Nottingham University Business School, University of Nottingham, Nottingham, UK.
Health Policy. 2012 Feb;104(2):172-8. doi: 10.1016/j.healthpol.2011.07.006. Epub 2011 Aug 10.
With increased possibility that public healthcare services in the UK will be outsourced to the private sector, this study investigates how clinicians working in Independent Sector Treatment Centres perceive the differences between public and private sectors.
Qualitative interviews with 35 clinicians recruited from two ISTCs. All participants were transferred to the independent sector from the public National Health Service. Interview data were analysed to identify shared experience about the variable organisation and delivery of services.
Clinicians perceived differences between public and independent sectors in the areas of 'environment and facilities', 'management', 'work organisation and care delivery', and 'patient experience'. The independent sector was described as offering a positive alternative to public services in regard to service environment and patient experience, but there were concerns about management priorities and the reconfiguration of work.
Clinicians' experience of moving between sectors reveals mixed experiences. Although some improvements might legitimise the growing role of the independent sector, there remain doubts about the commercialisation of services, the motives of managers and the impact of clinical roles and capabilities. With policies looking to expand the mixed economy of public healthcare services, the study suggests clinicians will not automatically embrace a move between sectors.
随着英国公共医疗服务向私营部门外包的可能性增加，本研究调查了在独立部门治疗中心工作的临床医生如何看待公共部门和私营部门之间的差异。
从两家 ISTC 招募了 35 名临床医生进行定性访谈。所有参与者均从公共国民保健服务转至独立部门。对访谈数据进行分析，以确定有关服务变量组织和提供的共同经验。
临床医生认为公共部门和独立部门在“环境和设施”、“管理”、“工作组织和护理提供”以及“患者体验”方面存在差异。独立部门在服务环境和患者体验方面被描述为公共服务的一个积极替代选择，但人们对管理重点和工作重组存在担忧。
临床医生在部门之间的经验揭示了混合经验。尽管一些改进可能使独立部门的作用合法化，但对于服务的商业化、管理者的动机以及临床角色和能力的影响仍存在疑虑。随着政策着眼于扩大公共医疗服务的混合经济，研究表明临床医生不会自动接受部门之间的转移。
