Healthcare Quarterly

Healthcare Quarterly 5(2) December 2001 : 11-11.doi:10.12927/hcq..16524

Survey: Managers and Administrators Still Feeling Hard-Pressed by Governments, Survey Shows

Don Guy


As many readers will be aware, POLLARA conducts the annual Health Care in Canada series of surveys in partnership with a host of healthcare organizations.* This year, for the first time, we surveyed a nationally representative sample of 200 administrators, chosen randomly from the Canadian Healthcare Association database. This quarter's column will report back on some of the key findings of that survey. (I should be upfront about my own personal interest in these findings, as my own dad worked in hospital administration for almost his whole career.)
Like the public, few administrators say that their confidence in the Canadian healthcare system is rising (9%). Instead, 50% say that their confidence is declining. That said, most (68%) indicate that Canadians are receiving quality healthcare, while 27% say that Canadians are not receiving quality healthcare.

The findings in the figure below, which are based on a battery of six prompted questions, may tell more about the state of mind of administrators who are tasked with leading change in the healthcare system than anything else.

The bottom bar suggests that the problem of adequate government funding continues to loom over the work of healthcare administrators. In fact, some 74% disagree with the statement "Governments are providing adequate funding for needed services." Administrators and managers are in sync with the public and other healthcare providers on this issue. More money is needed.

Still, almost everyone (97%, including 80% who strongly agree) believes that better management of the health system is possible, and there is still room for improvement. This suggests that the public is not off-side with administrators when it calls for improved management of the system as one way of dealing with the costs of modern healthcare.

However, there is cause for concern in two related results. A large majority of administrators agree that today's managers are appropriately trained and experienced to manage health organizations and the healthcare system in general. However, of the 79% who agree, just 20% strongly agree. Fully 59% only somewhat agree with this statement, suggesting that many are unsure that the profession is getting the support it needs to cope with the rapidly evolving changes demanded of it.

Perhaps even more disturbing is the next finding. Just 7% strongly agree that there will be enough appropriately trained and experienced managers for our future healthcare system. Some 68% disagree with this statement.

Taken in concert with the other two key findings - a large majority (91%) of respondents feel that a broader range of services will have to be incorporated into the publicly funded healthcare system and that a majority (53%) disagree that governments are appropriately delegating decision-making authority - you have a picture of the box that today's administrators and managers find themselves in. Its four walls are increased demands from stakeholders, funding constraints from governments, lack of sufficient authority to make appropriate decisions, and worries about whether training and experience is sufficient to balance those three challenges.

Consequently, while there has been a great deal of attention in recent years to shortages among primary care providers (and in fact, next quarter's column will focus on this issue), it is clear from these findings that today's managers feel that their profession is in trouble, to the extent that they are worried about whether sufficient numbers will follow them to manage the system of the future.

Administrators and mangers are sending a clear message in these findings: We can do better, and we know that new demands and new services will make doing better imperative, but we need the tools to do the job. Without them, there will be fewer of us in the future.

* Survey sponsors include: Merck Frosst Canada Inc., the Coalition of National Voluntary Organizations, Canadian Healthcare Association, Canadian Medical Association, Canadian Nurses Association, Canadian Homecare Association, Canadian Association for Community Care, Frosst Health Care Foundation.c and fiscal circumstances facing governments since September 11.

About the Author(s)

Don Guy is Senior Vice-President with POLLARA Inc. For questions or comments about this column, or similar matters, he may be contacted at 1-888-POLLARA or


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