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Zooming In On Public Health Institutions

Published on : 04 May 2015
Author(s):Rini Agrawal

Corporate Governance In The UAE

“When it comes to health, your zip code matters more than your genetic code.

&Dr. Tony Iton 

when one thinks of a hospital, the image that pops up in one’s head is that of doctors, emergency rooms, operating theatres and ambulances. What we fail to recognize is that for all of these elements to come together and provide effective medical treatment, it is imperative that the hospital is properly managed. A hospital is not just a medical institution but also a business and it will or should have a corporate structure in place. Hospitals and health systems across the world are constantly struggling with issues of governance, especially in the aspects of standardization and quality improvement. It has been difficult to establish clear channels of communication and clear lines of accountability for the innumerable committees, departments and business functions in a healthcare environment. This can certainly result in poor standards of care towards patients. What is compulsory for the efficient governance of hospitals? It is necessary for there to be an effective use of funds, professional and competent management and streamlined governing and reporting structures. By establishing and maintaining the public’s trust, being good stewards of the community’s resources, and ensuring high quality care Hospital Administrators can be an important asset on the governing board in fulfilling those duties.

Administrators add the perspective of the patient care process as well as a unique understanding of family issues; they grapple with overall health care concerns such as staff shortages, patient safety and quality of care; and they are the most knowledgeable about diseases and new treatment modalities, as well as
being aware of the ethical dilemmas posed by new technologies. His Excellency Sultan Bin Saeed Al Mansoori, the UAE Minister of Economy, has called for institutions to embrace corporate governance as “an institutional capacity, rather than a regulatory requirement”.

Let’s take a look at a few example of countries where such principles have been embraced in the systems of governance in medical institutions. The Healthcare Governance & Transparency Association (HeGTA) is an Egyptian non-governmental, non-profit organization founded in 2012 with the vision of promoting governance and transparency in the healthcare sector, in order to enable healthcare reform and to create investment opportunities. HeGTA aims to contribute to a healthcare system which is based on accountability, equality, fairness, efficiency and quality by the creation, pooling and dissemination of knowledge. Similarly in the United States, the U.S. Agency for International Development (USAID) is an independent federal government agency that receives overall foreign policy guidance from the Secretary of State. Its work supports long-term and equitable economic growth and advances U.S. foreign policy objectives by supporting agriculture and trade, global health, democracy, conflict prevention and humanitarian assistance.

Governance is important work, and how well it is done has significant consequences for health care organizations, the communities they serve, their patients, medical staff and employees. A technology is a set of principles for solving problems and seizing

Court Uncourt Vol II Issue II9opportunities. A key element of the public sector is that services are provided for the public good, suggesting that the public sector may have a higher sense of purpose in what it does than the private sector. Another difference lies in the fact that people who use public services may not be ‘willing customers’ – as may be the case with health care. Hospital governance is based on the two pillars of accountability and transparency. As the provision of health care is a ‘social good’ each group of stakeholders merit recognition. Resources are one of the most pressing issues in hospitals. Issues such as value for money, the reorganization of the health service and patient satisfaction has served to drive the governance process forward. International organizations like Joint Commission International, which is a US-based body, are now in place to award accreditation to institutions based on their compliance with various international standards. However these not only assess elements such as patient care and medical standards, but also consider systems of corporate governance and management.. Therefore such schemes would appear to have put governance on the agenda of the health service and hospitals in particular across the world.

Currently the prevailing conditions in so many hospitals in the UAE are the subject of discussion in terms of the management and facilities being provided. This may well be as a result of the fact that there is as such no regulatory framework available for the governance of public health institutions. However health institutions are supervised by the health authorities and there are provisions for internal committees, such as committees for ethics and compliance, wherein an employee can lodge his complaints against the management or report any mishaps in the system as a whistleblower. Moreover in a region with a low percentage of listed companies and a high percentage of family businesses, a lack of regulation cannot be seen as an excuse not to adopt a formal corporate governance framework.

In order to reach this level of integrity and reform, some structural solutions need to be taken into consideration. Research and interviews reassured the idea that the most promising way to solve current grievances is the implementation of governance. If leveraged upon, the efforts for a promising solution to do this have the potential to create unparalleled success in hospitals. It also bridges the gap between the social and humanitarian mission of the hospital on one side, and its organizational nature on the other.

According to the Millennium Development Goals access to basic health care is central to the poverty reduction worldwide. Hospitals constitute a very significant part of the overall health care sector and they provide essential services to the public.