New Public Management ( Npm )

The management of an organization plays an integral part in determining the direction and performance of the organization. The manner in which the management of an organization is handled has a profound effect on the organization. The success of an organization is dependent upon a flexible and skilled management and workforce. The management of an organization is responsible for shaping up the organizational behavior and ultimately the culture within the organization. Public management faces a multiple of challenges and opportunities, how the management deals with these issues translates to efficiency in management. The personal judgments and skills of public managers can make a significant impact in public management. If

Hospitals have organizational structures that allows them to carry out their duties efficiently and successfully. What separates the organizational structure of a healthcare organization from a business, essentially that the hospital 's organization is chiefly founded on the amalgamation of medical and administrative staff (Carayon, et al., 2014). The organizational structure of the twenty-first century solutions in health care hospitals involves, both divisional and hierarchical structure. In the of the chain of command hierarchy, there are various levels of professional’s that fall under other levels within the facility, and each staff member is organized in regards to departments that are related to their (KSA’s) skills, attributes and job duties (Carayon, et al., 2014). Hospital organization philosophies is based on development of values and ethics, with the understanding on moral principles relating to human conduct. These systems are comprised with the processes in decision making and determining the best actions to consider between the difficult alternatives when pertaining to patient care.

Healthcare organizations do not contribute to the society’s welfare and impact the society positively therefore the relationship with the stakeholders is poor. With a poor relationship, this causes conflict between the patient and the doctor. Enough financial resources should be allocated to prevent quality of care issues and improve the quality of care to the patients. The moneys allocated can be used to purchase equipments that are beneficial to the care of the patients. There are many issues when it comes to the allocation of resources and should be cost effective to ensure the health benefits of those in the community that are being treated. If the allocations of the resources are not done correctly it can affect the community. Human resources should allocate financial resources to eliminate the shortage of doctors and nurses which has affected the performance and

Kernaghan, K. 2000. The Post-Bureaucratic Organization and Public Services Values. Interational Review of Administrative Sciences 66. 2000, pp. 92-93.

Healthcare system across different countries has been affected by NPM reforms. Decentralisation as one of the main reforms under the NPM umbrella has started in different countries from different positions (Pollitt and Bouckaert, 2011, p. 102). For example, central government in the UK has praised the virtues of decentralisation, but in the early 1980s the UK was relatively a centralised country. Administrative decentralisation has been the preferred form. Few new powers have been given to local governments in the UK. In this case decentralisation has transferred authority to a range of specialised administrative bodies. However, the UK did experience a very significant act of political decentralisation when the Blair administration created elected assemblies for Scotland and Wales. When Cameron became prime minister in 2010 he strongly promoted the idea of a ‘big society’ rather than a ‘big government’ (Pollitt and Bouckaert, 2011). The precise implication of this were far from clear, but the general direction seemed to be towards decentralising services and seeking to enlist both commercial companies and civil society association to take over, or at least share in, activities previously performed by public authorities(p.315).

The health care institution has traditionally been focused on the provision of high quality medical services. In more recent years however, while the institution preserved attention to the medical act, it also became more attentive to other business and administrative aspects. Some examples at this level include the more cautionary management and allocation of the resources, the recovery of the costs owed for the medical services provided or the ability to implement regulatory compliance.

Improving the quality of health care system is the main goal of this organization. In this case study we will be talking about the strategic plans being made by the organization for the next decade to deal with the problems of resource management, network growth, patient satisfaction as well as nurse staffing. The readiness of the organization towards catering the citizens' needs for health care will also be discussed in this case study (Goetsch and Davis, 2010).

Apart from having the public sector, we also have a well established private sector The private sector absorbs 32% of the total expenditure on health in the country. . In a year, the private sector has 27, 000 admissions for in-patient treatment, undertakes 13,000 surgical operations and delivers over 2,000 babies. Some people choose private hospitals instead of public hospitals due to better service quality and admission procedures. There are reliable doctors and nursing officers and their attitude are courteous and they are more hospitable and are ready to help.

Also, we expect our public service to do the best it can with the community resources available to it. Yet there is usually great mismanagement in the public sector, Yet nobody act to resolve this issue or call the minister to order because it will harm the government’s standing and may cost it votes. This portrays a consequence of a community supported reward system unavoidably biased against good public sector management.

The need for financial stringency in public organizations due to budgetary pressures and tax resistance coupled with the need to Managing /balancing budget deficits and provide quality services with a reduction in revenue has always been a major challenge for public organizations. The need to save money and at the same time provide quality services, had forced government agencies to privatize and contract out. Recently, there is greater involvement of the private and nonprofit sector in public service delivery. More and more government functions in service delivery are now carried out by private and nonprofit organization. This is one part attributed to the belief that private organizations can provide services more efficiently and effectively than government operated services. And the other is the fact that it is cost effective and takes a lesser time frame. These two process are indeed unarguably beneficial to the government and private sector as well as the beneficiaries, but they can be also very daunting accompanied with huge challenges especially when not executed in the rightful manner. The case of the crummy contractor by Rainey depicts such a complex situation , where the process of contracting out was poorly conducted. The case highlights the demand for privatization and contracting-out and most importantly some of the challenges of privatization and contracting in government organization. it goes on further to identify some crucial pointed to be

Before compare the two different models TPA and NPM, I will illustrate what is the

Modern society has developed formal institutions for patient care. The hospital a major institution offers considerable advantages to both patient and society. Number of health problems requires intensive medical treatment and personal care which normally can’t be available in patients home or in the clinic of a doctor. This is possible only where a large number or professionally and technically skilled people apply their knowledge & skill with the world class expertise advanced sophisticated equipment and appliances. The excellence of hospital services depend on how well the human and material resources are utilized to promote patient care.

In the following paragraphs, I will explain the dominant theory in public administration practice and elaborate on the major theoretical assumptions of the Old Public Administration. As stated in the question, the world has transformed through globalization, information technology, and devolution of authority since the latter part of the last century. The dominant theory in public administration has been replaced from the traditional rule-based, authority-driven processes of the Old Public Administration with market-based, competition-driven tactics in the New Public Management, beginning in the 1980s (Kettl, 2000, p. 3). This was an effort to privatize government and streamline public administration to maximize efficiency and productivity. Heavily relying on market mechanisms to guide public programs, public administrators in the New Public Management are encouraged to “steer, not row,” meaning they should not bear the burden of delivering services, but instead define programs that others will carry out, through contracting or other means (Denhardt & Denhardt, 2011, p. 13). Core values of the New Public Management include using private sector and business approaches to the public sector, squeezing as many services as possible from smaller revenues, market style incentives, providing customers more choices, and focusing on outputs and outcomes instead of mainly processes.

As aforementioned that performance measurement as one of main characteristic of NPM (Pollitt 2007b:150), the Table 1.1. depicts a more clear division of the separation of the undisputed and contested characteristics of NPM summarized by Gruening (2001) from scholars likewise Borins, 1994, 1995; Boston, Martin, Pallot and Walsh, 1996; Buschor, 1994; Gore, 1994; Hood, 1991; Naschold et.al., 1995; Reichard, 1992; and Stewart and Walsh, 1992.