MANAGEMENT PROBLEM IN STATE GOVERNMENT OWNED HOSPITAL
(A CASE STUDY OF PARK-LANE GENERAL HOSPITAL)
ABSTRACT
The aim of this study is to find out the reason(s) why there is management, problem in state owned government hospital. A case study of Park-Lane General Hospital Enugu. The researcher in course of this  project made use of two sources of data  for this work. The sources are primary and secondary sources. Though the primary sources were more reasonable for practical purposes, the secondary sources were more substantial.
        The researcher later find out the reasons why there is management problem in state government owned hospital (Park – Lane General Hospital). The findings are;
i.      Over centralization of authority and power with the board causes management owned hospitals.
ii.      Finding that inadequate facilities, shortage of funds, shortage of drugs affect the output and efficiency of the Park-Lane General Hospital.
iii.     Finding that patients of Park-Lane General hospital experienced poor services.
iv.     Finding that performance of workers at different levels are poor, due to inadequate facilities and over all quality of care undermined.
v.     Finding from laboratory staff interviewed, mentioned of situations where reagents, to conduct laboratory test are unavailable thus, resulting either the particular test not done or the number reduced.
The researcher in the face of her findings was able to offer the following recommendations to the management of Park-Lane General Hospital.
i.      Authorities and power of the board should be centralized, so that other department should have a sense of belonging in the affairs of the hospital.
ii.      Government should map out substantial amount and manpower resources to improve the performance of the hospital. Drugs should also be by the federal government in order to boost their efficiency.
iii.     There should be an avenues to award excellent service to the staff to improve their service to patient.
iv.     Training and workshop should be organized for the staff in Park-Lane General Hospital to acquit them latest and best way to manage hospital. Adequate facilities should be put in place by government of the state in order to uplift the standard of the hospital.
v.     Adequate laboratory equipment should, be put in place in the hospital to carryout good test food test for the numerous patients.
 TABLE OF CONTENTS
CHAPTER ONE
1.0    Introduction                                                                
1.1    Background of the Study                                              
1.2    Statement of the Problem                                     
1.3    Objective of the Study                                         
1.4    Research Questions                                                     
1.5    Hypothesis Formulation                                        
1.6    Significance of the Study                                              
1.7    Scope of the Study                                                      
1.8    Limitation of the Study                                         
1.9    Definition of Terms                                                      
Reference
CHAPTER TWO
2.0    Literature Review                                                        
2.1    Historical Development of Management Practice       
2.2    Struggle for Professionalism                                  
2.3    The Act of Managing                                            
2.4    Conflicts in Hospitals                                            
2.5    Administration Medical Staff Conflict                       
2.6    Nursing Conflict                                                   
2.7    Approaches to the Resolution of Conflicts                
2.8    Utilization of Hospital and the Availability                 
2.9    Causes of Conflict in Park-Lane General Hospital       
Reference
CHAPTER THREE
3.0    Research Design and Methodology                 
3.1    Introduction of the Study                                      
3.2    Research Design and Method                         
3.3    Area of Study                                                     
3.4    Population of the Study                                        
3.5    Instrument for Data Collection                               
3.6    Validation of the Instrument                          
3.7    Reliability of the Instrument                          
3.8    Method of the Instrument                             
3.9    Method of Data Analysis                                       
CHAPTER FOUR
4.0    Data Presentation                                                
4.1    Presentation and Analysis of Data                  
4.2    Testing of Hypothesis                                   
4.3    Summary of Results                                             
CHAPTER FIVE
5.0    Discussion, Conclusions and Recommendations
5.1    Discussion of Result Findings                          
5.2    Conclusion                                                  
5.3    Recommendations                                               
Bibliography
Appendix CHAPTER ONE
1.0    INTRODUCTION
          Throughout the ages, there has been persistent efforts to improve the standard of human life, man on realization of his limitation, coupled with the fact of limited resources at his disposal, he choose to form organization to address these needs and wants he would not have been  able to help himself.
        It should be noted here, that those organizations formed exist for definite purposes and the people therein, make up of personal and corporate bodies interact for various purposes or objectives they intends to achieved.
        The above calls for the essence of management. The term “management” as used here, according to Agwu Akpala (1990:3) is the process of combining and utilizing of allocating an organizations inputs/men, materials and money) by planning, organizing directing and controlling for the purpose of producing output/goods and services or whatever objects are) desired by customers so that the organizational objective are accomplished”.
        These processes and the managerial functions, explain what are involved in the act of management practice in an organization, they are differentiated into groups of people having certain authorities and responsibilities for the achievement of organizational goal/called and manager’s) from what the non-managers/called the operatives) do. Again, to the process, management tried to relate the organization input resources effectively for optimal utilization through effective planning, organizing, directing, motivating so as to ensure achieving the organizational goal.
        Having given the insight of what the manager faces and need to act on, while at work, as shown above, we will now look at the impact of managerial, practice in government owned hospital in Enugu state with particular reference to the Park-Lane general hospital Enugu as our case study.
1.1    BACKGROUND OF THE STUDY
          The need for an established health care delivery scheme dates back to the days of our colonial master when the need for hospital services became so indispensable due to continuous increase in various kinds of sickness that were claiming lives on a regular basis. This was the time the now present day Park Lane General Hospital Enugu was build.
        In the light of the above, the 1979 constitution contained the “fundamental, objectives and principles of policy” a section of which provides that the Nigeria) state, shall direct its policy towards ensuring that “the health, safety and welfare of all persons in employment are safeguarded and not endangered or abused and that there are adequate medical and health facilities for all persons”.
        Furthermore, in other to ensure effective and efficient implementation of good health care system for all her citizens including those at the grass roots, the federal government involved all the various levels of government that is federal, state and local government, with the federal government taking the responsibility of ensuring smooth care delivery scheme of the Park-Lane General Hospital through hospital management board under the supervision of the federal ministry of health. At the state level the state government set up and appoints the people to run the Park-Lane General Hospital care delivery scheme and they are strictly under supervision of the federal ministry of health. At the level, the state government set up and appoints the people to run the Park-Lane General Hospital.
These are made up the secondary level of the health supervision of the respective, state ministry of health. The local government council is charge with the responsibility of providing primary health care maternity centres at the grass root.
        Nigeria has 14 teaching hospitals, 1170 general/central hospital and over 3,500 health care centres/maternity homes, in both urban and rural areas managed by the local government.
 1.2    STATEMENT OF THE PROBLEM
        Despite the important government at all level attach to Park-Lane General Hospital. For the people it was set up to serve. there is some problem that is laundering the growth of this hospital. The study takes a critical look at
i.      To find out quality of staff in the functional area of the hospital.
ii.      To examine the recruitment procedure of the hospital.
iii.     To find out the method they are using in the security of their hospital equipment.
iv.     To know how the Junior workers are treated by the senior staff management.
v.     To assertrate whether there is enough drugs for the hospital.
vi.     To get information on how their workers are being paid.
        Today, the government hospital whose main goal are continuous quality patient care, teaching and research service have become some of the complicated, organizations with a large number collection of highly trained professionals. It is highly labour and capital intensive.
        The “health of a nation is the wealth of a nation”. Organizationally, according to dr. Aguzu of University College hospital Ibadan, during an interview by Gideon Shande (1986) on “management performance in hospitals”, he said that a typical hospital, in Nigeria today is a mere loose aggregate of departments, each doing its own thing. Again, while speaking in an interview on the “problem of health care delivery” Prof. Olikoye Ransomikuts (1987) former Nigerian health minister, stated that the state government owned hospitals are engulfed in management, practice problems ineffective use of available resources and nonchalance attitude to the need of accountability.
        There is the deadly virus of fake drugs a phenomenon which drained the pocket of patients before sending them to their untimely death. The drug revolving fund designed to halt the part problem of drug shortage in Park-Lane General Hospital, have run into a lich, while the proposed health insurance scheme remains at least proposal because of all those problems. Most affluent Nigeria prefer to seek medical treatment abroad and those who cannot afford to go abroad patronize the private hospitals.
        In Enugu state, hospital management board is self accounting.
This is not withstanding, its activities are supervised by the ministry of health. It has a board of directors charged with the responsibilities of policy formulation, appointment, deployment and discipline. The director of health service/chief executive acts as a linch-pin between the board and the operational heads of the various department/units concern of the hospital management organizational, structure including the zonal medical directors who head the medical zonals at the Park-Lane General Hospital.
        Furthermore, it should be noted that at the zonal levels, in which its activities are usually co-ordinated under the leadership of zonal medical director, a case of Park-Lane General Hospital Enugu and many others like wise, the zonal medical director is often overloaded with administrative and clinical responsibilities, resulting in more emphasis on short-term planning with detail forecast of the likely near future that can permits the organizational survival. In fact, the authority, responsibility and level of accountability, relationship seems to be poorly defined, when considering the state of our Park-Lane General Hospital as analyzed above, from its world view out look, hence the researcher intention to use this study is to identify those problematic areas and prescribe recommendations.
1.3    OBJECTIVE OF THE STUDY
          Health care delivery is one of the fundamental functions of the government. It is aimed at promoting the general welfare of the people toward economic development of the nation as contained in article 25 of the universal declaration of human right for its importance the world health organization (WHO) as a matter of necessity, in October 1996 required every government of each country to allocate minimum of 5% of its annual budget to its health status of the citizens.
        However, it is unfortunate to note that despite the fact government at all levels has made provision for health, care delivery programmes at even a level higher than the minimum requirement, the nations health care services continue to deteriorate.
        In the lights of the above, the question that readily calls to mind is “where do we go from here”? what is the likely hope of the state of Nigerian health in the near future? What impact could, the situation therein will have on our economy”? an attempt to find out the cause of our state government owned hospital predicaments in Enugu state in general and that of the Park-Lane General Hospital Enugu in particular and to seek for solution for the above raised questions, calls for probing into the management effectiveness and operational efficiency in our Park-Lane General Hospital open, with a view to find a lasting solution to them, for the benefits of all.
i.      To review the organizational structure, and authority relations in Park Lane General Hospital.
ii.      Examine the organizational structure of Park-Lane General Hospital, hospitals management Board specially their chain of command, span of control of managers authority, responsibility, and accountability equation.
iii.     To ascertain if there is any political intervention in the management of Park-Lane General Hospital/or conflict) and determine of it affects the effectiveness and efficiency of their smooth operations.
iv.     To examine the line and staff function in relation to efficiency and effectiveness so as to identify conflict or co-operative areas.
1.4    RESEARCH QUESTIONS
i.      What causes managerial problem over centralization of authority and power in the state management board.
ii.      Does lack or shortage of facilities and poor quality care, deter patients from attending the state government owned hospital.
iii.     What renders management ineffective in the state government hospitals?
1.5    HYPOTHESIS FORMULATION
Ho1:  Over-centralization of authority and power with the state government hospitals, management board does cause managerial.
Ho2:  Over-centralization of authority and power with the state government hospitals, management board do cause managerial.
Hi1:   Lack or shortage of facilities and poor quality, care does deter patients from attending the state government owned hospital.
Hi2:   Lack or shortage of facilities and poor quality, care deter patients from attending the state government owned hospital.
Ho3:  Wide span of management and administrative over load does renders management ineffective in the state government hospitals.
Ho3:  Wide span of management and administrative over load renders management ineffective in the state government hospitals.
 1.6    SIGNIFICANCE OF THE STUDY
i.      Through this study, the researcher intends to either vindicate or disprove public confidence or lack of it in Park-Lane General Hospital.
ii.      This study will attempt to provide a useful way of looking at the Park-Lane General Hospital, as well as to identify the core cause of mismanagement inefficiency and ineffectiveness in Park-Lane General Hospital.
iii.     By being aware of the managerial problems and the possible solutions as will be revealed through the study.
iv.     This study will enable me contribute to knowledge in hospital administration.
v.     This study will serve as a reference point to other student of business studies who may wish to carry out further research, in the field of hospital management.
1.7    SCOPE OF THE STUDY
        This project work concentrated on management problems in state government owned hospital in Enugu and it lasted within 2009.
1.9    DEFINITION OF TERMS
i.       Virus: This is a virus poisonous elements smaller than bacteria causing the spread of infectious diseases.
ii.      Drug: This is substance used for medical purposes, either slone or in a mixture.
iii.     Linch-Pin: It means iron pin passed through the end of an axle to keep the wheel in position.
iv.     Theatre: It is a room where surgical operations are performed.
v.      Patient: A patient is a person that is on a doctor’s list for medical treatment.
vi.     WHO: World Health Organization
vii.    PTF: Petroleum Trust Fund
viii.   First Aid: Is an immediate treatment given to an injured person before taken him or her to the hospital.
ix.     Casualty Unit: This is where the people that are killed in war or seriously injured in an accident are kept.
x.      Disinfectant: This is used to make free from infection by bacteria.