Health Care Delivery System As One of Vital Component of Public Welfare Schemes of the Government - Essay Example

Health Care Delivery System Is One of Vital Component of Public Welfare Schemes of the Government Health care delivery system is one of vital component of public welfare schemes of the government. The healthcare components like accessibility to good medical care, quality and cost are increasingly moving beyond the grasp of general public. The down trend in the important component of the healthcare delivery system of the nation has become a major issue which, if not tackled soon, may boomerang on the government with serious consequences. The needed reforms, therefore, require not only a comprehensive feedback of delivery system as a whole, but a careful consideration to all the various pros and cons of the developing situations in the concerned areas of the public health care, has become the need of the hour. The NHS1 facing multi pronged problems needs to introduce some radical organizational changes to improve the health delivery systems. “Organizations must change because their environments change” (Bateman, 1990). They implement necessary changes in the organization to not only survive but also to improve their overall performance. But it is equally true that people tend to resist any kind of change and therefore it is important that changes are implemented in a manner that mitigates the resistance of the employees and instils confidence in them. A good leadership ensures effective communication with the employees with shared vision of the new technology and methods of administration, thus promoting better understanding among the employees for easy changeover. The NHS, in one of its trust hospital, had tried to introduce the concept of multi-skilled working in the wards on a pilot basis. We would be analyzing the particular case study with reference to the implementation of generic mode of working. The trust hospital provides full range of acute and midwifery services to roughly quarter of a million population. It has strength of 2800 staff, 62% of who are part time workers. 43% of the staff is female. The hospital is plagued with increasingly low number of staff presence which is adversely affecting the quality of its health delivery system which resulted in long waiting list and low quality of healthcare services. To cope up with the increasing ‘absenteeism’ and improve the quality of services which could reduce the waiting list while complying with the government initiatives, concept of multi-skilled working was introduced. It involved about 250 people, in a ward based teams of support workers. On the pilot basis, this multi-skilled concept was launched with porters and domestic staff who were required to provide services in different areas like cleaning, transporting patients, moving equipments and serving food, on ‘as and when’ required basis. The organization relied on the flexibility in the work by the available staff within the porter and domestic arena, so that emergency cases can be effectively dealt with. The pilot run failed for a number of reasons. Primary reason was that the staff was not taken into confidence and was not properly informed about the changes in the organization. In the book ‘Organization Behaviour’ the authors Hitt et al, have cited four basic causes of resistance to change: lack of understanding; different assessment; self interest; and low tolerance. The first factor normally happens when the employees and staff are not clear about the changes that need to be made which creates fear of the unknown among the persons who need to adapt to the changes. The leaders of the organization must facilitate and disseminate information regarding the changes so people are better able to understand and hence participate into the changing environment. A good leader ensures that all types of changes must be gradually introduced with full participation of the employees so that at each stage, they are able to understand the necessity and viability of the changes that must be enforced, in order to meet the broader aims and objectives of the organization. In healthcare area, especially while working for NHS, innovative approach is the key to successfully disseminate information and implement new schemes and better resources that meet the challenges of the time. The changing healthcare modalities are an integral part of the current fast changing time. Hence, change is something that must become part and parcel of the healthcare professionals. The supervisors and managerial staff lost the power to discipline the ‘multi-skilled staff’ that produced friction and frustration among them. Lack of awareness and understanding was responsible for interpersonal ego of the porters and domestic staff and resisted the change in their specified work. Proper dissemination of information is essential to dispel any doubts about their ability to adapt successfully to the changes and the usefulness of the new resource, thereby facilitating a change that is positive. According to Marrow ‘the changes required by the welfare of the business become everybody's business and get made’ (Marrow, 1957, p. 66). Therefore, the management must make efforts to develop consensus through proper dissemination of information. It is important for the leaders and management of the organizations to promote empowerment of its staff through well designed process of problem solving and self learning through mutual cooperation and innovative management approach. The conflicts can be solved through effective communication that encourages discussions and doubts clearing sessions and leaders must adapt such techniques to overcome resistance and create congenial atmosphere in the organization. Organizations’ culture is a complex process of evolution and adjustment of the employees within a system over a period of time. The various aspects of the interactive elements of the organization, which may comprise of diverse ideologies and personal conflicts of the individuals, work together to produce a cohesive output representing the organizations unique objectives and goals. Today the equation seems to have changed and ‘we approach managerial leadership as a relational, ongoing social construction process rather than as a single clear cut phenomenon’ (Sjostrand and Tyrstrup). Therefore, prior to introducing any type of organizational change, the management must disseminate information about the changes that are needed to be introduced for the betterment of the organization. It was realized that ‘strategies rather than operative planning and decision making, became the main factor of managerial leadership’ (Chandler, 1962; Ansoff, 1965). The managerial leadership has widened its scope of action and has embraced new spaces where the organizational influence can reach. Hence, according to theory of social construction ‘various institutions (re)produce construction of leadership that coincide with concurrent episodes and processes at the actor level’ (Hosking, 1988; Chenn & Meindl, 1991; Knights and Willmotts, 1992; Sjostrand, 1997). The theory helped unravel the qualitative paradigms that interpret and grasp the dynamics of managerial leadership which made one particular leader more effective than the other. The methodology of the delivery system of the healthcare and the administrative inputs are important ingredients that make it a success. It is a fact that despite huge spending by the state on the healthcare system, the complexities that encompass the inter-related processes of the various elements of the system, are seemingly contributing to its falling standard of effective delivery. The lack of transparency and cohesive integration of details of the deliverables like patients, payers and providers are few factors that undermine the accountability thus reducing the performance and increasing the cost management of the overall delivery system. The previous theories of management leadership was rigid in its perspectives and believed in imposing rules and regulation without taking into consideration the factors of human failings and human emotions. The new managerial leadership style is more labor friendly and believes in developing joint goals and objectives that are mutually beneficial, thus fostering mutual beliefs and better understanding of each others value system. The new dimension in the managerial leadership has also accepted the presence of ‘unexpected situations’ giving them fresh impetus to readily take up the challenges of unforeseen crisis and handle them with aplomb. The presence of uncertainty in an organization implies the recognition that unexpected situations will arise and that they will continue to do so time and time again (Tyrstrup, 1993). The empirical relationship of leaders and the emerging changes are critical for a given situation and therefore, good managerial leadership demands a better informed leader who is capable of taking initiative and at the same time, he is also able to inculcate confidence in his people to move forward. As the Sjostrand and Tyrstrup reaffirm ‘leadership is all about managing creativity’. Indeed, The change is pre-requisite for NHS to maintain efficient and cost effective health delivery system. It is equally important that the change must be accompanied by proper dissemination of information and collective decision making that promotes confidence building and strong sense of objectivity among the employees and staff so that the collective goal is easier to achieve. Reference Ansoff, H. Igor.(1965). Corporate strategy: An analytic approach to business policy for growth and expansion. McGraw-Hill. New York. Bateman, Thomas S., and Carl P. Zeithaml. Management: Function and Strategy. 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