Challenges of public sector change management: The case of medicine provision in public hospitals in Punjab

ABSTRACT

This case examines key change management challenges faced by public managers by discussing multiple policy and procedural changes introduced in the Primary & Secondary Healthcare (P&SH) Department, Punjab, Pakistan to improve its medicine procurement process. Under immense political pressure to introduce quick, visible and effective changes in the quality of medicine available in government facilities, the P&SH department initiated multiple change initiatives to improve its medicine procurement process. While this resulted in availability of top rated brand medicine in government hospitals, the annual cost of procurement increased by more than 75% prompting criticism from some quarters. There was also limited endorsement of this initiative by the frontline staff of the P&SHD limiting its popularity in the public. The administrative head of the P&SHD was, therefore, faced with a dilemma; whether to continue with the new procurement model or revert to the old one.

KEYWORDS:

• Change management
• procurement
• price vs quality
• market competition

Notes

1. This case has been written to serve as basis for class discussion rather than to illustrate either effective or ineffective handling of an administrative situation.

2. A rural district in central Punjab, Pakistan.

3. Suspension from service is a usual emergency disciplinary measure, entailing stoppage of the suspended official from work while formal inquiry is conducted into allegations against him/her.

4. Administrative head of the department.

5. WHO defines substandard medicine as medicine that has been manufactured by a registered manufacturer but does not meet the prescribed standards. Spurious medicine does not have the active ingredient they claim to have. Misbranded medicine carries misleading information on the label.

6. Harmon (1989).

Additional information

Notes on contributors

Muhammad Azfar Nisar

Muhammad Azfar Nisar is Assistant Professor at the Suleman Dawood School of Business at Lahore University of Management Sciences. He is primarily interested in questions related to social marginalization, street-level bureaucracy, and policy implementation. His research has been published in Journal of Public Administration Research & Theory, Public Administration Review, Gender & Society, Administration & Society, International Journal of Public Administration, Higher Education, and Public Administration & Development, among others.

Muhammad Ahsan Rana

Muhammad Ahsan Rana is Associate Professor at the Suleman Dawood School of Business at Lahore University of Management Sciences. Previously, he was a member of the Pakistan Administrative Service and worked at multiple positions in different government departments. His research focuses on agricultural policy, non-profit management, and public administration. His research has been published in multiple international journals and books.