MANAGEMENT IN THE HEALTHCARE SECTOR
Introduction:
Niet letterlijk uit de cursus in cursief
1. Salleramics: describe the evolution of Sally’s company, and the steps in her
career.
Phase 1:
- Production vs coordination
- Part-Time, later Full-Time
- Production = doing; versus coordination
Phase 2:
- Division of labour: with or without specialization
- Generalist vs specialist
- The more specialization, the more need for coordination
- In some form: management, government, ...
Phase 3: structure
- 1 entity vs divisions
Phase 4: ownership
- Private vs public
Evolution:
- Early Stage:
Sally started making pottery alone in her garage, handling all tasks herself.
Sold pots locally; demand grew after a National Trust buyer placed large orders.
Hired Tim, a friend and pottery classmate, on a profit-sharing basis.
- Initial Growth:
Sally divided tasks: Tim prepared clay and glazes; Sally handled most other work.
The brand "Made by Sally" gained recognition.
Hired more helpers including a Job Training Scheme trainee; husband and accountant
helped with finances.
- Team Expansion & Challenges:
Hired a pottery school graduate and others with experience.
Introduced formal employment contracts as the team grew to 6–8 people.
Informal coordination started to fail; production mistakes increased.
,Sally focused more on customers and planning, less on hands-on work.
- Formal Structure Introduced:
Tim was made Studio Coordinator, later Studio Director.
Moved to larger premises, purchased equipment, hired more staff.
Introduced workstations and standard instructions for production.
Bought a computer system for office and stock control (cost overrun of £17,000).
- Mature Business Stage:
Business sold to major clients (e.g., West End stores); orders often exceeded £100,000.
Sally hired a Finance Manager to manage complex finances.
Shifted toward employee involvement in decision-making.
Pay systems became complex and needed restructuring.
- Diversification & Divisional Structure:
Expanded into tiles, outdoor ceramics, and special commissions.
Created 3 divisions: Consumer Products, Contract Products, and Designer Products.
First graduate potter became Director of Design.
- Current Role & Challenges:
Sally, now Managing Director, coordinates via quarterly divisional reviews.
Personally intervenes when performance drops.
Faces challenges with staff morale and slowed growth due to recession.
Banker hinted at future stock exchange involvement.
This timeline shows Sally's transition from hands-on potter to strategic business leader,
managing a complex and diversified company.
2. What is the task of a manager in a world full of specialists?
There is a certain science to it: analysis, systematic evidence. But also a certain craft
that you learn by doing: by experience you learn things, practical learning (an aspect you
can not learn by studying books). Also a certain art (vision, creative insights): it’s a talent
people have.
3. What is the “management paradox”?
Not participating in the production process, increases the efficiency of the production
process !
,Example: harvesting potato’s: sometimes less people are doing the work and yet the
productivity is better. In management there is always a constraint when you grow in the
number of collaborators. But it is not efficient if a 10th person harvesting potatoes are
there a no more tools for this extra person. They have to wait for eachother or they
distract eachother more. The idea is that if this 10th person started coordinating, by
putting a system in place
4. What are the 3 types of organizations that exist in society?
Three pillars for a balanced society
Plural sector: social: Organizations that are neither public / private
'belong' to
- everyone: cooperatives, ...
- no one: foundations, clubs, religious orders, think tanks, activist NGO’s (Green
Peace, Amnesty International, ...), service NGO’s (Red Cross, hospitals, ....)
are not-for-profit
Private sector: economic: Organizations that create for-profit economic activity (from
single entrepreneurs to multinational corporations)
Public sector: political: Organizations administered by governments on behalf of the
public (governments at all levels)
5. Give a synonym for the for-profit sector.
Non governmental for profit: private sector, commercial sector
Governmental for profit: public sector
6. Give a synonym for the government sector.
Public sector
7. Give one or more synonyms for the not-for-profit sector.
Non governmental not-for-profit: plural sector, civil society, social profit
Govermental not-for-profit: public sector
8. Why do people work together? Why create organisations?
To achieve ends none of us could achieve alone – if not: it is simpler, cheaper, more
flexible to work individually
9. Why do we need management in general?
Because people that work together need coordination / resource allocation
, 10. What is the essence of management?
Many people think managing is being the boss. People will ask a lot but you will have to
choose and say often. You need to invest where you think you will get the most return.
You most prioritise: what are we working on? What is the most important and what can
wait? Recourse allocation: deciding who gets to use which tools? You will have to have a
good overview of the companie as a manager.
The essence of management is dealing with scarcity and making choices an
coordination people and make sure they ware working efficient.
11. Why do we need management specifically in the healthcare sector?
The healthcare sector is a non-profit sector. You will think managing is about making
more money. But why is that also important in this sector?
The amount of money that the society invests in healthcare grows faster by 2 or 5% than
the gross national product per year. Gross national product is all the money that the
country makes together. The growth in gross national product per year is not enough to
cover the amount of money we spend on healthcare. That is understandable because
therapies are more expensive and people live longer. But if you continue this you will
spend the complete groos national product on healthcare. That is impossible. This is the
challenge. We need to balance the amount of money that is spend on healthcare. We
need to get a handle on this. We can’t keep growing.
So we need management in the healthcare sector to reduce growth in healthcare costs
to sustainable levels.
12. Why do organizations exist?
What do we want to achieve as an organisation?
In laypeople’s terminology
- Solve a customer’s problem at a lower cost than if (s)he would have to solve it on
her/his own
- The company can then charge a part of customer’s “cost saved” to cover its own
costs + additional profit
- Win/win for customer/company
In theoretical terminology
- To create value for the customer
13. How do organizations create value?
According to Joan Magretta, organizations create value by **performing different
activities from their rivals, or performing similar activities in different ways**. This idea is
Introduction:
Niet letterlijk uit de cursus in cursief
1. Salleramics: describe the evolution of Sally’s company, and the steps in her
career.
Phase 1:
- Production vs coordination
- Part-Time, later Full-Time
- Production = doing; versus coordination
Phase 2:
- Division of labour: with or without specialization
- Generalist vs specialist
- The more specialization, the more need for coordination
- In some form: management, government, ...
Phase 3: structure
- 1 entity vs divisions
Phase 4: ownership
- Private vs public
Evolution:
- Early Stage:
Sally started making pottery alone in her garage, handling all tasks herself.
Sold pots locally; demand grew after a National Trust buyer placed large orders.
Hired Tim, a friend and pottery classmate, on a profit-sharing basis.
- Initial Growth:
Sally divided tasks: Tim prepared clay and glazes; Sally handled most other work.
The brand "Made by Sally" gained recognition.
Hired more helpers including a Job Training Scheme trainee; husband and accountant
helped with finances.
- Team Expansion & Challenges:
Hired a pottery school graduate and others with experience.
Introduced formal employment contracts as the team grew to 6–8 people.
Informal coordination started to fail; production mistakes increased.
,Sally focused more on customers and planning, less on hands-on work.
- Formal Structure Introduced:
Tim was made Studio Coordinator, later Studio Director.
Moved to larger premises, purchased equipment, hired more staff.
Introduced workstations and standard instructions for production.
Bought a computer system for office and stock control (cost overrun of £17,000).
- Mature Business Stage:
Business sold to major clients (e.g., West End stores); orders often exceeded £100,000.
Sally hired a Finance Manager to manage complex finances.
Shifted toward employee involvement in decision-making.
Pay systems became complex and needed restructuring.
- Diversification & Divisional Structure:
Expanded into tiles, outdoor ceramics, and special commissions.
Created 3 divisions: Consumer Products, Contract Products, and Designer Products.
First graduate potter became Director of Design.
- Current Role & Challenges:
Sally, now Managing Director, coordinates via quarterly divisional reviews.
Personally intervenes when performance drops.
Faces challenges with staff morale and slowed growth due to recession.
Banker hinted at future stock exchange involvement.
This timeline shows Sally's transition from hands-on potter to strategic business leader,
managing a complex and diversified company.
2. What is the task of a manager in a world full of specialists?
There is a certain science to it: analysis, systematic evidence. But also a certain craft
that you learn by doing: by experience you learn things, practical learning (an aspect you
can not learn by studying books). Also a certain art (vision, creative insights): it’s a talent
people have.
3. What is the “management paradox”?
Not participating in the production process, increases the efficiency of the production
process !
,Example: harvesting potato’s: sometimes less people are doing the work and yet the
productivity is better. In management there is always a constraint when you grow in the
number of collaborators. But it is not efficient if a 10th person harvesting potatoes are
there a no more tools for this extra person. They have to wait for eachother or they
distract eachother more. The idea is that if this 10th person started coordinating, by
putting a system in place
4. What are the 3 types of organizations that exist in society?
Three pillars for a balanced society
Plural sector: social: Organizations that are neither public / private
'belong' to
- everyone: cooperatives, ...
- no one: foundations, clubs, religious orders, think tanks, activist NGO’s (Green
Peace, Amnesty International, ...), service NGO’s (Red Cross, hospitals, ....)
are not-for-profit
Private sector: economic: Organizations that create for-profit economic activity (from
single entrepreneurs to multinational corporations)
Public sector: political: Organizations administered by governments on behalf of the
public (governments at all levels)
5. Give a synonym for the for-profit sector.
Non governmental for profit: private sector, commercial sector
Governmental for profit: public sector
6. Give a synonym for the government sector.
Public sector
7. Give one or more synonyms for the not-for-profit sector.
Non governmental not-for-profit: plural sector, civil society, social profit
Govermental not-for-profit: public sector
8. Why do people work together? Why create organisations?
To achieve ends none of us could achieve alone – if not: it is simpler, cheaper, more
flexible to work individually
9. Why do we need management in general?
Because people that work together need coordination / resource allocation
, 10. What is the essence of management?
Many people think managing is being the boss. People will ask a lot but you will have to
choose and say often. You need to invest where you think you will get the most return.
You most prioritise: what are we working on? What is the most important and what can
wait? Recourse allocation: deciding who gets to use which tools? You will have to have a
good overview of the companie as a manager.
The essence of management is dealing with scarcity and making choices an
coordination people and make sure they ware working efficient.
11. Why do we need management specifically in the healthcare sector?
The healthcare sector is a non-profit sector. You will think managing is about making
more money. But why is that also important in this sector?
The amount of money that the society invests in healthcare grows faster by 2 or 5% than
the gross national product per year. Gross national product is all the money that the
country makes together. The growth in gross national product per year is not enough to
cover the amount of money we spend on healthcare. That is understandable because
therapies are more expensive and people live longer. But if you continue this you will
spend the complete groos national product on healthcare. That is impossible. This is the
challenge. We need to balance the amount of money that is spend on healthcare. We
need to get a handle on this. We can’t keep growing.
So we need management in the healthcare sector to reduce growth in healthcare costs
to sustainable levels.
12. Why do organizations exist?
What do we want to achieve as an organisation?
In laypeople’s terminology
- Solve a customer’s problem at a lower cost than if (s)he would have to solve it on
her/his own
- The company can then charge a part of customer’s “cost saved” to cover its own
costs + additional profit
- Win/win for customer/company
In theoretical terminology
- To create value for the customer
13. How do organizations create value?
According to Joan Magretta, organizations create value by **performing different
activities from their rivals, or performing similar activities in different ways**. This idea is
