13 Chapter 2: Critical Literature Review 2.1 ... - Dissertation

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32population (Kingham, Kamara, Daoh, Kabbia and Kushner, 2009). In order to maintain thequality of healthcare in several countries, the decentralization of the healthcare delivery andfinancial system has been recommended in order to cut costs without impacting the quality ofcare provided. Decentralization refers to separate entities assuming responsibility for both theseinstitutions in an effort to create better performance levels (Geyndt, 1994, p.55).2.10 Working Conditions in Private and Public Health Care OrganizationsCompanies in private and public healthcare organizations are constantly trying toimprove working conditions and environment for their staff as one of the incentives for theircontinued performance at work. With the increasingly deteriorating world economy, there havebeen apprehensions regarding the quality of work life in the public sector. This is especially trueconsidering the increasing practice of non-permanent employment (Virtanen, et al., 2006). Therehas been a growing concern within the public sector, however, of the increasing privatization ofhospitals due to financial incentives. There are concerns within the healthcare industry that withincreasing privatization of healthcare, the call for individual contracts within the public sectorwill cause the equal pay for work aspect to disappear and affect the rights and dignity of medicalpractitioners (Soumeli and Nergaard, 2002). However, there is evidence that there is a greaterdeal of stability in the public sector compared to the private sector and that if publicorganizations paid wages that were comparable to those in the private sector, it would increaseemployment in said sector (Bellante and Link, 1981).2.11 Public-Private PartnershipsBefore this aspect of the healthcare system is delved into, it is important to first considerwhat public-private partnerships actually are. Public private partnership rather than be defined asprivatization of certain aspects of public sector healthcare may actually be an undertaking by
33both sectors in order to share the responsibilities of a task in order to reach a successful outcome.Perhaps, the most prolific example of this system is in Africa, where the public sector healthcaredoes not have many inroads into the African population and thus, cannot effectively deliver untothem the medicines and healthcare they would require to survive. In order to resolve thisproblem, the government is using its partnership with companies in the private sector to ensurethat there is a wider distribution net not only for pharmaceuticals but also for healthcare amongits people (Widdus, 2001). Other partnerships in recent years have included the medicine andreason project in Austria, which was created to provide flyers with disease and treatment optionsfor patients as well as an online component with the same information accessible, along withguidelines for doctors. The project printed 260,000 flyers and provided 18,000 guidelines, all at areasonable price. Another project from Denmark known as the Infomatum has an objective toincrease the existing standard of knowledge of doctors regarding medicines so that they maymake better decisions regarding their patients. To date, a website along with a book has beencreated in order to complete this task (Pharmaceutical Forum, 2008).2.12 National Health ServiceThe National Health Service was launched 60 years ago and is currently the world’slargest publicly-funded health service under the Department of Health. It operates upon the idealof free universal healthcare and is open to 60 million residents of the United Kingdom.The name of the National Health Service may be used in reference to four public sectorhealthcare organizations in the United Kingdom. The system of NHS operates not only inEngland but also in Northern Ireland, Scotland and Wales. Each of the system operates without acentral body, meaning, they are autonomous from each other and is politically attached to itsrespective government. It does not discriminate against any individual in terms of services in the
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