Managing expectations with emotional accountability: making City Hospitals accountable during the COVID-19 pandemic in Turkey

Abstract

PurposeThis paper explores the role of the COVID-19 pandemic in the financial and parliamentary accountability mechanisms of public-private partnership (PPP) “City Hospitals” in Turkey. Diverse and changing accountability mechanisms are explored regarding budgetary, affordability and emotions during the COVID-19 pandemic.Design/methodology/approachThis is a case study of City Hospitals in Turkey. Empirical data are collected and analyzed qualitatively from publicly available government and related sources, Turkish National Audit reports (Sayistay), strategic healthcare investment plans, relevant laws, decrees and NGO reports and news articles.FindingsExisting accountability mechanisms for arranging and/or delivering value-for-money (VfM) in Turkish PPP hospitals are weak. This provided policy makers with more flexibility to manage expectations of its citizens in dealing with COVID-19 pandemic. Political decision makers, through PPPs, created political capital for themselves by engaging in emotional accountability at the expense of better financial and parliamentary accountability.Originality/valueThis article contributes to the literature by articulating how roles of accountability change in crisis and introduces the concept of emotional accountability during a period of heavy infrastructure investments in City Hospitals in Turkey.

Accounting, management and accountability in times of crisis: lessons from the COVID-19 pandemic

“…Inevitably, public health institutions, such as hospitals and clinics, are centre stage in the fight against the virus (Demirag et al, 2021). Huber et al (2021) examine the role of accounting in the management of the COVID-19 pandemic in five German hospitals.…”

Budgetary responses to a global pandemic: international experiences and lessons for a sustainable future

“…Because of these measures, many countries, including those that had strong fiscal discipline and sound budgetary balances before the COVID-19 crisis, anticipate a significant jump in the level of indebtedness. This development has led to rising concerns about fiscal sustainability in the long run, especially among developing countries (Adhikari et al , 2020; Bashir and Ashfaq, 2020; Demirag et al , 2020; de Villiers et al , 2020; Dzigbede and Pathak, 2020, Ejiogu et al , 2020; Elkhashen et al , 2020; Jose et al , 2020) Only a few jurisdictions studied in this SI, such as China (Li and Wu, 2020), Estonia (Raudla and Douglas, 2020), Russia (Vakulenko et al , 2020) and Taiwan (Kuo et al , 2020) were able to remain fiscally intact.…”

“…Finally, the COVID-19 pandemic also draws our attention to other governance issues, such as the need to have a transparency and accountable budgetary process to deal with supplemental appropriations and re-budgeting (Anessi-Pessina et al , 2020; Kuo et al , 2020; Seiwald and Polzer, 2020), an open dialogue with citizens in budgeting (Cho et al , 2020; Vakulenko et al , 2020), good accounting and auditing practices to prevent frauds and abuse (Ahrens and Ferry, 2020; Ball, 2020; Demirag et al , 2020; Heald and Hodges, 2020) and effective collaborative governance to leverage the resources and capacity of non-governmental actors to address emergency needs (Johanson et al , 2020). At the same time, various studies also show how vulnerable small businesses, nonprofit and community organizations and even state-run enterprises and other hybrid organizations like public and private partnerships and social enterprises can be in an unexpected economic downturn, and how much these sectors need the financial backing of the state (Costa and Andreaus, 2020; Grossi et al , 2020; Sargiacomo and Walker, 2020).…”

Accountability in times of exception: an exploratory study of account-giving practices during the early stages of the COVID-19 pandemic in Italy

“…This paper contributes to the accountability literature by showing that during times of exception (Agamben, 2005), the emerging "styles of accountability" do not depend so much on cultural determinism or the exigency of aligning "rhetoric and practice with wider public discourses" (Ahrens, 1996, p. 140) as on the need to enhance "shared responsibility" (Sciulli, 2018). The existing literature has shown how governments have mobilized political capital to alter the role of accountability in times of crisis (Demirag et al, 2020). This paper builds on this research by critically analysing the mechanisms through which the Italian government sought to combine public governance and public accountability issues as a means of urging shared responsibility.…”