Control or Collaboration? Contrasting Accountability Relationships in the Primary Health Care Sector

Posted: 10 Sep 2010 Last revised: 17 Feb 2011

See all articles by Carolyn J. Cordery

Carolyn J. Cordery

Aston University; Victoria University of Wellington - School of Accounting and Commercial Law

Rachel F. Baskerville

Victoria University of Wellington - School of Accounting and Commercial Law

Brenda A. Porter

University of Exeter Business School - Department of Accounting

Date Written: December 1, 2010

Abstract

Purpose – This paper seeks to analyse accountability relationships developed since the introduction of reforms requiring nonprofit primary health organisations (PHOs) to discharge holistic accountability.

Design/methodology/approach – Case study data were obtained principally through semi-structured interviews with PHOs and their key stakeholders, observation of formal and informal meetings, and primary and secondary documents.

Findings – While government strategy requires these PHOs to discharge holistic accountability, prior hierarchical-based practices linger. A major impediment to securing holistic accountability is the failure of the new strategy to define clearly how the funder and provider should share accountability for improving their community’s health. The implementation of holistic accountability was retarded when funders’ propensity to control outcomes coincided with providers’ lack of enthusiasm for embracing a greater range of stakeholders. The history and structure of individual PHOs was a key indicator of whether they discharged hierarchical or holistic accountability.

Research limitations/implications – This case study research is context-specific and may have limited applicability to other PHOs or jurisdictions. However, the study shows that when funders and providers build trust rather than depending on control, holistic accountability relationships can be developed.

Practical implications – Despite government intention that primary health care relationships will lead to holistic accountability, this will not occur until funders clearly define responsibilities and trust their service providers.

Originality/value – There is a paucity of research into government-sponsored holistic accountability relationships with local nonprofit service providers. This research provides a unique contextual analysis of the perspectives of funders, providers and a wide group of stakeholders and the operationalisation of two different styles of accountability.

Keywords: Management accountability, Health services, Non-profit organizations

JEL Classification: L3, M4

Suggested Citation

Cordery, Carolyn J. and Baskerville, Rachel F. and Porter, Brenda A., Control or Collaboration? Contrasting Accountability Relationships in the Primary Health Care Sector (December 1, 2010). Accounting, Auditing and Accountability, Vol. 23, No. 6, 2010, Available at SSRN: https://ssrn.com/abstract=1634465

Carolyn J. Cordery

Aston University ( email )

Aston Business School
Aston Triangle
Birmingham, B4 7ET
United Kingdom

Victoria University of Wellington - School of Accounting and Commercial Law ( email )

Faculty of Commerce and Administration
PO Box 600
Wellington
New Zealand

Rachel F. Baskerville (Contact Author)

Victoria University of Wellington - School of Accounting and Commercial Law ( email )

Faculty of Commerce and Administration
PO Box 600
Wellington
New Zealand
006444636951 (Phone)
006444635076 (Fax)

HOME PAGE: http://www.victoria.ac.nz/sacl/staff/rachel-baskerville.aspx

Brenda A. Porter

University of Exeter Business School - Department of Accounting ( email )

Exeter, EX4 4QJ
United Kingdom

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