2011-03-182011-03-182011-03-18http://hdl.handle.net/10539/9172MBA - WBSThe purpose of this study was to investigate various organisational structures of hospitals in different countries with particular reference to South Africa, by review of literature and interview of some professionals working at a public hospital (Johannesburg Hospital) and then to develop an ideal and effective organisational structure for public hospitals in South Africa and lastly, to determine the changes required to implement it. The review of existing literature showed that a substantial attention was devoted to resolving the management problems of public hospitals across the world including South Africa. Various organisational structures were formulated and implemented for better functioning of those hospitals. Certain themes recur in the literature: • management problems in public hospitals are present across the world in both developed and developing countries; • most countries have instituted changes in organisational structures of public hospitals to improve their functions; • a functional relationship between clinicians and hospital managers is crucial for success; and • the South African government has changed the organisational structure of public hospitals without addressing all the issues necessary for the successful implementation of these changes (e.g. training of hospital managers). The analysis of the responses from the interviewees (30) showed that the relationship between clinicians and hospital managers was inadequate. Both groups agreed that there was a need for change and that an adaptive model should be introduced to improve the efficiency of the public hospitals in South Africa. There was also agreement about the need to train clinicians in management and to introduce training programmes that would target hospital managers. From the above discussion, it appears that the organisational structure of public hospitals needs to be changed from the current managerial dominance model to an adaptive model to improve efficiency. Implementation of the new model will require the establishment of a medical management department, clinical directorates, and specialised training for clinicians and hospital managers.enThesis