an interconnectedness that lies at the essence of belonging or Ubuntu (Tutu, 1999).

Baseline assessment of therapeutic injection practices in Pakistan in 2020: a cross-sectional study

2021 ◽  
pp. 16-21
Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  
Keyword(s):  
Public Sector ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Injection Equipment ◽  
Public And Private ◽  
Healthcare Facilities ◽  
The Public ◽  
Injection Safety

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...

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