The End of Publicness?: Public and Private Healthcare Organizations are Alike in all Important Respects

The End of Publicness?: Public and Private Healthcare Organizations are Alike in all Important Respects

Stuart Anderson (London School of Hygiene and Tropical Medicine, London, UK)
DOI: 10.4018/ijpphme.2013070104
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Abstract

When Wallace Sayre declared that ‘public and private organizations are alike in all unimportant respects' a quest began to establish the truth or otherwise of this assertion. Researchers have been investigating the topic for over sixty years. They have focused on two key questions; what is meant by a public or private organization? And what constitute ‘important respects' and ‘unimportant respects' respectively? This paper reviews current evidence relating to the testing of Sayre's statement, focusing on the healthcare sector. It is concluded that research has failed to provide unequivocal evidence that particular aspects of publicness impact aspects of organizational performance in particular ways. Sayre got it wrong; public and private organizations are alike in all important respects. It is argued that it is time to call a halt to publicness studies; what matters is management and organization, and it is on these issues that public organization researchers should now concentrate.
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Core Publicness: Publicness As Ownership, Funding Or Mode Of Social Control

Bozeman and Straussman first proposed the concept of publicness as a way of looking at issues such as the increasing diversity of organizational types, and particularly the blurring of the distinction between public and private organizations, in a chapter entitled ‘organization publicness and resource processes’ in Hall and Quinn’s (1983) seminal edited volume Organization Theory and Public Policy.Bozeman (1987) later developed the concept in his book All Organizations are Public: Bridging Public and Private Organization Theory. Since then extensive empirical and theoretical work has been carried out in the field of organizational publicness. Organizational studies of public/private differences in organizations have evolved rapidly, from an emphasis on generic approaches, through to a focus on core, dimensional, empirical, normative, and most recently on integrative publicness.

The rationale for comparing public and private organizations is the supposition that public organizations are different from business firms, and that different factors might therefore be important in optimising performance. A large body of research has now compared public and private organizations, using a variety of approaches, the purpose of which has been to consider whether one type of organization is more effective than others in delivering certain outcomes. Some studies have examined the extent to which particular organizational attributes are specific to one sector or are shared across several. Scott and Falcone (1998) reviewed the underlying conceptual frameworks used in these studies, and concluded that all could be reduced to one of three types; the generic, core and dimensional approaches.

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