WHO RUNS THIS PLACE? AN ANALYSIS OF THE LEADERSHIP OF PUBLIC HOSPITALS IN SOUTH AFRICA

摘要

The South African press frequently publishes articles which highlight the weakness and insufficiency of healthcare delivery. Anecdotal evidence suggests that poor leadership is partly to blame for poor service delivery. This study was designed to evaluate leadership in Healthcare. To do so, we formulated a best practice effective leader and measured South African hospital leadership against this prototype. This study derived a competence framework from available literature identifying the desirable characteristics of hospital leadership. This included academic qualifications, personal characteristics and functional competencies. A pilot study was conducted which evaluated the academic qualifications of management against hospital performance as measured by the South African Department of Health. Hospitals were categorised as either poor (or not-improving) and good (or improving). Making use of a limited national audit and press coverage, deductions were made about the performance of hospitals in relationship to the profile of the Chief Executive Officer (CEO) of the institution. We found that the global best practice models are roughly followed in South Africa, however at relatively lower qualification levels. We found that all the best run hospitals in South Africa are clinician led, but equally, so are all the worst hospitals. This paper presents a useful insight into the sort of leadership in South African hospitals, chiefly summarising existing qualifications and experience. This paper questions the current recruitment policy for hospitals which preferentially hires clinicians and asks questions about management qualifications which remain inadequately explored.