Conflict & Negotiation Advice
Word count – 2000 words
CONTEXT
Assessment 1 (Part B) requires a review of a set of facts and for you to prepare an advice to the Hospital CEO. To prepare for this assessment, you will need to review the negotiation-related e-readings, and reflect on the material and exercises presented during the program.
This will provide you with the information required to understand the purpose, nuances and principles of negotiations within health care.
Read the following short negotiation scenario. After reading provide a structured negotiation preparation advice.
Scenario Information
Hinchcliff Hospital is a 50-bed hospital servicing a rural town. It is well equipped for routine inpatient care and has an accident and emergency department which is open 24 hours a day, 7 days a week. The more serious and complex patients are transferred to the city, approximately 150 km away.
Until 15 years ago, Hinchcliff Hospital was in the middle of a growing rural community. However, a series of droughts and a downturn in agricultural prices has resulted in many people leaving the area. The community is now largely made up of low-income families, which includes a traditional indigenous community. Also, the age structure of the surrounding population has changed as most young people cannot find work and have moved to the city. As a result, the clientele of the hospital is ageing.
One other factor is affecting the demand on the hospital. There is only limited access to bulk billed general practice consultations, as there are only 4 General Practitioners (GPs) in the town and one of them is about to retire. As a result, many people in the community are going to the hospital instead of their local GPs for what are essentially GP consultation because there is no out-of-pocket expense if these consultations are done in the hospital. The hospital, through its emergency department, has now become the main source of medical care for residents who cannot afford, or cannot wait for, basic medical care.
Like most rural hospitals, Hinchcliff Hospital is facing financial difficulties. Because of the location of the hospital and the challenges in the town, it has become increasingly difficult to attract new medical practitioners of all types and harder to retain existing staff.
Although the hospital CEO is somewhat sympathetic to the medical care problems of the community, she sees her first priority as spending the hospital’s scarce funds in the most efficient way possible. Therefore, she has recommended to the head of the Local Health District that the hospital’s accident and emergency department should be closed and patients should drive 30 km to the hospital in the nearby town. The money saved would then be diverted into expanding the aged care facilities in the hospital.
Residents in the town have organised a Hinchcliff Hospital Action Group (HHAG). They are very concerned that given the hospital is the health and wellness hub of the town, it should not close its accident and emergency department, as people without transport will not be able to travel to the nearby town.
In addition, they do not support the plans for more aged care facilities as they are fearful that this will mean the hospital’s inpatient services will be closed in the future and also moved to the nearby town. The hospital CEO has suggested that there would be more patient transport provided by the hospital to resolve this situation.
Also, she has pointed out that operating the accident and emergency (A&E) department 24 hours a day and 7 days a week is extremely costly – particularly as very few people attend that department between 9pm and 7am.
Over the past six months the average number of people attending A&E during these hours was six (which included patients with alcohol related issues (mostly on weekends) and on some weeknights no one attended A&E at all). She also pointed out that more aged care facilities are needed given the age structure of the local community and these facilities will be more highly used by the community.
The HHAG has sent three letters to the CEO expressing their concerns about the future of the hospital. Their letters have been acknowledged but they do not believe that the CEO has taken their concerns seriously, and they have requested that she meet with them to discuss how the community and the hospital could work together. There is no person on the HHAG representing the indigenous community.
Three days ago, the CEO and the head of the Local Health District announced plans to extend the hospital and build 30 aged care beds. On learning of the plans, the leaders and members of the HHAG were so angry that they decided to organise a letter writing campaign to their local members of State and Federal Parliament.
This letter was also sent to the Hospital’s CEO. The leader of the HHAG is good friends with both these politicians. The CEO did not grow up in the town and has only met these politicians on a couple of occasions.
In this letter the HHAG have made the following demands.
That the accident and emergency department remain open, but perhaps not for 24 hours a day.
That local GPs should be approached to see whether they will operate an after-hours emergency service.
Money should not be spent on the new aged care beds, but rather a community health centre be established to promote wellness programs in the town. A recent survey found that people in the town were overweight and there were well known issues with drugs and alcohol.
That the head of the Local Health District be replaced with a person chosen by the community.
The hospital CEO has openly indicated that she would meet with representatives of the HHAG to discuss the matters raised in their letter. However, since she is time poor, she has requested you as the Hospital Corporate Manager (you manage finances, HR, administration and community relations) to provide an advice on possible discussions and direction with relevant parties.
Advice
In preparing your advice, you should carefully consider the material covered during the program including the seven-element framework.
