SHAPE Declaration on the Organisation and Management of Health Services: a call for informed debate

Purpose: This article presents a Declaration by the Society for Health Administration in Education Programs (SHAPE), to promote public debate on the reform of the organisation and management of health services. Methodology/Approach: The Declaration was developed from the SHAPE 2008 Symposium and was primarily based on a research study conducted by the author. The draft Declaration was circulated to SHAPE members who participated in the Symposium and other interested senior health managers and feedback was encouraged. Contributions received were incorporated into the final Declaration. The research study involved semi-structured interviews of a diverse purposive sample of 19 health service managers across Australia and New Zealand, conducted from 2004 to 2008. The literature review and the implications for policy and practice from the findings of that study were utilised in the preparation of the Declaration. Main Findings: The success of reform internationally, mostly through restructure and the adoption of management techniques, has been questioned in terms of effectiveness, cost and negative impacts on health systems. In Australia there have been constant calls for reform, a number of formal Inquiries into health services and the creation of a National Health and Hospitals Reform Commission (NHHRC). Conclusion: This Declaration proposes a public debate about how health services might best be organised and effectively managed and proposed principles and parameters for reform. Well-qualified and experienced health managers are considered to be of central importance to the effective organisation and management of health services and to the success of future health reform.