ENGLISH ABSTRACT: The aim of this research report was to identify a set of strategic tools that can be transferred from the private health sector to the public health sector, to improve efficiency in the public health sector. To attain to this aim, this research report attempted to identify the selectedbest practices employed by successful private health providers, to determine the most effective modes to transfer these best practices, and to establish key success factors for the identified best practices.Interviews were conducted with opinion-leaders from the health industry in the Western Cape,and inputs gleaned from these individuals were useful in applying the strategic model to the public and private health sector in the Western Cape.Globally the public sector has already embarked on strategic management initiatives, through the implementation of the New Public Management-model. The introduction of NPM in a few selected countries aimed at achieving cost-efficiency, budget accountability and improved customer focus in service delivery. South Africa however still needs a unifying and all encompassingvision for public and development management to advance the ideals of BathoPele.The use of evidence and the management of intellectual capital in the health care industry are recognised as important in decision-making.The health care trends of five selected countries (United Kingdom, United States of America, Greece, Canada, Slovakia) were researched , and demonstrated that countries face similar challenges (increasing resource demands, aging population, rapidly expanding technological possibilities, better-informed patients, rising expectations). It is recognised that businessskills and knowledge, as well as investments in IT can be effective tools in moving an organisation from a reactive approach to a pro-active approach.Managers in the public sector need different competencies than managers in the private sector due to the differences between the two sectors, and thus there is a need to adapt management training.While there are examples of best practices in the South African government, there is still room for improvement. A stable political economy, political leadership, management skills of political office-bearers and the professionalism of civil servants will be decisive in this regard.The White Paper on the Transformation of the Public Service provides a framework for the development of strategies to promote continuous performance improvements in quantity, quality and equity of health service provision. The areas where improvements are necessary are customer and stakeholder satisfaction, processes, organisation results, leadership and people management.The comparison between the current strategic approach in the Western Cape and a model designed for the public sector revealed that some of the steps can be developed further, namely the assessment of the internal and external environments, the development of an effective implementation process, and the reassessment of the strategies and the strategic planning process.The comparison between the current strategic approach in the Western Cape and the global best practices framework established that there is not sufficient balance between the resource and position based views, the decision-making approach is "quite formal", implementation of strategy is not a carefully planned change management process, planning is regarded as themost important part of the strategic planning process, and evaluating strategy implementation involves more than mere financial measures. It was also established that the Western Cape Department of Health's strategic stance is offensive, that it can be regarded as a prospector, that managing multiple stakeholders is a challenge and that the competitive advantage of thedepartment is its people.The industry analysis revealed that there is still a long way to go in terms of reliable information systems to support health services. The need for a strategic approach that can respond rapidly in a turbulent environment, and the re-look strategic processes to ensure delivery of quality health care through optimal use of resources were also established by theindustry analysis.It was established that a gap exists in the public health sector in respect of the strategic planning processes, and that the private health sector portrays characteristics compatible with the global best practices framework.Modes for the successful transfer of best practices were explored, namely management consulting, commercialisation and management development.Two key success factors for the transfer of best practices were identified, namely the application of the Batho Pele principles, and the recruitment and retention of suitably qualified staff.From a global strategic management perspective, it was clear that there is a definite need for the public sector to change to private sector strategic approaches. A shift from a reactive to a pro-active approach is also advisable.The global trends in public health care demonstrate the importance of political leadership, competent management, business knowledge and skills, IT investment and the use of evidence in health. It is clear that the provision of public health care in South Africa faces similar challenges to those experienced by the five countries researched.The application of the global best practices framework confirmed that there are in fact best practices employed by the private sector that can be transferred to the public sector.Most of the best practices discussed in this research report are not employed in the public sector, or only on a limited scale. The use of these practices should be explored by the public sector.In order to equip managers in the public sector with the necessary strategic management tools, training and development opportunities must include modules on strategic management.
