An analysis of the human resource management function during the decentralisation of Hospital management: case of North West Province
Date
2012-01-10
Authors
Mothoagae, Mogale Phillemon
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Abstract
Background: The National Department of Health adopted decentralisation of
hospital management as a key policy in pursuit of a more efficient, effective,
responsive and accountable public sector hospital system. The proposed
decentralisation of hospital management represented a fundamental policy shift
in the decision making processes between National, Provincial health
departments and Hospitals. Provincial health departments were to “delegate
significant decision making powers to hospital managers, including the authority
to make decisions relating to personnel, procurement, and financial
management”
Objective: To gain in-depth understanding of the decentralisation of hospital
management processes between 1996 and 2007 as it relates to the Human
Resource Management function in public hospitals.
Methodology: The study design was a descriptive qualitative comparative case
study design.
Results: Decentralisation was promoted as a policy reform to improve efficiency,
equity and effectiveness of hospitals in South Africa. There was no formal policy
from the National Department of Health guiding the implementation of
decentralisation of hospital management.
There was a shift of power over the control of HRM function between 1996 and
2007. Regional hospital gained more space and had more wide range of choices
allowed in almost all HRM activities. District Hospital has gained some space and
now has moderate choice allowed.
The experiences and understanding of health managers vary on what happened
during the policy process.
Conclusion: The study found conclusive evidence that there are changes to
HRM function during the ongoing debate on decentralisation of hospital
management. More HRM functions were delegated to Hospitals.