Organisational governance structures in allied health services:A decade of change

Abstract

A ten year review of developments in the organisation and management of allied health services in Australian acute care public hospitals reveals a steady transformation away from a medically managed universal model towards more complex and contested models of governance. This article revisits early observations about the reorganisation of allied health services and presents more recent research findings to guide managerial decision-making about restructuring the diverse disciplines that constitute allied health. A new organisational model "integrated decentralization" is presented as an approach to managing allied health services which accommodates multiple stakeholder demands in the context of New Public Management (NPM) related reforms. The focus on the institutional level is complemented by examining developments in the profile and activity of allied health at the regional, state and national levels to present a more comprehensive picture of change over the decade of the 1990s.

In search of wellness: allied health professionals' understandings of wellness in childhood disability services

“…Despite disciplinary differences, however, practitioners tend to cite factors such as the increasing value of community-based service delivery, the reduction of therapist control and a corresponding increase in client control, and sociopolitical determinants of health, for the adoption of wellness and its components [20][21][22]. As a result, allied health professionals are left to reconcile the tension created from the increasing consumer demand for wellness approaches [23] with the health and disability sectors. For instance, a recent Australian study searched for indicators of wellness and demonstrated that the rhetoric of wellness is drawn upon heavily within the policy and procedure documents of major childhood disability services providing allied health services within Australia [24].…”

The privatisation of Medicare and the National Health Service, and the global marketisation of healthcare systems

“…Sociologists have also focused on the well-being of health workers when their work environments are privatised or corporatised (e.g., Duff and Larsen 2003;Mahony 2005), and there has been a documenting of the deteriorating physical health of the broader population as a consequence of the privatisation of essential services, including water (e.g., Whelan and White 2005). There has also been a small amount of work on the effects of privatisation on health and medical workers, particularly with regard to the issue of professional autonomy and the potential for marketisation to undermine medical dominance (e.g., Benoit et al 2010;Boyce 2001;Lewis et al 2003;Lewis and Marjoribanks 2003).…”

Deutero‐learning: implications for managing public health change

“…In contrast to the organisational structure in this first case, the second case operated within a divisional structure characterized by integrated decentralisation (Boyce, 2001). This structure builds on the benefits of a division of allied health model and the programme management-based unit dispersement approach.…”