Repositioning the Role of Management Control Practices in Hospitals

The global fiscal crisis of 2008 deeply affected management control practices within the Irish healthcare system. Drawing on in-depth, qualitative case study evidence, this paper examines the repositioning of the key... [ view full abstract ]

The global fiscal crisis of 2008 deeply affected management control practices within the Irish healthcare system. Drawing on in-depth, qualitative case study evidence, this paper examines the repositioning of the key components of hospital control systems. Specifically, we observe the increasing volume and detail of budget control information, the reducing the significance of operational control information and the changing focus of activity control information. These changes took place against a backdrop where hospital management attempts to respond to inflexible call for cost reduction resulted in them pragmatically adopting a centralised approach. While initially successful in eliminating organisational slack, this had potentially harmful side effects. This experience highlights the relevance of investigating the individual and organisational outcomes of management control, to complement the existing focus on budget-related performance.