Making sense of stakeholder responses to impending major policy reform in the private healthcare sector
Year: 2016
Type: dissertation
Abstract: Implementing policy change is notoriously difficult, often marred by chronic delays or \noutright failure to achieve its originally desired mandate. This challenge drew the \nattention of many scholars who, over the years, published many studies attempting to \ndescribe and analyse what the policy change process looks like and most notably, \nstrategies on how to better manage it. However, most of these studies tacitly \ncommitted themselves to strategic issues of managing change from a policy-maker s \nperspective, with very little consideration of what the change process actually looks and \nfeels like from the perspective of the change recipients. Yet, it goes without saying that \nresponses of these change recipients directly affect the outcomes of the change \nprocess. \nThis study sought to address this gap in literature by exploring South Africa s prevailing \nNational Healthcare Insurance (NHI) policy reform. Using a qualitative design and \ntheoretical insights from political sciences, social sciences and organisational studies, \nthe study analysed how the relevant stakeholders in the private healthcare industry \nwere variously thinking about and responding to the proposed reforms. \nThe findings of the study emphasised the critical role of temporally sequenced \nhistorical events in shaping an industry and influencing its change orientation. The \nstudy also weighed in on scholarly debates that challenged general characterisation of \nany recipients contradictory opinions as resistance to change . In this study, the \nstakeholders seemingly antagonistic attitudes and responses to the NHI policy were \nnot necessarily a contestation against change in itself. Instead, the conflict was over \ncompatibility with the policy s implicit secondary goals. This contestation evoked \nopinions and responses so strong that it overshadowed the stakeholders initial felt \nneed for change. From this perspective, this research argued for a distinction to be \ndrawn between diagnostic congruence and goal congruence. It further proposed that \npaying diligent attention to formulating an accurate diagnosis of the problems to be \naddressed through policy change could attenuate haggling and achieve far better \nresults than finding the best way to attain an agreed upon goal across all relevant \nstakeholders.
Author: Adolf Tapelo Makgatho
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2417878197