Thriving in the cash strapped organisation

Abstract

Allied health professionals make valuable contributions to the health of their clients and communities as expert clinicians in their field of expertise. Work priorities are often dominated by managing large caseloads and meeting complex client needs. Less well appreciated is the need for a range of non-clinical skills that both support and amplify the health professional's clinical outcomes. Competence in management, leadership and especially finance, come to the fore in environments where resources are declining, unstable or where political and organisational politics are rife over the allocation process. Resource allocation processes are inherently competitive and the relative prosperity of the allied health professions, in terms of their ability to acquire resources, depends on being able to obtain and manage money creatively. In this chapter, the focus is on the art of acquiring resources, particularly in the cash strapped publicly funded health care sector. The rationale is that firstly, although allied health professionals work across many settings, the publicly funded health sector in many western industrialised countries is the majority employer. Secondly, compared to the private sector, the publicly funded health sector is often more constrained by the methods and techniques that can be used in obtaining money. Bureaucratic controls and public accountability standards typically act as limiting factors on public sector management and financial behaviour.(1, 2) The espoused priorities for health professionals in the public sector are usually expressed as a demand to concentrate on the ‘core business’ of meeting client demand, not on generating innovative revenue streams. Despite these espoused priorities health professionals need to exercise strategic thinking about how to acquire additional funding within the constraints of public sector practice. Where resource environments are unstable, service providers also need to use the same strategic thinking to ensure they maximise the available resources and opportunities. This is especially the case for the allied health professions. Marginalised or 'cinderella' services in the health system are often targeted for deeper cuts, so service leaders need to be especially skilled in the finance and leadership area.