Governance and the functions of boards

Pettersen, Inger Johanne; Nyland, Kari; Kaarbøe, Katarina

doi:10.1016/j.healthpol.2012.07.006

Cited by 16 publications

(5 citation statements)

References 18 publications

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“…Unfortunately, evidence suggests that these mechanisms have been compromised by an insufficient transfer of authority to local levels, a lack of clarity about the roles and responsibilities of the boards or committees, politicization of the committees’ mandate and the perceptions of community interference in health facility matters which may lead to poor working relationships. 19,66,69 Molyneux et al indicate that the involvement of health facility boards and community members in facility operations may be viewed as interference by the staff and as undermining their autonomy. 68 …”

Section: Resultsmentioning

confidence: 99%

“…If anything, if external accountability mechanisms are implemented successfully, if there is greater clarity about the roles and responsibilities required and greater oversight is transferred from the centre to local actors, the available management decision space could be made more responsive to local needs by reinforcing local feedback loops. 19,66,69 …”

Section: Discussionmentioning

confidence: 99%

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Exploring the Functioning of Decision Space: A Review of the Available Health Systems Literature

Roman

Cleary

McIntyre

2017

Int J Health Policy Manag

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Background: The concept of decision space holds appeal as an approach to disaggregating the elements that may influence decision-making in decentralized systems. This narrative review aims to explore the functioning of decision space and the factors that influence decision space. Methods: A narrative review of the literature was conducted with searches of online databases and academic journals including PubMed Central, Emerald, Wiley, Science Direct, JSTOR, and Sage. The articles were included in the review based on the criteria that they provided insight into the functioning of decision space either through the explicit application of or reference to decision space, or implicitly through discussion of decision-making related to organizational capacity or accountability mechanisms. Results: The articles included in the review encompass literature related to decentralisation, management and decision space. The majority of the studies utilise qualitative methodologies to assess accountability mechanisms, organisational capacities such as finance, human resources and management, and the extent of decision space. Of the 138 articles retrieved, 76 articles were included in the final review. Conclusion: The literature supports Bossert’s conceptualization of decision space as being related to organizational capacities and accountability mechanisms. These functions influence the decision space available within decentralized systems. The exact relationship between decision space and financial and human resource capacities needs to be explored in greater detail to determine the potential influence on system functioning.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Exploring the Functioning of Decision Space: A Review of the Available Health Systems Literature

Roman

Cleary

McIntyre

2017

Int J Health Policy Manag

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“…A fundamental thesis of stakeholder-based arguments is that organizations should be managed in the interest of all their constituents (Laplume, Sonpar, and Litz 2008). Therefore, the board can be a tool to maintain and balance the different stakeholders' goals, so its composition is important to secure the different stakeholders' interests, as the functions of the board are highly influenced by the people constituting it (Pettersen, Nyland, and Kaarboe 2012). The board, under a stakeholder approach, will influence, and it will be more concerned about, issues other than financial performance or financial accountability, because these wider audiences have more diverse interests.…”

Section: Stakeholder Accountability and The Corporate Governance Of Ftsmentioning

confidence: 99%

Examining Audit Committees in the Corporate Governance of Public Bodies

Ellwood

García‐Lacalle

2015

Public Management Review

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Public bodies have adopted corporate governance regimes from the private sector assuming that accountability and performance will be improved. This paper analyses audit committees in a local public body context, NHS foundation trusts (FTs). Audit committees play a key role in enhancing governance. FTs follow the recommendations made by Monitor, their independent regulator. FTs, however, appear to adapt the role of the audit committee to meet the accountability needs of the wider stakeholders of public hospitals. Audit committees assure (vertical) financial accountability, and also provide assurance along horizontal lines of accountability to local communities, professional bodies and other stakeholders.

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“…Thus, the boards of Norwegian health trusts have put much emphasis on securing budget balance. During periods of deficit, board members have expressed that keeping budget balance is their most important task (Pettersen et al., 2012).…”

Section: Introductionmentioning

confidence: 99%

Budgeting in public hospital trusts: Surplus, optimism, and accuracy

2023

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Hospitals in Norway are organized as trusts, required to follow the same accounting principles as the private sector, and responsible for funding their own investments. Thus, being able to run with a surplus has been an important part of their management. We analyze hospital budgeting for the whole sector over a 9-year period, looking at the size of the budget surplus, degree of optimism bias, and degree of budget accuracy when comparing to the actual financial results. Our findings indicate that on average, health trusts budget with a relatively small surplus. We find indications for optimism bias, but also examples of pessimism bias. Large health trusts seem to have a higher degree of accuracy of the budgeted results. Trusts that fail to meet budgeted results have a lower budgeted surplus the following period. Capital intensity, an indication of need for new investments, is not associated with budget surplus, degree of optimism, or budget accuracy.

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Governance and the functions of boards

Cited by 16 publications

References 18 publications

Exploring the Functioning of Decision Space: A Review of the Available Health Systems Literature

Exploring the Functioning of Decision Space: A Review of the Available Health Systems Literature

Examining Audit Committees in the Corporate Governance of Public Bodies

Budgeting in public hospital trusts: Surplus, optimism, and accuracy

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