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Health sector is one of the most important sectors when the size of spending and the number of people and organizations involved are considered. An important characteristic of this sector is the dominance of governments as health care providers and/or financers. This fact has important procurement policy implications. This paper gives a detailed overview of the health sector in Turkey and issues surrounding public procurement in this sector. It presents a model for implementation of eprocurement in Turkey’s public health sector, a discussion about the extent to which e-procurement can solve prevailing problems and suggestions to improve procurement in this sector.

The purpose of this paper is to analyze the institutional and social forces that influence collaborative data sharing practices in cross-sector interorganizational networks. The analysis focusses on the data sharing practices between professionals in the transportation and public health sectors, areas prioritized for collaborative action to improve public health.

A mixed methods design is utilized. Electronic surveys were sent to 57 public health and 157 transportation professionals in a large major metropolitan area in the USA (response rate 39.7 percent). Focus groups were held with 12 organizational leaders representing professionals in both sectors.

The application of the institutional-social capital framework suggests that professional specialization and organizational forces make it challenging for professionals to develop the cross-sector relationships necessary for cross-sector collaborative data sharing.

The findings suggest that developing the social relationships necessary for cross-sector collaboration may be resource intensive. Investments are necessary at the organizational level to overcome the professional divides that limit the development of cross-sector relationships critical for collaborative data sharing. The results are limited to the data sharing practices of professionals in one metropolitan area.

Despite mandates and calls for increased cross-sector collaboration to improve public health, such efforts often fail to produce true collaboration. The study’s value is that it adds to the theoretical conceptualization of collaboration and provides a deeper understanding as to why collaborative action remains difficult to achieve. Future study of collaboration must consider the interaction between professional specialization and the social relationships necessary for success.

The purpose of this paper is to reduce the research gap in private sector participation in the Danish and German health systems, where empirical evidence is still very scarce compared with the impressive accumulation of similar literature in Anglo-Saxon countries.

Based on the findings of two case studies – one Danish and the other, a German hospital – the paper assesses the future potential of different private sector participation strategies in health care.

The assessment is that low-level private sector participation approaches such as outsourcing and concession models remain limited and specialised financing instruments for health care in Denmark and Germany due to legal restrictions and lesser importance being placed on operational financial savings and improved management than on achieving strategic goals. Furthermore, existing approaches do not necessarily prepare the ground for public-private partnerships.

To date, longitudinal studies of private sector participation in health care are almost non-existent for continental Europe, yet critical for the assessment of the outcomes of long-term projects of ten to 40 years' duration. In addition, there is still a need for more international comparisons, especially for studies comparing more than two countries.

Case studies about private sector participation in health care with transnational European or international comparisons are very scarce. The paper, which compares two cases of a Danish and a German hospital, is therefore a contribution to reducing a relevant research gap. To date, private sector participation in the German health system, in particular, has rarely been discussed in international journal publications.

The purpose of this paper is to investigate accounting and performance reporting practices embraced in the midst of a pluralistic institutional environment of an emerging economy (EE), Zambia. The research is necessitated due to the increased presence and influence of donor institutions whose information needs may not conform to the needs of local citizens in many EEs.

The study draws on institutional pluralism and Ekeh’s post-colonial theory of “two publics” to depict pluralistic environments that are typical of EEs. Primary data were collected through semi-structured interviews with 33 respondents drawn from the main stakeholder groups involved in health service delivery including legislators, policy makers, regulators, healthcare professionals and health service managers. Data analysis took the form of thematic analysis which involved identifying, analysing and constructing patterns and themes implicit within the data that were deemed to address the study’s research questions.

Findings indicate that Zambia’s institutional environment within the health sector is highly fragmented and pluralistic as reflected by the multiplicity of both internal and external stakeholders. These stakeholder groups equally require different reporting mechanisms to fulfil their information expectations.

The multiple reporting practices evident within the health sector entail that the effectiveness of health programmes may be compromised due to the fragmentation in goals between government and international donor institutions. Rather than pooling resources and skills for maximum impact, these practices have the effect of dispersing performance efforts with the consequence of compromising their impact. Fragmented reporting equally complicates the work of policy makers in terms of monitoring the progress and impact of such programmes.

Beyond Goddard et al. (2016), the study depicts the usefulness of Ekeh’s theory in understanding how organisations and institutions operating in pluralistic institutional environments may be better managed. In view of contradictory expectations of accounting and performance reporting requirements between the civic and primordial publics, the study indicates that different practices, mechanisms and structures have to be embraced in order to maintain institutional harmony and relevance to different communities within the health sector.

This paper aims to provide insights into how the New Zealand Office of the Auditor-General (NZOAG) legitimised the selection of topics for performance audit in the New Zealand public health sector over a 10-year period, 2003-2013, by fulfilling the key actors’ “taken for granted beliefs” of the dual roles of the NZOAG: its independence and accountability.

This paper uses evidence gathered from interviews with representatives of the District Health Boards, the Ministry of Health (including Health Advisory Committee members) and NZOAG staff, along with publically available documentary evidence over a 10-year period. The authors draw on Suchman’s (1995) authority on institutional legitimacy to inform the research findings.

The New Zealand Auditors-General (NZAGs) get inputs from various sources such as their own audit teams, parliamentary deliberations, the Ministry of Health, the District Health Boards, media and public concerns and complaints. These sources initiate ideas for performance audits. Subsequently, the NZAGs use the recurring themes and risk assessment criteria while simultaneously consulting with the auditees (the MOH and the DHBs) and other actors, such as health advisory groups, to select topics for such audits. This signals to the key actors, such as the MOH and the DHBs, that the NZOAG is addressing the topics and concerns relevant to the former while discharging its public accountability role. Furthermore, the consultative approach acts as a catalyst, ensuring that the actors involved with public sector health service delivery, specifically the auditees, accept the selected topic. This leads to a lack of resistance to and criticism of the topic; the selection process, therefore, is legitimatised, and credibility is added to the audits. Because of the consultative approach taken by the NZAGs, the actors, including the performance auditors, continue to believe that the Office acts independently from third party influence in selecting their audit topics, elevating the NZAGs’ moral legitimacy with respect to their public accountability role.

The study’s focus group does not include parliamentary representatives, only representatives from the DHBs, the MOH and the NZOAG; therefore, the conclusions on effective discharge of the NZOAG’s accountability role and Parliamentary acceptance is not conclusive – the NZOAG acts on behalf of the Parliament in discharging its accountability role and the latter is also the formal recipient of the reports.

The implications for practitioners and policymakers are that the use of a consultative approach to select topics for performance audit in the absence of performance auditing standards ensures auditee readiness and acceptance of such audits. This also promotes mutual benefits and “trust” between the AG and auditees. Such audits can be used to bring about efficacy in health service delivery.

The selected topics for audits will have an impact on citizens’ lifestyles, with improved health services delivery.

There is a dearth of research on who initiates the ideas for performance auditing and how the Office of the Auditor-General selects topics for such audits. This study adds a new dimension to the existing performance auditing literature. The authors reveal how the NZOAG seeks to legitimise the selection of topics for such audits by consulting with the auditees and other actors associated with public sector health service delivery, while upholding its independent status and making transparent how it discharges its accountability role within the context of performance auditing.

The purpose of this paper is to probe experiences of entrepreneurs in the social and health care service provision.

Information was collected regarding entrepreneurs’ views on the factors affecting the collaboration between public and private sectors. A sample of social and health care entrepreneurs was interviewed using open-ended questions. The interviews were transcribed and analysed using inductive content analysis.

Three main categories of factors affecting the success of partnership were identified: the nature of partnership, business aspects and tension builders.

The research was undertaken in rural Finland and the sample consisted 13 entrepreneurs. The results must be considered as observations with more generalised conclusions.

The results of this study support municipalities in their social and health care service strategy work and especially in consideration of how to also facilitate a fruitful public-private partnership (PPP)-framework, which will largely depend on mutual understanding and consensus.

The reform of the social and health care system has raised intensive public debate throughout Europe. Key issues include the reorganising of social and health care processes as well as PPPs in provision of services. This study observes the views and experiences of private entrepreneurs and points out where some potential problems and solutions of social and health care PPPs are.

Privatization as a general policy was introduced into Malaysia in the 1980s. Subsequently, selected elements of the public health-care system were privatized. This chapter analyzes the effects of privatization on the health-care system in terms of both intended and unintended consequences. The outflow of experienced specialist doctors from the public sector to the private sector and the emergence of a two-class system of health care in Malaysia have been major unintended consequences of privatization.

The purpose of this study is to examine the ongoing dynamics of the public service sector reform through an embedding process of a municipal enterprise from the field of basic social and health care services – a pilot model in Finland.

The framework of a multi‐level perspective on transitions is used to describe the change process. At the lowest level of this perspective are the experimental niches acting as “seeds of change” represented by the case organisation, a municipal enterprise operating in the basic social and health care sector. The data consist of 16 thematic interviews with the key persons of the operating system, analysed with the principles of content analysis.

The examination uncovers diverse pressures affecting niche level innovations and manifesting as clashes and controversies between old and new ways of thinking, but these clashes can also act as a platform for innovations when opened up, analysed and facilitated.

Clashes that appear in societal transition processes and regime changes, both in the regimes and also on the organisational level, should not be seen solely as bottlenecks, because they can act as innovation potential when opened up and facilitated. This implies the need for not only new technological, service‐related and organisational innovations in the public sector reform, but also innovative practices, “second level innovations”.

This paper contributes to the discussion on the ongoing change processes in the reform of the social and health care sector, emphasising emerging clashes not only as obstacles but opportunities.

Purpose – The paper explains how internal reporting systems, as embedded practices informing organizational actions and “know-how”, contributed to the inertia in implementing a corporate form of governance in a transitional public organization in a developing country – Egypt.

Design/methodology/approach – The paper synthesizes an institutional theory framework in order to capture the case study mixed results. Drawing on DiMaggio and Powell's (1983) notions of isomorphic mechanisms, Ocasio (1999) and Burns and Scapens’ (2000) notions of organizations’ memory, history, cumulative actions and routines, Brunsson's (1994) notion of organizational institutional confusion as well as Carruthers's (1995) notion of “symbolic window-dressing” adoption of new practices, the paper explores the dynamic of a public hospital corporatization processes. Data collection methods include semi-structured interviews, documentary evidence and direct observation.

Findings – The case study evidence shows that the interplay between the new form of “corporate” governance and the intra-organizational power, routines and “know-how” created internal organizational confusion and changed organizational members’ narrative of risk and uncertainties.

Research limitations/implications – The paper does not reveal the role of reformers involved in the public sector “governance” reform in developing countries. Exploring such a role goes beyond the scope of this paper and represents an area of future research.

Originality/value – The paper provides a comprehensive account of public sector “governance” reform in a developing nation, while exploring the role of management accounting and costing systems in facilitating or otherwise that reform processes.

In Hungary, as in other Central and Eastern European countries, the concept of social enterprise (SE) has attracted increased attention in recent years, with certain key actors shaping the organisational field. This growing interest is largely because of the availability of European Union funds focussing on the work integration of disadvantaged groups but ignoring other possible roles of SEs. This study aims to consider a seldom examined and underfunded area: SEs’ institutional environment and organisational activities in the social and health sectors.

Based on neoinstitutional theory, the paper uses desk research and qualitative case studies. It presents the experiences of SEs providing social and health services for specific disadvantaged groups.

This paper identified the key actors influencing the everyday operation of SEs and examined their connections, interactions and partnerships. Based on the findings, SEs primarily depend on the central state, public social and health institutions and local governments. At the same time, their connections with private customers, networks, development and support organisations, third sector organisations and for-profit enterprises are less significant. The key actors have a relevant impact on the legal form, main activities and the financial and human resources of SEs. SEs, however, have little influence on their institutional environment.

The paper contributes to understanding the opportunities and barriers of SEs in Hungary and, more generally, in Central and Eastern Europe, especially regarding their place in social and health services.