Management, collaboration and new public governance: A case study of a public hospital in Thailand

Abstract

This study is a typical case study research which explores some factors underpinning multi-level governance in the Thai public health system and examines some variables comprising New Public Governance of public hospital administration. Various qualitative data were investigated, mainly from overseeing officials, former and present executives, and current personnel in Ban-phaeo Hospital (Public Organization) (BHPO), the country’s only private-style managed public general hospital. Using the methods of chronologies, explanation building and pattern matching, empirical analyses were conducted. It found that governance in Thai public health-care service delivery had never been totally separated from outside power. This research identifies and elaborates the co-existing governances based on market efficiency and based on stakeholder collaboration in Thai public health administration. Moreover, the unique context of various stakeholders actively participating in managing BHPO empirically supports the proposition that public value management can be applicable and pragmatic for public administration. Therefore, a public general hospital can deliver health services efficiently with sufficient resources and effectively for medical performance when stakeholders are empowered to collaborate in the administration. The results plus the theoretical and practical implications are discussed, and public value management as a paradigm is verified with some refinements. Three activities at organizational level and three social arrangements at policy level are suggested for future practices. Finally, a reform of the Thai public health system governing the administration of public health-care services is urged, with a re-configuration of power arrangements for enhancing stakeholder collaboration.