Implementation challenges of the performance management policy at the Joe Gqabi District Municipality public hospitals

摘要

Public administration seems to have shifted towards the New Public Management doctrines that emphasize performance management. The healthcare reforms have been a global phenomenon ever since the early 1980s, with the major focus on managerial restructuring, to produce a more responsive and efficient system (Liang and Howard , 2007:393). The South African public sector has gradually introduced a comprehensive performance management system, since the early 80s. In response, the Province of the Eastern Cape began the design and the development of a performance-management policy in early 2000. This policy was later refined and aligned to the National Department of Public Service and Administrations’s performance management policy. The policy was intially implemented in the Province of the Eastern Cape in mid-2003, through a Performance Management and Development System (PMDS). Moderating Committees were established at each level of government, and at the institutional level. The mandate of these Moderating Committees was to ensure the proper implementation of the perfomance-management policy.The purpose of the policy is to provide practical guidelines on the improvement of individual and organisational performance; however, the implementation challenges of this policy have been identified in Joe Gqabi Health District. This study evaluates the implementation challenges of performance-management policy at all the Joe Gqabi District Municipality public hospitals.The main objectives of the research study are, therefore, to : To provide exposition of the provision of the Province of the Eastern Cape performance management policy and regulatory guidelines; To analyse the utilization of performance-management information for determining remunerations, rewarding outstanding performance and for the development of the personnel; To provide a set of recommendations for the policy implementation to improve service delivery in the Joe Gqabi Health District.Both qualitative and quantitave methods were utilised to collect the data for the study. The research questionnaire was distributed to the eleven public hospitals in the Joe Gqabi Health District. The response rate was 52percent and this was considered adequate for scientific analysis and reporting. The research study reached the conclusion that there is generally poor adherence to policy guidelines in the district, in that: Although most hospitals have structured PMDS committees, their meetings are inconsistent, and are generally held only once a year during final assessment. Performance contracts are signed very late, towards the end of the first quarter. Performance-related bonuses are also effected very late, and are considered a demotivating factor by most participants. The support provided by the provincial and district offices for the implementation of the performance-management policy was viewed as being quite inadequate by most of the participants. The majority of the respondents recommended that the policy be replaced by another form of performance management; however, some considered it adequate, but the implementation of the policy requires further attention.The study therefore came to the following recommendations: The Province and the District should provide consistent support to district hospitals for the implementation of the performance-management policy. The provincial offices should authorize performance-related payments timeously, and the district should effect these payments promptly. The co-ordination of the skills-development programme should be decentralized, in order for district hospitals to improve their efficiency and effectiveness in co-ordination. The Accounting Officers of the respective institutions should monitor the implementation of these policy guidelines to ensure compliance.The research findings conclude that provided the above recommendations are implemented, this would improve the implementation of the provincial performance-management policy, and service delivery in public hospitals in the Joe Gqabi District Municipality.