Academic journal article Australian Health Review

Competencies Required by Senior Health Executives in New South Wales, 1990-1999

Academic journal article Australian Health Review

Competencies Required by Senior Health Executives in New South Wales, 1990-1999

Article excerpt

What is known about the topic? The literature confirms that health reform affects senior health care managers' acquisition and demonstration of new skills and knowledge to meet new job demands.

What does this paper add? This paper provides a detailed description of the competencies required for senior health care managers in New South Wales in the 1990s after the introduction of the area health management model, the senior executive service and performance agreements. It confirms that restructuring and reform in the health care sector will lead to changes of the tasks performed by health care managers and, consequently, changes in the competencies required.

What are the implications for practitioners? The competencies required by health care managers are affected by distinct management levels, diverse health care sectors and different contexts in which health care systems operate. The competencies identified for senior health executives in this study could guide educational programs for senior health managers in the future.

Health care reforms and restructuring have been a global phenomenon since the early 1980s to produce better, more responsive and efficient systems.1-3 Reforms have been seen as not only inevitable, but also necessary. Due to the different contexts in which the health care systems operate, the content and the process of the reforms may vary in different countries or different parts of a country.4 However, Altenstetter and Bjorkman5 recognised that there has been some borrowing from one system by another. After an extensive study of the literature, Liang et al.4 summed up health care reforms around the world in the following three main areas: changes of conceptual and legislation frameworks, changes of health care financing and changes of health care provision and management frameworks (p. 285).

In New South Wales, Australia, significant structural reform was introduced and implemented in the mid 1980s. Liang et al. provided a useful summary of the major changes witnessed in NSW since 1986, which included the introduction of the Area Health Management Model, the Senior Executive Service and performance agreements.6 Three major forces were behind the changes: the pattern of population redistribution, the inefficiency of a regionalised structure and public sector reforms. After critical analysis of the literature, Liang et al.4,6 suggested that health reforms have affected senior health care managers in a number of ways including high levels of burn-out and turnover, changes in managers' career paths and the introduction of new tasks, roles and competencies. They concluded that reforms have heralded a new era in management responsibility and accountability, which resulted in the change of competencies required for senior health care managers. No studies have been published examining the competencies required for senior health care managers in the NSW health public sector since the significant reforms implemented in the mid 1980s and 1990s.

Studies examining the competencies required by senior health care managers since the mid 1980s used two competency assessment methods. The first was to provide an extensive list of competencies (knowledge/skills/attitudes) from which senior health care managers selected their choices.7-15 The other was to ask senior health care managers to express their perceived competencies freely.16,17

A number of studies18-22 were conducted with the intention of examining and establishing a list of reliable competencies or a competency assessment approach. Although sharing some similarities, the lists of competencies in these studies are diverse, not only in the number of competencies developed or identified, but also in the content of each competency. In addition, the lists of competencies developed by recent studies have not been replicated by other studies. Individual studies have tended to develop and use a competency list of their own. Thismaybe due in part to the lack of well tested and recognised lists of competencies or competency assessment models and, in part, due to the different levels of management and context being addressed by the various studies. …

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