Developing Health Managers for effective health care delivery

Health systems are facing challenges from the impact of changing demographics, high cost technology, global economic uncertainty, workplace globalisation and shortages, consumer expectations and pandemics (Sax 1984; Decter 2000; Duckett 2000; Palmer & Short 2000; Walsh 2002). The World Health Report (WHO) (2000:231) suggested that the evolution of healthcare has been affected by political and economic changes with transformation from centrally planned economies to market economies with reduced state intervention, less government controls, and greater decentralisation. The calls for reform across healthcare systems have also challenged hospitals and health services to restructure and adopt more commercial business practices. These strategies are adopted and regularly called upon to achieve significant efficiencies (Rathwell & Persuad 2002) but the success of these approaches has been questioned (McConnell 2000; Ferlie & Shortell 2001; Rathwell & Persuad 2002). Restructuring across national health systems is the universal response to these forces and is both continuous and pervasive (Braithwaite 2005; Braithwaite, Westbrook & Iedema 2005).