Global Network for Advanced Management

University of Ghana Business School

June 12 – 16, 2017

Accra, Ghana

State Corporatization of Social Services: A study of Ghana’s Experiment in the Health Sector

Background

In many countries, whether developed or developing, the state has always had a role to play especially in the delivery of essential public goods. A major argument advanced in favour of state participation in the production of public goods revolved around the issue of market failure and the quest for equity and fairness. However, the upsurge of conservative ideas in the late 1970s and early 1980s and the argument that the public sector constituted a grossly inefficient mechanism for producing any form of goods and services popularised neoliberal propositions for the production and distribution of public goods. Several countries in Europe have employed neoliberal channels to produce and distribute public services, especially those with commercial significance (i.e. utilities, public transportation etc).

Although the existing literature is not conclusive on the benefits of using neoliberal vehicles to produce and distribute public goods, there are countries especially in Africa that seek to expand their use of such neoliberal vehicles (i.e the use of pure private sector principles and mechanisms) to run public organisation responsible for the production and distributions of critical social services such as health and education. In Ghana for example, the policy of government in the recent past has been that public institutions seeking funds to support their operations are expected to borrow on the strength of their balance sheet. This means that such organisations will be responsible for the repayment of such funds borrowed and not the central government. This also implies that such state organisations may need to operate purely on commercial lines to be able to repay such loan, thus undermining their social welfare function.

The specific case that will be the subject matter of this course is a brand new hospital for the University of Ghana worth over US$ 217 million, funded with an on-lending loan guaranteed by the Government of Ghana. Although the loan was guaranteed by the government of Ghana, the Hospital is nonetheless is expected to operate as a pure private limited liability company and pay the loan back. Against the background of high levels morbidity and mortality, poverty and the ever-increasing levels of inequality in Ghana, Will neoliberal models for the production and distribution of critical social services such as healthcare maximise the social welfare function of the Ghanaian state? If so, under what condition will such experiment be successful?

 

Course Objective

The objective of this course is to help participants to

  1. Understand the nuanced nature of the production and distribution of social services in the context of developing countries such as Ghana
  2. To explore the appropriate use of neoliberal vehicles for the production and distribution of social services

Scope of the Course

The course will be made up of two parts; classroom work that is expected to take about 60% of the time of participants in the course and field work expected to cover the remaining 40% of participants’ time.

The classroom work will cover three sub models as spelt out in detail below:

  1. Literature, History, Models and Context of State Corporatization

This aspect of the course is possibly the most important and seeks to help participants to understand capitalist development from the mid-1970s through the concept of ‘neoliberalism in relation to society, economics, politics and culture. The objectives of this aspect of the course will be to:

  1. introduce participants to the idea of “neoliberalism” as a means of understanding capitalist development since the mid-1970s;
  2. explore neoliberalism as a totality, showing the inter-relationship between economy, polity, society and culture; and
  3. show how social theory in general and sociology in particular has responded to neoliberalism.

By the end of this very important sub model, participants are expected to be able to:

  1. explain the extent to which neoliberalism constitutes a distinct stage in the development of capitalism;
  2. identity the different phases of the neoliberal era, from its origins through the successive ‘vanguard’, ‘social’ and current ‘crisis’ modes;
  3. assess the different theoretical approaches to neoliberalism, ranging from those which see it as primarily ideologically-driven to those who see it primarily as a pragmatic response to economic crisis; and
  4. judge the extent to which neoliberalism involves both continuity with and change from the previous period of ‘embedded social-democracy’

Facilitator of this sub model will be Dr. Agyenim-Boateng, PhD

Reading Materials:

David Harvey (2007) A Brief History of Neoliberalism, Oxford University Press, Oxford.

Steger, M. B. and Roy, R. K. (2010) Neo-liberalism, A Very Short Introduction, Oxford University Press, Oxford.

 

Supplementary Materials

Agyenim-Boateng, C., Stafford, A. and Stapleton, P. (2017) ‘The role of structure in manipulating PPP accountability’, Accounting, Auditing & Accountability Journal, Vol. 30 Iss: 1, pp. 1-26

Ezzamel, M. and Willmott, H. (1993) ‘Corporate Governance and Financial

Accountability: Recent Reforms in the UK Public Sector’, Accounting Auditing and

Accountability Journal, Vol. 6(3), pp. 109-132.

Finlayson, A. (2009) Financialisation, Financial Literacy and Asset-Based Welfare, The British Journal of Politics and International Relations, Vol. 11, pp. 400-421.

Froud, J., Haslam, C., Johal, S. Shaoul, J and Williams, K. (1996) ‘Stakeholder Economy? From Utility Privatisation to New Labour’, Capital and Class, Vol. 60, pp. 119-134.

Froud, J., Shaoul, J. and Williams, K. (1998) ‘Persuasion Without Numbers? Public Policy and the Justification of Capital Charging in the NHS trust hospitals’, Accounting, Auditing and Accountability, Vol. 11(1), pp. 99-125.

Hellowell, M. and Pollock, A. M. (2010) ‘Do PPPs in Social Infrastructure Enhance the Public Interests? Evidence from England’s National Health Service’, Australian Journal of Public Administration,Vol. 69(S1), pp. S23–S34.

Peck, J. (2013) “Explaining (with) Neoliberalism” Territory, Politics, Governance, Volume 1, Issue 2  Pages 132-157.

Smyth, S. (2012) ‘Contesting Public Accountability: A Dialogical Exploration of

Accountability and Social Housing’, Critical Perspectives on Accounting, Vol. 23, pp.

230-243.

  1. Managing Change: From a Public Sector Bureaucracy to a Corporation

This sub model will discuss how to manage the politics associated with such massive administrative, bureaucratic and institutional changes to ensure that the use of neoliberal vehicles for the production and distribution of social services is successful.  The objective of this sub model is to introduce students to practical steps and skills involved in delivering successful business change and transformation programs to ensure organizational development. Topics to be treated will include but not limited to

  1. The concept of change
  2. Human reactions to change
  3. The politics of change,
  4. Approaches to managing change
  5. Strategies for effective change management
  6. Change management and organizational development

Facilitator: Kwesi Amponsah-Tawiah, PhD E-Mail: Kamponsah-tawiah@ug.edu.gh

It is expected that at the end of the course participants should be able to:

  1. demonstrate how to plan, launch and deliver successful change programs
  2. demonstrate the skills necessary to deliver change
  3. demonstrate the core principles and strategies of change

Facilitator: Kwesi Amponsah-Tawiah, PhD

Reading Materials

Pugh, L. (2016). Change management in information services (2nd ed). UK: Aberystwyth

Cameron, E., & Green, M. (2015). Making Sense of Change Management: A Complete Guide to the Models, Tools and Techniques of Organizational Change (4th Ed). London; Kogan Page.

McCalman, J., & Paton, A. R. (2015). Change Management: A Guide to Effective Implementation (4th Ed). UK, Sage Publications Ltd

Kotter, J., & Holger Rathgeber, H. (2016). Our Iceberg Is Melting: Changing and Succeeding Under Any Conditions (2nd ed). New York,

Penguin Random House, 5. Paul Gibbons (2015). The Science of Successful Organizational Change: How Leaders Set Strategy, Change Behavior, and Create an Agile Culture (1st Ed). London: Pearson FT Press.

McCalman, J., & Potter, D. (2015). Leading Cultural Change: The Theory and Practice of Successful Organizational Transformation (2nd Ed). Londom: Kogan page.

  1. State Corporatization of Social Services: Understanding the Control

Environment

A major challenge facing organisations that have metamorphosed from state corporations into pure private corporations is the general absence of the right control measures to ensure value for money and thereby reduce waste. The main aim of this sub model is to help participants to appreciate the necessary control environment needed to ensure the success of such major reforms.

The scope of the model will include the following

  1. Understanding and creating value
  2. Business risk management
  3. Financial governance
  4. Financial management information systems and decision-making

It is expected that at the end of this sub model participants will be able to understand and use standard financial management tools to manage such massive changes in a way that delivers success.

 

Reading Materials

Finlayson, A. (2009) Financialisation, Financial Literacy and Asset-Based Welfare, The

British Journal of Politics and International Relations, Vol. 11, pp. 400-421.

Froud, J., Haslam, C., Johal, S. Shaoul, J and Williams, K. (1996) ‘Stakeholder Economy?

From Utility Privatisation to New Labour’, Capital and Class, Vol. 60, pp. 119-134.

Froud, J., Shaoul, J. and Williams, K. (1998) ‘Persuasion Without Numbers? Public Policy

and the Justification of Capital Charging in the NHS trust hospitals’, Accounting, Auditing

and Accountability, Vol. 11(1), pp. 99-125.

Hellowell, M. and Pollock, A. M. (2010) ‘Do PPPs in Social Infrastructure Enhance the

Public Interests? Evidence from England’s National Health Service’, Australian Journal of

Public Administration,Vol. 69(S1), pp. S23–S34.

Peck, J. (2013) “Explaining (with) Neoliberalism” Territory, Politics, Governance, Volume 1, Issue 2  Pages 132-157.

Smyth, S. (2012) ‘Contesting Public Accountability: A Dialogical Exploration of

Accountability and Social Housing’, Critical Perspectives on Accounting, Vol. 23, pp.

230-243.

 

Facilitator: Moshood Abayomi Amusa

The final part of the course will be fieldwork that will be carried out by participants at the new University of Ghana Medical Centre referred to above. The fieldwork will allow participants to put into practice knowledge gained through the theory session.