Leadership in public health care: the effect of a poorly designed authority system

  • A A Rust
  • J W De Jager


A main objective of this study is to evaluate expressed levels of staff satisfaction regarding specific leadership characteristics at two public hospitals in two South African provinces. Currently, public hospitals in South Africa are highly stressed institutions because of understaffing, management and leadership failures. For example, a lack of effective leadership and management capacity exists; hospital managers are disempowered and frustrated by growing centralised control at provincial level; doctors and nurses have departed for more lucrative positions within the private sector; and there has been a significant reduction of posts for support workers. Frustrations culminated in the most severe strike within the South African public sector (June 2007). It was assumed that the wage dispute was the highlight of a variety of conflicts that have undertones of several other examples of frustrations and unsatisfactory behaviour. These problems and obstacles reflect inappropriate leadership.