Major Stakeholders In Health Care System
Introduction
The health care system is intended to provide services and resources for better health. This
system includes hospitals, clinics, health centers, nursing homes and special health programme in
school, industry and community. Health system operates in the context of socioeconomic and
political framework of the country.
Stakeholder :- Stakeholder is a person, group, organization or system who affects and can
be affected by an organizational action
Types of Stakeholders
1. External Stakeholders
2. Interface Stakeholders
3. Internal Stakeholders
External stake holders : A health care organization must respond to large number of
external stakeholders. They fall into three categories in their relationships to the
organization.
Those that provide inputs to organization.
Those that compete with it.
Those that have particular special interest.
The first category includes suppliers, patients and Financial community.The relationship
between the organization and the stakeholders that provide necessary input is one of
mutual dependence. As such the both parties cannot, or do not want to, do without one
another. stakeholders depend on the organization to take their outputs. The relationship
between the organization and these external stakeholders is a symbiotic (interdependent
relationship) one, as organization depends on them for its survival.
Special interest group are the government regulatory agencies, private accrediting
associations, professional associations, labor union, the media and political group.
Because of special interest conflicts most often occurs.
The competitor stakeholder may be direct competitor for patient (e.g. other hospital) or
they may be competing for skilled personnel. competitor dose not need one another to
survive. The organization must provide sufficient inducements to continue to make
appropriate contribution. The organization may offer professional autonomy institutional
prestige or political contacts, special services and benefits etc.
Interface Stakeholders
Some stakeholders function on the interface between the organization and its
environment. The major categories of interface stakeholders include the medical staff, the
hospital board of trustees.
Internal Stakeholders
The stakeholder determine whether the inducement are sufficient for the contribution that
they required on the basis of alternative contribution offer received from competitive.
Management attempts to provide internal stakeholders with sufficient inducements to
gain continual contribution from them. Almost entirely within the organization and
typically include management, professional and non professional staff.
Stakeholders in Health Care System
1. Government : The role of government in the administration of health care can
not be overestimated. Many federal government health care efforts are headed
by a cabinet- level officer, the secretary for health and human services, who
runs the department of health and human services. The federal government
makes budget and other planning related to expenditure in health care. As the
major payer, the federal government has been active in regulating the health
care industry.
2. Public : In addition, the public has a more positive view of health promotion
and illness prevention than in past.. Health care resources remain focused on
illness, however, with only 1% of health care expenditures going to public
health. The public has a stake in health care from several perspectives. As
consumers of health care services or as patients, the public is concerned with
quality, cost and access to care. Many people believe that health care is a right
and should be universally available to all citizens, regardless of the cost.
Providers
1. Community Health Care Professional : Professional Includes nurses, health workers,
dais, doctors of the community health centers, voluntary health workers etc
2. Hospital Health Care professional
* Physicians The role of physicians in the health care system is an important one.
Physicians provide direct medical services to clients in variety of settings, including
offices, clinics, hospitals and freestanding centers. In addition, physician control 60% to
70% of hospital costs through their decisions regarding the use of resources. Physicians
decide which client to admit, where to admit, the length of stay, the ancillary services,
whether to perform surgery, when to initiate and to discontinue treatment regimens, and
which medications to prescribe.
*Nurses An individual who provides care to clients. The extent of participation varies
from simple patient care tasks to the most expert professional technique necessary in
acute life threatening situations. The ability of nurse to function independently and
making self directed judgment will depends on his or her professional development.
Nurses provide a unique perspective on the health care system. The greatest impact and
the most frequently discussed aspect of nursing has been the recurring shortage of nurses
* Pharmacists The roles of the pharmacist are changing. Some can now prescribe as well
as dispense medicine. They are more interested in meeting the requirements of
pharmaceutical industry.
*Hospital Administrators And Governing Boards :Tthe chief executive, chief financial
officer, chief nursing officer, and governing boards of hospitals strongly influence health
care delivery in their institutions
*Non- Governmental Stakeholders: The voluntary agencies occupy an important place in
community health care system. These organizations directly or indirectly act as
stakeholder. These organizations are administered by autonomous boards which hold
meetings, collect funds from private sources and spend money for providing health
services and health education to individual, family and community .
. There are many NGO’S in India these are as follows
1. Indian Red Cross Society : It was established in 1920 and has over 400 branches all over
India. It has been executing programmes for the prevention of diseases and promotion of
health. Its activities are:
Blood bank and first aid.
Family planning.
Maternal and child welfare services.
Armed forces.
Milk and medical supplies.
2. Hindu Kusht Nivaran Sangh :It was founded in 1950 with its headquarters in New Delhi. Its
precursor was the Indian council of British Empire Leprosy Relief Association (B.E.L.R.A)
which was renamed as LEPRA in 1950. The programme of work of the sangh include
rendering of financial assistance to various leprosy homes and clinics, health education,
training of medical worker and physiotherapists conducting research and field investigation.
The Sangh has branches all over India and work in close cooperation with the Government
and other voluntary agencies.
3. Indian Council For Child Welfare : It was establish in 1952. It is affiliated with international
union for child welfare. The services of I.C.C.W are devoted to secure for Indian children
those opportunities and facilities, by law and other mean which are necessary to enable them
to develop physically, mentally, morally, spiritually and socially in a healthy and normal
manner and in conditions of freedom and dignity.
4. Tuberculosis Association of India : It was formed in 1939. It has branches in all states of
India. The activities of this association comprise organizing T.B campaign every year to raise
funds, training of doctors, health visitors and social workers in anti tuberculosis work,
promotion of health education conferences.
5. The Bharat Sevak Samaj which is non-political and nonofficial organization was formed in
1952.0ne of the prime objective of the Bharat sevak is to help people to achieve health by
their own actions and efforts. The B.S.S. has branches in all the states and nearly all the
districts. Improvement of sanitation is one of the important activities of the B.S.S
6. The Kastubra Memorial Fund : Created in commemoration of Kastubra Gandhi, after her
death in 1944, the fund was raised with the main objective of improving the status of women,
especially in the villages, through gram-savikas. The trust has nearly one crore of rupees and
is actively engaged in various welfare projects in the country.
7. All India Women’s Conference It is the only women's welfare organization in the country.
Established in 1926, it has now branches all over the country. Most of branches running
M.C.H. clinics, Medical centers, and adult education centers, milk centers and family
planning clinics
8. The All India Blind Relief Society : It was established in 1946 with a view to coordinate
different institutions working for the blind. It organizes eye relief camps and other measures
for the relief of the blind
9. Professional bodies :The Indian Medical Association, All India Dental Association, The
Trained Nurses Association Of India of all men and women who are qualified in their
respective specialties and possess register able qualifications. These professional bodies
conduct annual conferences, publish journals, arrange exhibitions, foster research, set up
standards of professional education and organize relief camps during periods of natural
calamities
Management Of Stakeholders Relationship(fig)
Diagnose Of Stakeholder Relationship
1. Stakeholder potential for threat.
2. Stakeholder potential for co-operation.
Stakeholder’s Potential For Threat A health care organization's manager needs to
anticipate and evaluate systematically the actual or potential threats in its relationship with
stakeholder. These threats may focus on obtaining inducements from the organization that may
or may not be provided. The desired inducement may include financial resource, participation in
decision making.
Stakeholder’s Potential For Cooperation The stakeholder's dependence on the
organization and its relevance for any particular issue facing the organization determine the
stakeholder's co-operative potential. Generally the more dependent the stakeholder on the
organization, the higher the potential for co-operation.
Types of Stakeholder Relationship
1. Mixed blessing stakeholder relationship.
With the mixed blessing stakeholder relationship's the health care executive faces a
situation in which the stakeholder rank high on both type of potential: threat and co-operation.
Physicians-hospital relationships probably are the clear example of this type of relationship
2. Supportive stakeholder relationship
The ideal stakeholder relationship is one that supports the organization's goals and
actions. Managers wish all their relationships were of this type, such a stakeholder is low on
potential threat but high on potential co-operation for e.g. the relationships of well managed
hospital with its board of trustees, its manager, its staff employees, local community and nursing
homes
3. Non supportive stakeholder relationship.
The most distressing stakeholder relationship for an organization and its manager's are
non supportive ones. They are high on potential for threat but low on potential for co-operation.
Typical non supportive relationships for hospitals include competing hospitals, employee unions,
the federal government, other govt. regulatory agencies the news media.
4. Marginal stakeholder relationship
. The marginal stakeholder relationships are high on neither threatening nor co-operative
potential. This type of relationships include professional associations for employees, volunteer
groups in community etc, for a well run hospital.
Stakeholder’s Potential To Reduce Stakeholder Threat
Monitor efficiently in the marginal relationship
Defend proactively in the non supportive relationship
Involve trustingly in the supportive relationship
Collaborate cautiously in the mixed blessing relationship
Strategy Implementation And Outcome
The fifth step of management of stakeholder relationship is implementation of planned
and articulated strategies. With conscious, consistent relationship and implementation of
strategies, a quite fully organized health care system can be developed. The outside of the
strategy implementation also has to be evaluated.
