IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v12y2003i12p1005-1020.html
   My bibliography  Save this article

Classical versus relational approaches to understanding controls on a contract with independent GPs in South Africa

Author

Listed:
  • Natasha Palmer
  • Anne Mills

Abstract

Contracts have played a central role in public sector reforms in developed countries over the last decade, and research increasingly highlights their varied nature. In low and middle income countries the use of contracts is encouraged but little attention has been paid to features of the setting that may influence their operation. A qualitative case study was used to examine different dimensions of a contract with private GPs in South Africa. Features of the contract are compared with the notions of classical and relational contracts. Formal aspects of the contract such as design, monitoring and resort to sanctions were found to offer little control over its outcome. The relational rather than classical model of contracting offered a more meaningful framework of analysis, with social and institutional factors found to play an important role. In particular, the individual nature of GP practices highlighted the role played by individual motivation where a contract exercised little formal control. Due to the similarity of factors likely to be present, results are argued to be relevant in many other LMIC settings, and policy‐makers considering contracts for clinical services are advised to consider the possibility of experiencing a similar outcome. Copyright © 2003 John Wiley & Sons, Ltd.

Suggested Citation

  • Natasha Palmer & Anne Mills, 2003. "Classical versus relational approaches to understanding controls on a contract with independent GPs in South Africa," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 1005-1020, December.
    • Handle: RePEc:wly:hlthec:v:12:y:2003:i:12:p:1005-1020
    DOI: 10.1002/hec.792
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.792
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.792?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Joanna Coast, 1999. "The appropriate uses of qualitative methods in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 8(4), pages 345-353, June.
    2. Maria Goddard & Russell Mannion, 1998. "From competition to co‐operation: new economic relationships in the National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 105-119, March.
    3. Tony Scott & Alan Maynard, 1991. "Will the new GP contract lead to cost effective medical practice?," Working Papers 082chedp, Centre for Health Economics, University of York.
    4. Schick, Allen, 1998. "Why Most Developing Countries Should Not Try New Zealand's Reforms," The World Bank Research Observer, World Bank, vol. 13(1), pages 123-131, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Natasha Palmer & Anne Mills, 2012. "Contracting-out Health Service Provision in Resource- and Information-poor Settings," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 23, Edward Elgar Publishing.
    2. Donato, Ronald, 2010. "Extending transaction cost economics: Towards a synthesised approach for analysing contracting in health care markets with experience from the Australian private sector," Social Science & Medicine, Elsevier, vol. 71(11), pages 1989-1996, December.
    3. Palmer, Natasha & Mills, Anne, 2005. "Contracts in the real world: Case studies from Southern Africa," Social Science & Medicine, Elsevier, vol. 60(11), pages 2505-2514, June.
    4. Oliveira Cruz, Valeria & McPake, Barbara, 2010. "The "aid contract" and its compensation scheme: A case study of the performance of the Ugandan health sector," Social Science & Medicine, Elsevier, vol. 71(7), pages 1357-1365, October.
    5. Laamanen, Ritva & Simonsen-Rehn, Nina & Suominen, Sakari & Øvretveit, John & Brommels, Mats, 2008. "Outsourcing primary health care services--How politicians explain the grounds for their decisions," Health Policy, Elsevier, vol. 88(2-3), pages 294-307, December.
    6. Guinness, Lorna, 2011. "What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?," Social Science & Medicine, Elsevier, vol. 72(12), pages 1939-1947, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Leonard, David K. & Bloom, Gerald & Hanson, Kara & O’Farrell, Juan & Spicer, Neil, 2013. "Institutional Solutions to the Asymmetric Information Problem in Health and Development Services for the Poor," World Development, Elsevier, vol. 48(C), pages 71-87.
    2. Roy T. Meyers, 2017. "Is the U.S. Congress an Insurmountable Obstacle to Any “Far-Sighted Conception of Budgeting”?," Public Budgeting & Finance, Wiley Blackwell, vol. 37(4), pages 5-24, December.
    3. Russell Mannion & Andrew Street, 2009. "Managing activity and expenditure in the new NHS market," Public Money & Management, Taylor & Francis Journals, vol. 29(1), pages 27-34, January.
    4. Independent Evaluation Group, 2008. "Public Sector Reform: What Works and Why? An IEG evaluation of World Bank Support," World Bank Publications - Books, The World Bank Group, number 6484, December.
    5. David Kernick, 2002. "Health economics: an evolving paradigm but sailing in the wrong direction? A view from the front line," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 87-88, January.
    6. AfDB AfDB, 2005. "Working Paper 81 - Re-Orienting Public Management in Africa: Selected Issues and Some Country Experiences," Working Paper Series 2215, African Development Bank.
    7. Fritz, Verena & Hedger, Edward & Lopes, Ana Paula Fialho, 2011. "Strengthening Public Financial Management in Postconflict Countries," World Bank - Economic Premise, The World Bank, issue 54, pages 1-7, April.
    8. Scott, Anthony & Hall, Jane, 1995. "Evaluating the effects of GP remuneration: problems and prospects," Health Policy, Elsevier, vol. 31(3), pages 183-195, March.
    9. Alison J. Blaiklock & Cynthia A. Kiro & Michael Belgrave & Will Low & Eileen Davenport & Ian B. Hassall, 2002. "When the Invisible Hand Rocks the Cradle: New Zealand children in a time of change," Papers inwopa02/20, Innocenti Working Papers.
    10. Bjoern Dressel & Jim Brumby, 2012. "Enhancing Capabilities of Central Finance Agencies : From Diagnosis to Action," World Bank Publications - Reports 12752, The World Bank Group.
    11. Stirling Bryan & David Parry, 2002. "Structural reliability of conjoint measurement in health care: an empirical investigation," Applied Economics, Taylor & Francis Journals, vol. 34(5), pages 561-567.
    12. Virgil, Candale & Andreea, Ocoli?anu, 2022. "Budgetary Performance In The Case Of Local Public Authorities, A Target To Reach, But More Than That, A Must," Management Strategies Journal, Constantin Brancoveanu University, vol. 55(1), pages 13-19.
    13. Roy Valiant Salomo & Krisna Puji Rahmayanti, 2023. "Progress and Institutional Challenges on Local Governments Performance Accountability System Reform in Indonesia," SAGE Open, , vol. 13(4), pages 21582440231, October.
    14. Andrews, Matt, 2015. "Has Sweden Injected Realism into Public Financial Management Reforms in Partner Countries?," Working Paper Series 15-063, Harvard University, John F. Kennedy School of Government.
    15. Anwar Shah, 1999. "Governing for Results in a Globalised and Localised World," The Pakistan Development Review, Pakistan Institute of Development Economics, vol. 38(4), pages 385-431.
    16. Julie A. Campbell & Douglas Ezzy & Amanda Neil & Martin Hensher & Alison Venn & Melanie J. Sharman & Andrew J. Palmer, 2018. "A qualitative investigation of the health economic impacts of bariatric surgery for obesity and implications for improved practice in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1300-1318, August.
    17. Khaleghian, Peyvand & Gupta, Monica Das, 2005. "Public management and the essential public health functions," World Development, Elsevier, vol. 33(7), pages 1083-1099, July.
    18. Manasan, Rosario G., 2000. "Public Sector Governance and the Medium-Term National Action Agenda for Productivity (MNAAP)," Discussion Papers DP 2000-24, Philippine Institute for Development Studies.
    19. Verena Fritz & Edward Hedger & Ana Paula Fialho Lopes, 2011. "Strengthening Public Financial Management in Postconflict Countries," World Bank Publications - Reports 10097, The World Bank Group.
    20. Karen Bloor & Alan Maynard, 1993. "Expenditure on the NHS during and after the Thatcher years: its growth and utilisation," Working Papers 113chedp, Centre for Health Economics, University of York.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:12:y:2003:i:12:p:1005-1020. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.