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Table 2 Perceived weaknesses in priority setting in the PHSA

From: Priority setting in the provincial health services authority: survey of key decision makers

Systemic

Internal

 

Central decision making creating a feeling of disempowerment among managers

 

Lack of true accountability to conserve resources

 

"Do it all" mentality that prevents the organization from identifying disinvestments

 

Incentive to overspend because efficiency is not rewarded

 

Lack of structural and cultural integration due to the recent creation of the PHSA

 

External

 

Confusion regarding role and authority of the BC Ministry of Health and the PHSA

 

Limitations in priority setting due to provincial mandate and global priority setting

Individual

Lack of priority setting skills and tools which support resource re-allocation

 

Unwillingness to release resources from own budgets to fund investments elsewhere

 

Fear of being explicit in priority setting

 

Decision makers jaded to change processes because of too much change in the institution

 

Lack of management training for physician-leaders