Accountability is the administrative act by which the managers of public service justify and are responsible for the implementation of the resources made available in a fiscal year. It is the obligation to inform certain people that the law determines, for all the history, facts and results of operation or administration conducted in accordance with the entries in the books of who pays and accompanied the respective vouchers.
The transparency of management in public entities has been and remains a constant demand of citizens. Public managers are accountable for their management in a clear, appropriate and timely way in the exercise of the responsibilities they have. To facilitate the achievement of this unstable balance between what citizens demand and accountability demonstration by managers needs some drastic measures.
Public service governance has been traditionally seen as the crucial interaction between three different areas: the public sector, the civil society and private sector (Schedler & Proeller, 2000). However, these domains are incrementally looking for new ways of interaction, by forming a new paradigm of governance in which such interactions are invigorated as more innovative and efficient.
Accountability in Public Service Organizations
Since the 80s, the accountability of the public administration plays an important role in government policies in several countries (Hood, 1991). If consensus was made about the accountability of the public administration, the debate on implementation process is not yet closed. The phenomenon of accountability was considered as means to address the failure of the management of public administration; but now the opinion has changed. The goal of implementing proper accountability is to improve the performance of public administration companies (Kaufmann, 1999).
The traditional view is that in public administration companies, the control is not impaired at the outset, but it becomes in a cycle. In other words, it is not the government control which leads to better performance, but rather the modes associated with leadership and modern management practices that meet environmental requirements. In fact, the performance of state institutions depends more on management teams who run them. However, the public administration suffers from two decades of ineffective actions.
This inefficiency is due to lack of vision, incompetence, irresponsibility and rigidity of some leaders of public administration. Thus, all attempts to change faced more resistance from the top of the base. With the shift change at the head of some departments or state agencies, the performance would necessarily fluctuate. The idea is not just to change the leadership but rather to change the way we see the practical and technical management, organizational structure etc. by borrowing successful modern methods from private sector (Christensen & Laegreid, 2001).
Currently, in order to balance performance and government policy, public administration is able to rethink its objectives in the light of new logics introduced by accountability measures. However, the success of the latter depends on the process of its inception (design and conduct). In fact, the way to deal with implementation of accountability could be behind the success or failure of the organization. The goal is to derive an integrated model of strategic change management that will serve as a reference model. It is a dynamic model which will be adjusted for many public administration companies (Anderson & Anderson, 2001).
National Health Service (NHS) of UK
The NHS - Public Health Service of UK - was established in 1948, as a pillar of the welfare state, set up by the Labour government after the war. It was during the Second World War that the national coalition government has formed a commission under the supervision of the academic economist William Beveridge to review medical and social insurance systems that existed in the country. The Beveridge Report recommended the establishment of national systems for social and medical coverage for all citizens "from the cradle to the grave" (Gorsky, 2008).
At first, the new National Health Service (NHS) was completely free for all medical coverage. Lump sum contributions paid by all those who worked (called National Insurance contributions) were supposed to essentially contribute to the financing of social benefits, and very little health financing. The health service is funded directly from the general budget of the state. Britain was the first country in the world to offer its citizens a kind of totally free public health service which was open for all.
However, even directly funded by the state, the system has from the start been more expensive than expected, and it took three years to the Labour government to undermine the principle of ‘totally free’. In 1952, the new Conservative government introduced the first prescription charge per package or envelope on prescribed medication. The visit to the doctor, and hospital care, were left free, but for other services citizens have to pay partially (Gorsky, 2008). Overall, this remains the situation today. Hospitalization and general visits to the doctor are free but drug, dental or ophthalmic are paid - to varying degrees - by the patient.
Like all systems of public health, the National Health Service has seen its costs explode over the years, because of growing aging population of the UK and the development of new drugs and treatment forms much more expensive than those available in 1948. All governments, Labor or Conservative, have tried to control the costs of the system, while maintaining or improving the quality of service, but the problem of financing the system is still relevant.
The first major overhaul of the system took place under Margaret Thatcher. Considering the high cost of national service was, at least, partially due to its poor management and lack of business sense by officials and system managers. Thatcher government has prompted reforms by establishing a decentralized administration of hospital services and an internal market put competing service providers. Forced to meet financial limits, NHS trusts or regional hospital services were often limited their activities rather than depending on patient demand, in light of budgetary constraints (Gorsky, 2008).
Since 1997, government has made efforts for strengthening the NHS by focusing on policy and promising return on the commodification of service. A budget increase made possible by sound public finances has further reduced waiting lists. But the operating costs of the service remained very high, and the government was unable to reverse, the competition between medical providers, who had reduced service costs, and Labour governments who do not wish to increase again.
In 2010, the coalition government, Conservative-Lib-Dem was committed to further improving the system by introducing more accountability which ultimately led to reduced operating costs. The Health and Social Care Act 2012 provides for the abolition of NHS Trusts and regional authorities, and the transfer of the management of regional resources for hospital doctors themselves. The new system is intended to make significant savings in terms of administrative staff. The new proposals are very controversial, some seeing a fundamental shift in the nature of the service or partially privatizing it.
Accountability in National Health Services
In the UK, the strong involvement of charities in public service has been widely encouraged by the British government through a three-year action plan (Partnership in Public Services), submitted in December 2006 and includes 18 actions to improve the relations between public authorities and charities in charge of the management of a public service. This has not only enhanced the accountability of NHS but also evaluate legal, management or financial risks. The establishment of an evaluation of these risks is indeed developed the checks carried out by the regional chambers of accounts, giving rise to adverse observation reports.
The main methodology of this risk analysis was developed in close collaboration between the local communities and the state. A working group comprising representatives of the State and local government has developed a guide whose recommendations include developing a map to better assess the risks, especially financial and legal risks, in order to improve the targeting of controls (Gruening, 2001). The development of these mapping has enabled local communities to have engaged in this process of acquiring detailed knowledge of the working of private sector companies and introduced the same efficient and accountable structure in NHS also.
The implementation of accountability structure in NHS combined a radical change setting of establishment of an "internal market", which is mainly financed by taxation. The introduction of incentives and market sanctions was allowed for the initiators of the reform to improve the level and quality of care while facilitating the transfer of resources from hospital to primary care. The maintenance mode of funding should perpetuate the positive aspects of the old system: equity, accessibility, and "Last but not least" expense control (Scholz, 1997).
Managerial accountability indicates the adoption of essential instruments of accountability by the administration for the economic and social development of the country. It is set up of services which are the basis for the population in the areas of education, health and social services, among others, and build basic infrastructure throughout the territory to facilitate the occupation. However, the aim for administrative reform attempts for better accountability of public sector organizations is to improve performance (effectiveness and efficiency) and the image of the government vis-à-vis its citizens. What interests in this respect is the accountability component insofar as it constitutes a radical change in time. In principle, it is the implementation of the new management philosophy and for the first time adoption of customer-based approach in the public sector.
It is a major change, a modification of long-term goals to the extent it affects several organizational domains. For administrative accountability at NHS, it aim first with the modernization, implementation of new modes, new practices and management techniques borrowed from private sector for the development of customer focus and improved performance, without compromising the political objectives of the state, then it provides coordination between departments within the same ministry and among all departments to encourage communication and promote the integrated management of human resources. Finally, it aims, through this process of accountability, creativity in the administration and management of the initiative at all levels of hierarchy. The goal is to serve the citizens (Punch, 2010).
A number of initiatives have emerged to strengthen the public confidence in organizations using the generosity of the public, following various financial scandals. Among them, the most famous are the "Committee of the Charter” and "Governance and Certification" which help to develop standards on governance, transparency and rigor of management. Public authorities could therefore ask private agencies to whom they entrust the management of a public service to comply with certain rules of governance, whether in their status or their practice, even if it is more difficult to assess. In addition, public authorities should ensure the terms of their self- Participation in management bodies of private organizations.
Thus, the process of implementing accountability is the process of planned change which summarized in three main phases:
1. Diagnosis of the situation and action planning;
2. The execution of the action;
3. Evaluation of the action or process of change (results) (Levesque, Prochaska & Prochaska, 1999)
This is the first phase of implementing accountability that relates to the diagnosis situation, the pilot study and detailed planning. As its name suggests, this is the time when NHS will implement the action plan that is drawn in the design phase. The degree of success will vary depending on the circumstances. Indeed, the implementation is of self-evident importance. Clearly this was no guarantee that the implementation work would be done properly or skilfully.
It is in the interest of the public administration that performance launched the movement of accountability and innovative management. In fact, the performance is conceived as the result of the success of the accountability program. In this respect, it seems obvious to define what is meant by performance.
This concept encompasses both the effectiveness and efficiency. Efficiency equals productivity performance, economy and all ratios results / outcomes and resource / work organization. The effectiveness is equal to relevance of objectives, level of achievement of objectives, usefulness and satisfaction of the medium and long term customer needs.
Hambrick and Mason (1984) divided performance into four components that are profitability, changes in profitability, growth and survival. There are two types of performance measured by one economic productivity ratios and other measured by financial covenants. With the exception of the survival component, it is a purely economic perspective where performance is measured. Indeed, people emphasize on the financial aspect to measure organizational performance because it is linked to the profitability of the company. It assesses if the company reaches its objective, if management is geared towards meeting this objective, if the capital is placed and if the company is financially sound.
However, there are other factors to be taken into account when defining performance, as the goals set by the organization, the social impact of mission of the organization, the acquisition of new methods and techniques of management make the organization more flexible, open and facilitator. Organization reputation, collective effort, the trust, the culture of cooperation and solidarity, humanitarian management, self-assessment, individual learning, etc. are all elements indicating the performance without the logic of the balance sheet or by shareholders' equity. This is what we call performance not measured. There is to note that although we try to quantify the qualitative many individual and social behaviours are beyond the logic of calculation.
In addition, some authors speak of strategic performance identifies the strategic choices made by the organization, the value of an organization and its future (Pollitt & Bouckaert, 2004). The idea is to develop a form of evaluation that integrates the performance elements related to important variables neglected by the measurement of economic performance. Emphasis was placed on quality of product or service rendered and leadership.
Performance can be understood as the realization by someone’s goals, objectives, duties and responsibility to distinguish his potential, his ability, his knowledge and his ability. The performance of the public sector can be related to strengthen the values of the state by strengthening its relations with citizens, in particular, the improvement of the quality of service (Henry, 1999). The emergence of new trends in thinking and innovative lines of action have a growing influence on the performance of organizational power as the new public management that makes modernizing a large factor in improving performance.
The market that is set up by the reform is an "internal" and organized market because the total internal expenditure remains predetermined and controlled, and that sellers and buyers involved in this market are system organs themselves. District Health Authorities (DHA) are the financiers and they have the responsibility for the promotion of the health of the population. They have to identify local health needs, identify priorities, develop prevention and health promotion etc.
Under the reformed and more accountable structure of NHS Volunteers become budget holders ("Fund Holders ") and GPs are also become buyers. The importance of covered population is the minimum requirement for balancing risk. It has significantly limited the scope of care for the general practitioner, the budget holder can buy. It is the cheapest and most common care (ENT, orthopaedic surgery, hernias, varicose veins etc.). Finally last protection is when charges of the patient cross £ 5,000 per year limit in hospital treatment, the additional costs are supported by the district (Gorsky, 2008).
In many cases, if not the vast majority, public entities have had to resort to public borrowing to finance a significant volume of investments. On extent that they have made use of bank loans and credits or the bond issue annually and depending on conditions of each operation, have had to allocate an amount of their income to service the debt, composed the interest expenses (primarily interest) and repayment of principal. The amount of financial burden to be accommodated under the budget of expenses for the year is an important component in the financial risk assessment of the entity.
One of the peculiarities presented by public entities for the analysis of its balance sheet in relation to the private companies, is the reference to its financial structure, embodied both the different sources of funding and proportion between equity and debt capital, as well as the sense that it is attributed to the relationship. The possibilities of using the debt by part of the Public Entities are perfectly covered and bounded on its own jurisdiction, directly affecting their financial structure. Thus, the volume of government expenditures is depending on the income possibilities, and not according to net assets, as this is not a security right to third parties.
In the new and reformed structure of NHS, the reception of GPs to this reform became rather positive. Some GPs, who feared that the contracts award between districts and hospitals reduce their freedom, see in managing their own budget with the possibility of getting more autonomy. GPs also quickly including the management of budget which gave them an important means of pressure on the hospital especially regarding the timing of obtaining the results of examination (Radio, laboratory). It also opened the possibility for them to initiate a dialogue with hospital doctors. To be paid, the hospital must provide results of consultation reports of hospitalization.
Corruption and fraud in public sector companies appears to be an obstacle that the organizations must fight to achieve effective competition, maximizing assistance and funding international growth and faster development (Gordon & Maiko, 2001). However, all the solutions are not good and some may perverse effects. The increase in complexity of standards and rules is a breeding ground for corruption. It is therefore necessary to consider the effectiveness of existing standards, the issue of monitoring and control and the possible solutions for the future, and to search for new tools and to improve existing ones. To effectively fight against the phenomenon of corruption, the first step is to attempt to define the boundaries and limits (Punch, 1996). This is how the fight against corruption has been implemented and on what basis it rests.
To do this, including developing risk maps based on their impact and their occurrence. Accountability and control then helps them provide answers in the form of procedures and best practices, while internal audit examines the effectiveness of internal control. Many functions are involved in risk management at large today and there is a significant issue for public companies to ensure consistency between all the functions involved, also providing the means to measure their performance.
Accountability is the process by which the public company regulates its activities to accomplish its mission, effectiveness and efficiency. Accountability should not be considered as a separate system; instead, it should be recognized as an integral part of any system used by the public managers to guide their operations (Doyle, Ge & McVay, 2007). The establishment of an effective financial accountability involves evaluating the risks the organization faces both from the outside and from within. A prerequisite for risk assessment is formulation, organization, clear objectives and consistency, which are the goals or the desired outcome. Risk assessment is identification and analysis of relevant risk inherent in achieving the objectives (Doyle, Ge & McVay, 2007).
Financial accountability methods should then be developed and implemented to achieve the goals. Similarly, in order to make NHS more efficient and to make its public managers take more ethical decisions, it is necessary that the relevant information must be communicated to them. Monitoring of financial accountability should be to assess the quality of results in time and to ensure that the findings made during audits and other controls are prompt solutions.
Having financial accountability and control is not necessarily needs big, heavy and costly bureaucracy because more the procedures are simple, known and accepted, more it is effective. Stack layers of control or have cumbersome procedures are inherently antithetical to the purpose of internal control, which is a matter of efficiency and performance. Thus, the recipe lies in the right dosage but that is not always easy to achieve. It is to believe that there are good practices everywhere. But this is far from proven. Moreover, the requirements of financial accountability aimed at the sincerity of the image performance than the latter. Financial accountability also does not pretend to make companies more efficient, it seeks to influence the quality of financial reporting.
To date, most internal controls introduced in OECD countries, many of them are based on the principle CoE (comply or explain). According to this principle, listed companies have the possibility to derogate from certain provisions of the code, but if made public and motivate such a decision. The other solution most frequently adopted in OECD countries is to require full information on internal control arrangements in respect of major aspects covered in the national codes.
Internal control is not new to the business. Its implementation before and supervision by laws and standards have, by cons, recently been strengthened, forcing companies to react and organize appropriately. The general trend, leads us to consider that the inclusion of the procedures of internal control as one of the strong elements of corporate governance and ethics in general. The importance of internal control should be, in all likelihood, sustainable over time. The accountability of public sector organizations has reduced costs, increased service quality, increased productivity and a sharp decrease in the number of officials by managing budget surpluses which ultimately reduced the public debt (Dunsire et al., 1988).
Beyond the financial aspects of the devolution of public service, control of public authorities should also aim to measure efficiency of its agencies in the conduct of the missions for which they are responsible. This dimension of control is absolutely essential from the point of view of the users of the public service. The procedures for control now exercised by the state departments of organizations are in fact under the terms of the unsatisfactory services themselves. The checks, which are largely the responsibility of decentralized services, are primarily to ensure that organizations have well fulfilled their regulatory balances disclosure obligations activities and records. The assessment of the financial situation of these public sector organizations is limited accordingly, taking the form of a simple examination of the accounts.
It is necessary that public service organizations realize the importance of transparency of their financial management. The obligations in this area have been strengthened. Thus, organizations that received grants from the administrative authorities of the amount exceeds EUR 153,000 or receiving donations eligible for tax benefits exceeding EUR 153, 000 must have an auditor, establish financial statements including a balance sheet, an income statement and a schedule and ensure publicity of their accounts. In addition, only in the case of organizations receiving donations, the notes to the financial statements must have an account to use funds collected from the public. This tool is particularly useful because it is the only one that can be read and understood by the public. Given its usefulness, the use of account resource could be extended to associations having spent a subsidized public service agreement.
In UK, in the late 1980s, measures were introduced to reduce waste and improve the quality of public services organizations. Thereafter, this has led to the creation of many executive public agencies with specific public service missions. These agencies, including the mode of operation is similar to that of companies, can emancipate public law. They placed a great deal of autonomy in financial matters, in management, Human resources, organizational and production methods to provide citizens better public services at lower cost. Various texts have followed to accompany the reform of the public sector as the Citizen's Charter in 1991 (placing the citizen at central administration), the Deregulation and Contracting Out Act 1994, People Investors program in 1996 or the Modernizing Government White Paper in 1999 encouraging effective and efficient public service, but also fair and diverse.
New legal obligations imposed by different new legislations induce a change in the definition and organization instead of the accountability (Hawkins, 2010). Internal control is of more global ambitions.Following the adoption of the innovative Cadbury Code in the United Kingdom in 1992, the national codes on corporate governance has increased. Estimated that there were already over 50 in the world four years ago (McKinsey, 2004), and there are certainly much more today, since many emerging markets have also adopted codes. Although they are not in the source, the fellowships, sometimes with the authorities of financial markets and investor associations have quickly played a key role in the development codes and recommendations for governance.
The public sector is essentially based on legal rationality while private sector is rather based on managerial rationality. The legal accountability of NHS tends to substitute the latter type of rationality in the classical legal rationality. Thus, the adoption of a more accountable structure in NHS can participate in improving the image sometimes tarnished the public sector.
There are few legal requirements for the governance of public service companies. The only truly binding framework is the recognition of public utility among the conditions of guarantees for the name. These conditions are also reflected in the published model statutes which applicants are invited to comply (Domberger & Hall, 1996). The introduction of provisions relating to governance, nevertheless, raises doubts as to their compatibility with the principle of freedom of organization claimed by the public service companies. However, it is noted that if associations are attached to their freedom of organizational representative bodies, they have taken the initiative to publish governance guides for use by community leaders. Their main recommendations focus on the usefulness of independent directors, clarification of the role and functioning of the Board, the limitation of the duration of directorships and finally the definition of responsibilities within the public organization.
The use of public authorities to the association as an instrument of policy meets multiple needs, including the legitimacy and legality. Coordination between various government entities and / or private will to overcome some public law considered too restrictive or inappropriate in particularly those relating to public accounting and the Staff. The nature of the associations created by the administration itself is variable. The "administrative" associations in the form of associations that are based and directed by authorities or agents of one or more public entities and which are further financed wholly or mainly by public subsidies to ensure activity normally in their duties. Four criteria possible to recognize Administrative organization are: public creation, public composition, public funding public and the public service. This category of administrative associations can oppose the "mixed" reserved for cases in which the presence was planned by private alongside public Persons.
The law, when it entrusts the management of a public service to concerned public authorities, may be the possibility of failure to use an association to provide this service. Importantly, the association created by the administration may be described as transparent. The notion of "transparent organization" was coined to designate the association which cannot be distinguished from the public authority that created it and who, having no real existence, is treated as an abuse of law. Recognition of the transparent nature of the association involves the application of public rules and law on its inner workings: past contracts may be particularly cancelled. The public authority which depends on the association is recognized by the judge as a true counterparty. The use of association may therefore be a source of legal uncertainty, both for the public entity and for its partners and private contractors.
Another aspect of the calibration and competition, both between public structures and private structure for the implementation of public policies, is likely to create a profitable emulation to all users and taxpayers. The competition is, in this sense, a guarantee of efficiency. Task delegation of services to agencies allows increased transparency, clarity and reducing the information asymmetry between politicians and public administration. Requirements are then identified and more reliable actions for better control of public sector companies can be implemented.
It is not correct to believe that all staff is opposed to any introduction of accountability in the public sector. In UK, 59% of public sector employees feel a pressing reform of government operations and public services. Especially, the young employees of public sector organizations are often overqualified and want autonomy, with a rate exceeds 70%. They want the changes in the following areas:
· To better meet the needs of users;
· To make the work more interesting;
· To adapt to technological developments;
· To improve the situation of staff (Pollitt & Bouckaert, 2004).
Moreover, a large majority of them support mobility between public functions, expanding the opening hours, the introduction of a minimum service, the merit pay and a performance culture. Blockages occur when it comes to transfer functions of the State to local governments or the private sector.
The concepts of transparency and accountability have reached an important stage in recent years. Terms have been widespread and have permeated all sectors. In fact, the measures called for by the general public for the business sector in expanding the levels of transparency, self-regulation, control and accountability, have been claimed also for the public sector and NGOs. Social organizations have installed since forever, and as a key element of identity, processes of transparency and accountability. Public Sector companies must understand transparency and accountability, not as an exercise to justify behaviour, but as a staple of exchange aimed at promoting greater participation and involvement of those who are part of the organization. Transparency and accountability are the elements that generate confidence for public sector companies.
The public sector is deemed ineffective, overly bureaucratic, rigid, costly, focused on its own development, not innovative and having a centralized hierarchy too. Therefore, to perfect it is necessary to increase the room for maneuver managers to enable them to respond better at lower cost to citizens' expectations. These latter are now treated as customers (consumerist) while administrators become true managers. This conception of the public sector - and particularly administration, based on the three E "Economy, Efficiency, Efficiency" – is opposite to that of Weber for which the real ideal type of "bureaucracy" is a prerequisite for same efficiency through its rationalist dimension.
In general, public opinion is favorable to public industry changes. The reforms can be well received especially when the country is going through a delicate situation. The ideology barrier that could oppose the implementation of accountability in public sector, the neo-liberal side rejecting the state is not fully founded. For example, the agencies do not lead to a dismantling of the state since they do not have their own legal personality. Moreover, the competition between public and private sectors in the tendering often results in obtaining market by public sector. Finally, the accountability is not synonymous with privatization, even if it is sometimes applied to its name, it is not a requirement.
Accountability in public sector companies is often motivated by the desire to enhance their flexibility, responsiveness and, when in direct contact with the public, their individualized treatment of problematic situations. Indeed, it is very difficult to talk about the accountability, sustainability and efficiency of public administration in a world characterized by many contradictions and inequalities. The adaptation of the public sector to the new challenges of our societies (globalization, new information technologies and communication, standardization, etc.) and increased demands from citizens seems like a necessity. Good governance in this area necessarily implies to take into account the views of all stakeholders to take ownership of reforms and resistance is minimized. Imposed solutions are not viable, the individual and collective interests to be reconciled.