Title:
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Managers' and consultants' perceptions of changes resulting from the Health Service Reform Programme (2003) and its impact on the performance of an acute hospital
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This dissertation focuses on the impact of the restructuring of the Irish
health system on the performance ofa· hospital. The general context of
the research relates to the modernisation of public services, in
particular health services, and the impact of resulting changes on
managers and consultants. The theoretic perspectives inform the nature
of the modern welfare state in the p.rovision of public services, health
policy. formulatiQn and implementation; organisational design and
organisational change; and the tensions that exist between managerial
and professional staff. The methodology used generated multiple data
streams - quantitative data on corporate and hospital performance pre
and post restructuring and qualitative data provided a narrative on the
impact of restructuring on the hospital, as perceived by consultants and
managers.
The findings show that the change expected by staff did not materialise
and that the performance of the hospital, in terms of output, cannot be
said to have been influenced by general organisational changes.
However, bureaucratic changes imposed by the· new corporate
management did cause irritation at hospital level and a loss of overall
corporate reputation.
The research also demonstrate~ that organisation type needs. to be
factored into the design· of. national. reform· and transformational
programmes if they are to be successfully implemented i.e. if the desired
behaviour changes at hospital level are to be achieved and the services
delivered by the hospital are to be improved.
Some recommendations for future research are made.
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