Thai Public Health Policy and Decentralization: a Case of Pro-Social Rule Breaking of Thai Local Health Staff

Authors

  • Kobchat Vichieansri Graduate School of Public Administration, National Institute of Development Administration, Bangkok, Thailand. Email: kobchat.vic@stu.nida.ac.th
  • Achakorn Wongpreedee Graduate School of Public Administration, National Institute of Development Administration, Bangkok, Thailand. Email: achakorn@nida.ac.th

Keywords:

Pro-social rule breaking, Public health decentralization, Thai local health staff

Abstract

The study examines the pro-social rule breaking theory to understand the motivation and behavior of Thai local health staff over the rule breaking for local people/patients' benefit. This theory demonstrates why local staff tend to use their discretion to accomplish their jobs for the local people's benefit, although their discretions may contrast with the rules, especially the central administration’s rules and procedures. The factors behind local staff rule-breaking consist of three levels of analysis within the local workplaces: individual, relational, and organizational factors. The research intends to demonstrate the reason behind the use of discretion among Thai local health staff who work in local administration's health facilities for the social benefits of local people as their clients.

The research analysis was from an original questionnaire (n=205; 51.25% response), and the multiple regression model analyzed the relations of all variables. The results of the research analysis demonstrated that pro-social rule breaking behaviors are positive with local health staff conscientiousness and educational background. So, the research suggests that conscientiousness is the only theoretical factor that can convince Thai local health staff to break the rules, while other factors have no significant relationship with pro-social rule breaking behaviors.

Finally, the research suggests policy recommendations for strengthening the human resource development of Thai local health staff by supporting the role of public health unions and associations to protect Thai local health staff’s interest and to control the standardization of discretion and pro-social rule breaking of Thai local health staff.

References

Office of the Decentralization to the Local Government Organization Committee. Decentralization Plan [Phaen pa ti bat karn kam nod khan torn karn kra jai am nat hai kae ong korn pok krong suan thong thin]. In: Committee OotDttLGO, editor. Bangkok: Royal Thai Government Gazette; 2002.

Office of the Decentralization to the Local Government Organization Committee. Decentralization Plan (the Second Edition) [Phaen pa ti bat karn kam nod khan torn karn kra jai am nat hai kae ong korn pok krong suan thong thin cha bap thi 2]. In: Committee OotDttLGO, editor. Bangkok: Royal Thai Government Gazette; 2008.

Sirilak S, Sueasaengthong Y. Public health decentralization [Karn kra jai am nat dan suk ka parb]. In: Ministry of Public Health, editor. Thailand public health profile 2008-2010 [karn sa tha ra na suk thai 2551 - 2553]. Bangkok: The Printing House of the War Veterans Organization of Thailand; 2011. p. 419-38.

Determining Plan and Procedures in Decentralizations to the Local Administrative Organization BE 2542 (1999) [Pra rat cha ban yat kam nod paen lae kan torn karn kra jai am nart hai kae ong korn pok krong suang thong thin por sor 2542], (1999).

Strategy and Planning Division of Ministry of Public Health. Thailand public health profile 2016-2017 [karn sa tha ra na suk thai 2559 - 2560]. Bangkok: Saeng Chan Press; 2017.

Department of Local Administration. The local administration's survey report [Rai ngarn pol karn suk sa kor sang ket nai kran pa ti bat ngan puea perm pra sid ti pab khong ong korn pok krong suan thong thin]. Bangkok: Department of Local Administration 2016.

Borry EL, Henderson AC. Patients, Protocols, and Prosocial Behavior: Rule Breaking in Frontline Health Care. American Review of Public Administration. 2020; 50(1): 45-61. DOI: 10.1177/0275074019862680

Department of Local Administration. The name list of the subdistrict health centers and subdistrict health-promoting hospitals that devolved to the local administrative organizations (23 July 2020) [Rai chue sa tha ni a na mai lae rong pa ya ban song serm suk ka pab tam bon ror por sor tor thi thai on hai kae ong korn pok krong suan thong thin] In: Administration DoL, editor. Bangkok: Department of Local Administration; 2020.

Lipsky M. Street-level bureaucracy: dilemmas of the individual in public service. Updated Edition ed. New York: Russell Sage Foundation; 2010.

Morrison EW. Doing the job well: an investigation of pro-social rule breaking. Journal of Management. 2006; 32(1): 5-28. DOI: 10.1177/0149206305277790

Jenkins-Smith HC, Ripberger JT, Copeland G, Nowlin MC, Hughes T, Fister AL, et al. Quantitative research methods for political science, public policy and public administration (with applications in R). 3rd ed. Norman, Oklahoma: University Libraries, The University of Oklahoma; 2017.

Yamane T. Statistics: an introductory analysis. 3rd ed. New York: Harper and Row; 1973.

Dahling JJ, Chau SL, Mayer DM, Gregory JB. Breaking rules for the right reasons? An investigation of pro-social rule breaking. Journal of Organizational Behavior. 2012; 33(1): 21-42. DOI: 10.1002/job.730

Vadera AK, Pratt MG, Mishra P. Constructive deviance in organizations: integrating and moving forward. Journal of Management 2013; 39(5): 1221-76. DOI: 10.1177/0149206313475816

Fleming CJ. Pro-social rule breaking at the street level: the roles of leaders, peers, and bureaucracy. Public Management Review 2019; 22(3): 1-26. DOI: doi.org/10.1080/14719037.2019.1619817

Fleming CJ. Public employees and workplace rules: determinants of the pro-social and destructive rule breaking of street-level bureaucrats. Raleigh, North Carolina: North Carolina State University; 2016.

Ajzen I, Fishbein M. The Influence of Attitudes on Behavior. In: Albarracin D, Johnson BT, Zanna MP, editors. The handbook of attitudes: Lawrence Erlbaum Associates Publishers; 2005. p. 173-221.

Blau PM. The dynamics of bureaucracy. Chicago: University of Chicago Press; 1955.

Maynard-Moody S, Musheno M. Cops, teachers, counselors: stories from the front lines of public service. Michigan: University of Michigan Press; 2003.

Vardi Y, Weitz E. Misbehavior in organizations: Theory, research, and management. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.; 2004.

Davis KC. Discretionary justice. Baton Rouge: Louisiana State University Press; 1969.

Hupe P, Hill M. Street-level bureaucracy and public accountability. Public Administration. 2007; 85(2): 279-99. DOI: 10.1111/j.1467-9299.2007.00650.x

Mashaw JL. Bureaucratic justice. New Haven: Yale University Press; 1983.

Sambrook S. Discourses of HRD in the NHS. In: Sambrook S, Stewart J, editors. Human resource development in the public sector: the case of health and social care. Abingdon, Oxon: Routledge; 2007.

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Published

2024-04-30