Governance structure and public health provision

Abstract

Purpose A key question in the provision of public health concerns how that provision is governed. The purpose of this paper is to examine the governance structure of a public health board and its perceived impact on the efficacy of clinical operations. Design/methodology/approach Structural issues examined the level of centralisation and public participation, and whether governance should occur through elected boards or appointed managers. These issues were examined through multiple lenses. First was the intention of the structure, examining the issues identified by parliament when the new structure was created. Second, the activities of the board were examined through an analysis of board meetings. Finally, hospital clinicians were surveyed through semi-structured interviews with both quantitative and qualitative questioning. Findings A contradiction was revealed between intention, perception and actual activities. This raises concerns over whether the public are significantly informed to elect the best-skilled appointees to governance positions. Practical implications This research holds implications for selecting governance structures of public health providers. Originality/value Few studies have looked at the role of a publicly elected healthcare governance structure from the perspective of the clinicians. Hence, this study contributes to the literature on healthcare structure and its impact on clinical operations, by including a clinician’s perspective. However, this paper goes beyond the survey and also considers the intention of the structure as proposed by parliament, and board activities or what the board actually does. This enables a comparison of intention with outcomes and perception of those outcomes.

The Impact of Government Governance on Regional Public Health and Development Measures from the Perspective of Ecological Environment

“…With the implementation and continuous expansion of China’s basic public health services in 2009, scholars have successively investigated the awareness rate and satisfaction of residents’ public health services around the country. Many research results show that Chinese residents’ satisfaction with public health services shows the characteristics of uneven geographical distribution [ 2 ]. Although many achievements have been made in the construction of Chinese government efficiency, relatively speaking, empirical research on the factors affected by government efficiency is not sufficient, and most of these factors focus on the impact of regional and even national macro policy implementation, including talent gathering, innovation and entrepreneurship, business environment and other fields.…”

Measuring the impact of critical factors on government supported healthcare supply chain: an approach towards efficient governance

“…Hence, GHSC are under strong pressure to improve the quality of service and provide affordable, accessible, safe health-care facilities at limited financial resources (Poksinska, 2010). To achieve efficient governance in health-care sector especially government supported, an effective CFs is highly obligatory which can be extracted by the analysis of supply chain (Hossain, 2018;Sheard, 2019). Although, the available studies related to enablers and barriers which have been conducted in different extents like private HSC and GHSC reported that the impact of CFs on GHSC is generally dependent on how well these CFs are implemented before expecting positive result on effort made in the GHSC (Khan et al, 2018;Hussain et al, 2019;Dixit et al, 2020b), but unfortunately, there is neither such practice is carried out by the government authorities and top management of GHSC nor specific studies devoted to measure and evaluate impact of CFs on GHSC through the performance of CFs.…”