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This study investigates the impact on human resource management (HRM) practices in the public health sector in Victoria, Australia of two different government policy environments. First, it explores the Liberal Coalition Government's decentralisation of public health sector management, from 1992‐1999 and second, the Labor Government's recentralisation of employment relations in the sector. This paper focuses on three dimensions. First, it outlines the main policy directions impacting on people management in the health care sector under the different governments. Second, it explores the impact of these policy directions on HRM. Third, it discusses the implications for future directions of the practice of HRM in the public hospital sector.

The purpose of the study is to establish the relationship between public health sector performance (PHSP), fleet management system, perceived service quality (PSQ) and management style (MS).

A total of 260 managerial employees were randomly selected from 5 major public hospitals in Zimbabwe to participate in this cross-sectional survey.

Fleet management system was found to positively influence both PSQ and PHSP. The results indicated that PSQ has a positive effect on PHSP. MS was found to moderate the effect of fleet management system on both PSQ and PHSP.

The current study provides fresh insights and validates extant knowledge on PHSP, fleet management and PSQ within the public health sector departments. It extends further knowledge on the public health performance in the Sub-Saharan region, as it shows that dimensions on fleet management have a direct influence on PHSP.

Owing to the rising costs and shrinking budgets; inefficiency can be observed in the financing and delivery of health service both in the private and public sectors, which is not only causing organizations to reconsider their management patterns but also to use new strategies to achieve competitive merits in the current world of business. Outsourcing is one of the best alternates. The purpose of this paper is to study: the nature and magnitude of outsourcing of health-care services in a Smart City of Eastern India; the motives behind outsourcing: and the factors affecting outsourcing decisions.

The study was conducted in Bhubaneswar, a Smart City of Eastern India and capital of Odisha State. Data relating to the outsourcing of health-care services were collected from 40 hospitals (each having a minimum of 10 beds) through a structured schedule. Descriptive statistics were calculated through Statistical Package for Social Science to substantiate the objectives.

Most of the clinical services were outsourced by small hospitals, while a significant portion of non-clinical services were outsourced by large and medium hospitals. Reduction in cost and better management control were the major driving forces of outsourcing. Loss of control over service providers and quality of measurement were considered as the main disadvantages in the decision-making process of not outsourcing the services by hospitals.

The study is the first-ever survey based on empirical evidence about the state of facilities management services outsourced in public and private hospitals in Odisha, India. The paper concluded that the effect of outsourcing did not synchronize successfully as shown in international literature.

In recent years, effective leadership initiatives have been emphasized in the healthcare industry all over the world. This paper aims to examine contemporary healthcare development in the Kingdom of Saudi Arabia (KSA) and prescribe four essential policy dimensions to its leadership, depicting the imperative needs for direction, integration, revision, and evidence – the “DIRE needs” approach.

The paper reviews literature on the contemporary KSA health system and provides guidelines for policy reforms vis‐à‐vis the emerging challenges.

First, the paper offers a conceptual model to examine the ongoing and future health policy development of the KSA. It identifies four key policy dimensions – direction, integration, revision, and evidence and links these to the scope of broader health sector reforms. Second, it characterizes these dimensions as key initiatives for health resource capacity and infrastructural development, essentially the primary health care, which need to be taken up by KSA mainstream health services leadership. Third, it underlines the importance of integrating institutional research and information systems for evidence‐based policy‐making and practicable implementation. Fourth, it offers a social science research perspective to the need for multi‐dimensional health policy reforms in the KSA.

This paper opens up KSA health leadership initiatives that may be viewed as the DIRE needs, to be mainstreamed in the domains of policy and strategic planning, research and development, and healthcare management practices.

Social research in KSA health policy and planning is rare. This paper introduces a context‐specific multi‐dimensional model that provides critical insights into challenges and complexities that the Saudi health leadership must attend to. It defines a set of four essential benchmarking dimensions for guiding future policy reforms.

This paper examines the progressive exertion of external managerial control over New Zealand pathologists as the country’s New Public Management health reforms were implemented during the 1990s. Perspectives on professionalism, and its role in the effective use of resources, are discussed as part of the examination of this shift in decision‐making power from pathologists to external management. Our analysis, based on a range of archived and interview data collected over the period 1997‐2000, suggests that publicly unacceptable compromises in pathology service quality were risked by the pursuit of tight bureaucratic and free market controls over pathology practice. The paper concludes with suggestions for a health professional control model facilitative of maximal health gain.

The purpose of this paper is to give an overview of the use of strategic management accounting (SMA) techniques in hospitals under competitive market environments. The paper analyses the dissemination of SMA techniques in consideration of structural characteristics and perform a cluster analysis in order to investigate performance differences between various groups of hospitals.

The paper collected empirical data in a nationwide survey of German general hospitals. Analyses are based on questionnaires from 116 hospitals.

Results show that strategies are applied and regularly adjusted in most hospitals. However, SMA techniques are not in widespread use. The paper explores performance differences between the clusters comprised. The paper finds evidence that the use of SMA techniques varies among hospitals based on their structural characteristics.

The authors' exploratory analysis suggest that further study exploring both the determinants and effects of the use of SMA techniques in hospitals represents an interesting path for future research. This study is subject to limitations, particularly concerning the limited number of contextual variables and performance measures taken into consideration.

Considering the limited use of SMA techniques, this paper conclude that hospitals should consider the adoption of additional practices. The paper identifies particular potential for development in the areas of risk management and capital budgeting methods.

This study provides the first comprehensive overview of SMA techniques used in hospitals and advances the literature, which primarily includes case study evidence on single SMA techniques or analyses of the impact of strategies and health reforms on “conventional” management accounting practices. This paper, then, constitutes a useful starting point for further research on SMA practices in hospitals.

The subject areas are business communication, human resource management and health care.

The case was designed for use in a first-year MBA-level course in business communication but would serve well in a course for executives or for advanced undergraduates. It might also be assigned in general management courses to evoke discussion on communication skills required in sensitive and critical situations; human resource courses; and course on health care.

Palliative care is a specialized medical care focussing on improving the quality of life of patients suffering from life-threatening illnesses. It addresses symptom management and psychosocial and spiritual concerns of the patient and its caregivers. With the intent to alleviate the sufferings of terminally ill patients, Rajbala Foundation, a non-government organization (NGO), works at the psychosocial and spiritual levels. While training their volunteers in effective palliative care communication, it often encounters challenges such as socio-cultural variations, organizational challenges, appropriate verbal and nonverbal communication, etc. This teaching case focuses on the communication challenges faced by the volunteers of Rajbala Foundation. It would lead to a broader discussion on communicating empathically during critical situations. The case has a focus on NGOs, and non-profit organizations, public sector management, health-care management and human resources management. There is significant literature on communication skills for medical practitioners in palliative care. As an increasing number of NGOs step in to provide the second level of care to critically ill patients in non-physical domains, there is a need to understand the role of effective communication for such care providers. This case deals with non-medical care providers in palliative care; the issues of communication they face as they interact with patients; and the skills they require to address the emotional and spiritual needs of patients and their families.

The aim of this case is to raise awareness of the complexities involved in the communication process during an emotional and sensitive interaction. It aims to encourage volunteers involved in palliative care to reflect on good communication practices when communicating with patients and family members. After reading this case, the students should be able to discuss the complexities involved in the communication process when communicating in situations with high emotional involvement; understand the core elements of emotional interactions for effective practice; and emphasize the need for the development of communication skills within palliative care.

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS 6: Human Resource Management

In recent years, there is a steady increase of studies documenting the emergence of “contracting back-in” in many countries around the world, that is, governments bringing previously contracted services back in-house and once again relying on public employees to deliver these services. Through a survey of the academic discourse on contracting back-in, this manuscript describes the phenomenon of contracting back-in and discusses its implications for “bringing the state back in”.

The manuscript conducts a systematic review of existing literature on contracting back-in with a focus on the scope and rationale of contracting back-in.

The existing literature demonstrates that contracting back-in is often as common as contracting out and can be found in a variety of countries and across different service areas. Existing studies also suggest that contracting back-in is driven by a mix of managerial, political, and environmental factors. The rise of contracting back-in could imply a revival of the administrative state in public governance and a more dynamic, potentially more complicated, system of public service delivery.

The manuscript contributes to the special issue on “bringing the state back in” through the lens of government contracting. It adds a number of implications to the discussion on the emergence of the “new” administrative state and strategies to reinvent it.

Since 2009 Swedish municipalities may apply the Act on System of Choice (LOV) in, among other things, eldercare. About half of the 290 Swedish municipalities have chosen this within home-care services for older citizens, thus creating conditions for a welfare mix where private and public providers compete. Some of these municipalities later made decisions to abolish LOV. This article aims to analyse the arguments put forward by municipal politicians to abolish LOV and discusses if the case of abandoning LOV represents a case of re-municipalization.

Qualitative method was used to analyse decision protocols and media materials from 20 Swedish municipalities that had abolished LOV in home-care services.

The article shows that politics and ideology seem to have only a limited significance in abolishing LOV. The most important arguments found in the empirical materials were instead pragmatic and related to the transaction costs: in smaller municipalities about the weak position of private providers and in larger municipalities about reported cases of welfare crime and extensive needs to control and review. In smaller municipalities, LOV was replaced by public monopoly and in larger municipalities by other types of procurements.

With its focus on eldercare in party-dominated municipalities, the article adds knowledge to the literature on drivers of re-municipalization but also discusses possible delimitations of the concept of re-municipalization.

The author describes how the University of Central Lancashire has chosen to make electronic document delivery available to remote users in accordance with the requirements of the European Commission research project BIBDEL. Details are given of the information technology resources deployed to offer this service and the difficulties experienced in doing so. The library management issues contingent on offering the service operationally are then explored; among which the current imprecision of copyright legislation is held to be the most important.