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Ceremony held Wednesday, November 6th, 2013 at Government House, Mount Fitzwilliam, Nassau, Bahamas

The Public Hospital Patient Charter is a part of the Northern Territory and Commonwealth Governments' program to improve the delivery of hospital services to the public. Providing better information for health care consumers is a major commitment. The Charter is produced to provide people with straightforward information about public hospital services and what patients can expect under Medicare from the public hospital system, such as • When charges may apply • Access to medical records • How patients can lodge a complaint if they are unhappy about their treatment in a public hospital ; Y

AbstractIt is estimated that there are more than seven thousand independent public authorities in the United States. What makes these quasi‐
governmental authorities unique is a blend of public powers with a more private‐sector‐like administrative style. By being able to avoid the formal rules that permeate most public bureaucracies, they can move more swiftly and decisively than government, but at the potential risk of special interests having substantially greater influence over public policy decisions than the public at large.

The article analyses the issues involved in the privatization of public hospitals inthe U. S. Faced with increasing costs, many public hospitals are bleeding red ink andthus encounter difficulties when making investments necessary to cut costs and increaseperformance. Hospital expenditures accounted for almost a third of the $1.6trillion the United States spent on health care in 2000. According to the U.S. Departmentof Health and Human Services, over the ten-year period from 1990 to 2000the average cost of an inpatient stay at a public hospital increased by nearly 50 percent,compared to only 20 per cent at private for-profit hospitals. By 2001 the $7,400cost of a stay at a public hospital was 24 per cent greater than at a private for-profit($5,972). In the case of public hospitals, a conflicting mix of social, political, andbusiness objectives results in weak incentives to control costs. Cost burdens comefrom inefficient accounting, restrictive government personnel and procurement regulations,a tangled web of bureaucracy, and a general lack of accountability. Mostpublic hospitals lack the strategic advantages enjoyed by private hospitals including:a marketing orientation, volume purchasing systems, state-of-the-art information systems,standardization of supplies, outcome management systems, computerized casemanagement systems with cost-per-procedure variables among physicians performingthe same procedures, physician practice management, and technologically advancedpatient care.

Since the public sector traditionally has provided the public goods viewed as unprofitable by the private sector, the growing trend to manage public hospitals under outside private contract raises some fundamental issues of concern. It is hypothesized here that the system maintenance and output goals of privately managed public hospitals become increasingly similar to those of investor-owned hospitals. The thesis is empirically tested using documented effects of private contract management on the operative goals of short-term, general hospitals owned by local governmental bodies. Traditionally managed public hospitals matched with the study hospitals on important characteristics serve as the control group. Costs do appear to be reduced under private contract management, but the service structure becomes somewhat altered. It is the task of public health policymakers to reconcile the cost-control and efficiency mechanisms brought about by private management with the community's right of access to comprehensive medical care. Carefully structured regionalization plans--a possible means of providing both--will require the stimulation of more government involvement during an era of cutbacks.

This study examines the long‐run and short‐run behaviour of public hospital average costs in two Australian States: Victoria and Queensland. Using adjusted weighted inlier‐equivalent separations as a measure of hospital output, and floor area as a measure of capacity, the study finds a hump‐ or '∩'‐shaped long‐run average cost curve at the 5 per cent significance level in both data sets. The study also finds a saucer‐ or '∪'‐shaped relationship between capacity utilisation and short‐run average cost at the 5 per cent level.

BACKGROUND: In Ethiopia, public hospitals deal with a persistent human resource crisis, even by Sub-Saharan Africa (SSA) standards. Policy and hospital reforms, however, have thus far resulted in limited progress towards addressing the strategic human resource management (SHRM) challenges Ethiopia's public hospitals face. METHODS: To explore the contextual factors influencing these SHRM challenges of Ethiopian public hospitals, we conducted a qualitative study based on the Contextual SHRM framework of Paauwe. A total of 19 structured interviews were conducted with Chief Executive Officers (CEOs) and HR managers from a purposive sample of 15 hospitals across Ethiopia. An additional four focus groups were held with professionals and managers. RESULTS: The study found that hospitals compete on the supply side for scarce resources, including skilled professionals. There was little reporting on demand-side competition for health services provided, service quality, and service innovation. Governmental regulations were the main institutional mechanism in place. These regulations also emphasized human resources and were perceived to tightly regulate employee numbers, salaries, and employment arrangements at detailed levels. These regulations were perceived to restrict the autonomy of hospitals regarding SHRM. Regulation-induced differences in allowances and external employment arrangements were among the concerns that decreased motivation and job satisfaction and caused employees to leave. The mismatch between regulation and workforce demands posed challenges for leadership and caused leaders to be perceived as incompetent and unable when they could not successfully address workforce needs. CONCLUSIONS: Bottom-up involvement in SHRM may help resolve the aforementioned persistent problems. The Ethiopian government might better loosen regulations and provide more autonomy to hospitals to develop SHRM and implement mechanisms that emphasize the quality of the health services demanded rather than the quantity of human ...

Abstract: This paper advances the conjecture that external budgetary pressure on a bureaucratic hierarchical organisation, such as a hospital, can cause an imbalance in that organisation, whereby administrative practices may proliferate, an "inert" segment of the organisation may successfully resist change, and the clinical work, the raison d'être of the organisation, may decrease markedly. First, a mathematical model for the behaviour of a single level in the organisational hierarchy is developed; secondly, the aggregate model formed by applying the single‐level model simultaneously to all levels in an organisation is examined. The approach presented may enable administrators to view and understand the behaviour of their organisations from a new and potentially useful angle.