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Is there room for whistle-blowing in hospital mergers? The feedback dimension of the policy process

Bringselius, Louise LU (2012) International Research Society for Public Management (IRSPM), 2012 p.1-12
Abstract
Whistle-blowing can serve as a powerful mechanism helping policy-makers and other stakeholders recognize ethical misconduct and other types of wrongdoing in autonomous public agencies. This mechanism is of particular importance in major public sector reforms, such as agency mergers, when it may be difficult to secure continuity in the quality of organizational processes. Yet, we know little of what opportunities for whistle-blowing characterize these reforms, as the feedback dimension of the policy process has been relatively neglected. This paper explores what opportunities for whistle-blowing are provided to physicians in mergers of autonomous public hospitals. In the health care sector, the professional ethics of physicians may provide... (More)
Whistle-blowing can serve as a powerful mechanism helping policy-makers and other stakeholders recognize ethical misconduct and other types of wrongdoing in autonomous public agencies. This mechanism is of particular importance in major public sector reforms, such as agency mergers, when it may be difficult to secure continuity in the quality of organizational processes. Yet, we know little of what opportunities for whistle-blowing characterize these reforms, as the feedback dimension of the policy process has been relatively neglected. This paper explores what opportunities for whistle-blowing are provided to physicians in mergers of autonomous public hospitals. In the health care sector, the professional ethics of physicians may provide strong incentives for whistle-blowing, aiming to preserve patient interest. A survey was distributed to 663 physicians and 12 managers at a Swedish hospital, which two years earlier had undergone a merger. Today, this is one of the largest hospitals in Europe. The response rate was 54 per cent and 7 out of 12 managers. Results reveal that managers and physicians had the opposite perceptions of merger outcome – 80 per cent of physicians considered it a failure, whereas most (5 out of 6 responding) managers considered it successful. Among physicians, 64 per cent stated that employees could not express objections to the hospital management without risking sanctions, whereas most managers (5 out of 7) believed that they could. Finally, responses reveal that physicians (93 per cent) and managers (7 out of 7) agree that there is not a working dialogue between professionals and policy-makers. In this specific merger, opportunities for whistle-blowing were limited. Some possible explanations are outlined. The lack of transparency is a democratic problem, aggravated by the major stakes in hospital mergers. (Less)
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author
organization
publishing date
type
Contribution to conference
publication status
published
subject
keywords
mergers, public management, whistle-blowing, policy process, hospitals, health care management
pages
12 pages
conference name
International Research Society for Public Management (IRSPM), 2012
language
English
LU publication?
yes
id
d9aa0895-dfc0-4cd9-bfc4-86241e91dd8e (old id 2477966)
date added to LUP
2012-04-23 11:37:24
date last changed
2016-04-16 10:51:39
@misc{d9aa0895-dfc0-4cd9-bfc4-86241e91dd8e,
  abstract     = {Whistle-blowing can serve as a powerful mechanism helping policy-makers and other stakeholders recognize ethical misconduct and other types of wrongdoing in autonomous public agencies. This mechanism is of particular importance in major public sector reforms, such as agency mergers, when it may be difficult to secure continuity in the quality of organizational processes. Yet, we know little of what opportunities for whistle-blowing characterize these reforms, as the feedback dimension of the policy process has been relatively neglected. This paper explores what opportunities for whistle-blowing are provided to physicians in mergers of autonomous public hospitals. In the health care sector, the professional ethics of physicians may provide strong incentives for whistle-blowing, aiming to preserve patient interest. A survey was distributed to 663 physicians and 12 managers at a Swedish hospital, which two years earlier had undergone a merger. Today, this is one of the largest hospitals in Europe. The response rate was 54 per cent and 7 out of 12 managers. Results reveal that managers and physicians had the opposite perceptions of merger outcome – 80 per cent of physicians considered it a failure, whereas most (5 out of 6 responding) managers considered it successful. Among physicians, 64 per cent stated that employees could not express objections to the hospital management without risking sanctions, whereas most managers (5 out of 7) believed that they could. Finally, responses reveal that physicians (93 per cent) and managers (7 out of 7) agree that there is not a working dialogue between professionals and policy-makers. In this specific merger, opportunities for whistle-blowing were limited. Some possible explanations are outlined. The lack of transparency is a democratic problem, aggravated by the major stakes in hospital mergers.},
  author       = {Bringselius, Louise},
  keyword      = {mergers,public management,whistle-blowing,policy process,hospitals,health care management},
  language     = {eng},
  pages        = {1--12},
  title        = {Is there room for whistle-blowing in hospital mergers? The feedback dimension of the policy process},
  year         = {2012},
}