Hard for the local authorities to form a whole of healthcare efforts

In the past years, the local authorities in Denmark have taken over the responsibility of a number of healthcare tasks, which has meant entirely new challenges in terms of organisation and management. According to a new study carried out by Local Government Denmark (LGDK), the biggest challenge in organising and managing the healthcare tasks in the local authorities is to form a whole of the efforts.

- It is very interesting, but also expectable that the managers point towards forming a whole of the efforts as the biggest challenge. When organisations become so big as they have after the structural reform, and when the number of tasks increase and become more complex, then it is a managerial challenge to ensure coordination and coherence, says Søren Thorup, department manager in LGDK and chairman of Væksthus for Ledelse (management growth house). The study also shows that just under three fourths of the respondents think that the cross-organisational collaboration between for instance the administrations work satisfactorily. It seems to indicate that even if forming a whole is the biggest challenge, it is still worked on. And a lot of things actually succeed.

And even if the challenge of forming a whole is seen as the biggest, the study also shows that only a few respondents feel that their performance is measured by their ability to form a whole of the healthcare efforts.

- While there has been an increase in both measurement and documentation in the public sector in the past years, we right now face the paradox that the problem, which local authority managers themselves think is the biggest, is not an independent point of measurement, like finances, for instance, says Associate Professor Morten Knudsen, Programme Director for the Master of Health Management at CBS.

- The growth in measurement and documentation in the local authorities raises the question whether the local authorities are able to ensure the focus on the issues on which they are not measured, for instance coherence of the healthcare efforts, says Morten Knudsen.

Furthermore, the study shows that the managers attach great importance to general management competences.

- We are pleased that the managers feel that general management competences such as clear communication or the ability to find common ground are more important than being the most academically skilled. The interaction between general management and operational management is very debated in the local authorities and LGDK. It is a discussion, which changes character in light of the increase in complexity and tasks, says Søren Thorup.

It is also worth mentioning that the major part of the respondents think that the demands for their unit harmonise with their ability to live up to them.

For further comments, please contact

Morten Knudsen, Associate Professor from the Department of Organization and Programme Director at the Master of Health Management at CBS, tel. +45 38 15 28 98, e-mail mk.ioa@cbs.dk

Søren Thorup, Department Manager in Local Government Denmark and chairman of Væksthus for Ledelse (growth house for management), tel. +45 33 70 37 68, e-mail sto@kl.dk