sahr2001 - Health Systems Trust

These themes are presented in four sections. Firstly, in a section entitled ‘The
People’, we provide a profile of the managers interviewed, most of whom
had joined the health system in the post 1994 period. Their visions and
motivations on joining the new government are outlined and how these have
evolved over time. The second section, entitled ‘The Departmental
Environment’ speaks to the organisational factors influencing how managers
experience their work, and outlines what managers say about the various
people with whom they work: their colleagues, those immediately above and
below them in the hierarchy, the administrative staff and departmental
leadership. Organisational culture and factors linked to it are then reflected
upon in some detail. The third section addresses themes that have their origin
outside of individual departments in the broader public sector context and
looks at issues such as the interface between the political and the executive,
civil service rules and procedures, and access to resources. Fourthly, societal
factors, in particular gender and race, and how these play themselves out at
departmental level, are briefly addressed. The chapter ends with a concluding
section summarising the main features of the experiences of managers, and
draws some broad policy conclusions from these.
The People
The profile of interviewees, provided in Table 1 below, suggests that a wide
cross-section of people (age, gender, race, professional background) are
accessing mid-level managerial positions in the health system.
246