The context of decentralised financial management in South African hospitals

I have just uploaded a scanned copy of another chapter from the 1996 Hospital Strategy Project’s analysis of decentralised financial management issues.

This chapter examines the regulatory and policy environment that governed options for decentralised financial management in South African hospitals in the 1990s.  Some of these factors remain pertinent today although other aspects may be somewhat out of date.

Look on one of my ealier posts, entitled Decentralised Financial Management of Hospitals, for the uploaded file.

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Factors inhibiting effective financial management in South African hospitals

I have just uploaded a scanned copy of another chapter from the 1996 Hospital Strategy Project’s analysis of decentralised financial management issues.

This chapter examines factors that inhibited effective financial management in South African hospitals in the 1990s.  Some of these factors remain pertinent today although other aspects may be somewhat out of date.

Look on one of my ealier posts, entitled Decentralised Financial Management of Hospitals, for the uploaded files.

Financial management in the ideal hospital

I have just uploaded a scanned copy of another chapter from the 1996 Hospital Strategy Project’s analysis of decentralised financial management issues.

This chapter characterises financial management in an ideal hospital.

Look on one of my ealier posts, entitled Decentralised Financial Management of Hospitals, for the uploaded files.

Financial management problems in hospitals

I have just uploaded scanned copies of another two chapters from the 1996 Hospital Strategy Project’s analysis of decentralised financial management issues.

These relate to the financial management problems experienced by South African hospials in the mid-1990s.

Look on one of my ealier posts, entitled Decentralised Financial Management of Hospitals, for the uploaded files.

Decentralised financial management of hospitals

This post contains a scanned version of Section 7 of Module 2 of South Africa’s 1996 Hospital Strategy Project.  Section 7 discusses decentralised financial management of hospitals and is a substantial report in its own right.  Hitherto this part of Module 2 has not been available electronically.  The other sections of Module 2 are available here.

If you use any of this material, please reference as follows:

Deloitte and Touche.  1996.  Section 7.  Decentralised financial management in hospitals.  In:  Monitor Company, Health Partners International, Centre for Health Policy and National Labour and Economic Development Institute. 1996. Module 2: Strengthening Hospital Management. In: Achieving equity, efficiency and accountability: a vision and strategy for South Africa’s public hospitals. Final report of the Hospital Strategy Project. Johannesburg: Monitor Company.

 

Contents of Section 7

Foreword, Contents, Glossary  Fin Mx_Cover pages and contents

Executive Summary  Fin Mx_Exec Summ

Chapter 1:  Introduction and background to financial management  Fin Mx_Intro

Chapter 2:  The present situation  Fin Mx_Present situation

Chapter 3:  The ideal hospital  Fin Mx_Ideal hospital

Chapter 4:  Factors inhibiting the reform of hospital financial management  Fin Mx_Inhibiting factors

Chapter 5:  The context of decentralised financial management in South Africa  Fin Mx_Context

Chapter 6:  The way forward – creating effective decentralised financial management  Fin Mx_The way forward

Chapter 7:  Conclusions  Fin Mx_Conclusion

Annexure A:  Methodology  Fin Mx_Annexure A

Annexure  B:  Framework for normative measures for financial management in the public sector  Fin Mx_Annexure B Fin Mx_Annexure B contd.

Annexure C:  Bibliography  Fin Mx_Annexure C

Annexure D:  The Bradshaw and Johnston conceptual model of information for financial management  Fin Mx_Annexure D  

Annexure E:  The foreign experience  Fin Mx_Annexure E

Annexure F:  Tabular presentation of recommendations for pilot sites  Fin Mx_Annexure F  Fin Mx_Annexure F missing page  

Annexure G:  The dispensation of financial managers  (I have not uploaded this annexure because it was written in 1996 and the regulations are certainly out of date) 

Annexure H:  Exemption from restrictive provisions of the provincial Exchequer Acts, Treasury instructions and financial regulations – enabling legislation  (I have not uploaded this annexure because it was written in 1996 and the regulations are certainly out of date) 

Annexure I:  Delegations of Functions Bill – Gauteng Province  (I have not uploaded this annexure because it was written in 1996 and the regulations are certainly out of date) 

Annexure J:  Lists of issues raised by provinces when discussing the draft report  Fin Mx_Annexure J

Labour policy and management in hospitals in South Africa

Please note that I have just uploaded Module 4 of the Hospital Strategy Project.  This module deals with labour relations policy and management in hospitals in South Africa.

There have been many changes in labour policy and management since this module was written in 1996 so some of the information and recommendations will be out of date.

The Hospital Strategy Project: Module 4

In 1996 the Hospital Strategy Project produced a lengthy and detailed report based on year-long national consultations with government officials and other experts in South Africa.  The report, which was commissioned by South Africa’s National Department of Health and funded by the European Union, set out ‘A Vision and Strategy for South Africa’s Public Hospitals.’ 

Fifteen years later, many of the Hospital Strategy Project’s recommendations remain pertinent, although some need to be updated in light of current circumstances.

Although the report is technically in the public domain, it is very difficult to access hard copies, let alone electronic versions.  Over the coming weeks I will try to upload as many of the component parts of the report as I can access.  Today I have uploaded Module 4 which deals with labour relations policy and management in hospitals (see links below):  there has been considerable progress on this topic since the publication of the Hospital Strategy Project report so some of this module is likely to be considerably out of date.  Unfortunately some of the components are missing as the original electronic files have been damaged.

If you use any information from these reports, please acknowledge the source: 

Monitor Company, Health Partners International, Centre for Health Policy and National Labour and Economic Development Institute.  1996.  Module 4:  Labour Relations Policy and Management.  In:  Achieving equity, efficiency and accountability: a vision and strategy for South Africa’s public hospitals. Final report of the Hospital Strategy Project.  Johannesburg:  Monitor Company.

Contents of volume on Module 4:  Labour Relations Policy and Management

– Labour Relations Policy and Management:  Final Report  Mod4LabourRelationsReport 

– Outline of key problems and module hypotheses  HYPOTHES

– Situation analysis

– Presentation to workshop on contracting out of hospital services

– National workshop on the decentralisation of hospital management

– Developments in public sector bargaining:  presentation to the Hospital Coordinating Committee

– The changing nature of public service and labour relations:  a presentation for public hospital managers and workers’ representatives

– Important memoranda to the Director-General