Look at government in any country and you will find varying departments. Not all citizens of a nation can be completely satisfied but the majority of people will show some compliant towards their healthcare system, more than any other government department. Some healthcare system do succeed but it is safe to say that many fail. There are three different ways of a healthcare system being deemed a failure:
- Rationality-Reality Gaps: these arise from the formal, logical planning of the healthcare system, which is not inclined to match the way the system will actually be ran.
- Private-Public Sector Gaps: often called the 2-tier system. These happen when private healthcare systems try and adopt the way a public sector healthcare system is planned.
- Country Gaps: this happens when one country will adopt the healthcare system used in a different country. Although this may seem good in theory it rarely works as what is effective in one place may not be what is wanted or needed in another.
Not only is there differing types of failure but also varying degrees of failure:
- A total failure: this is where a system will completely fail. It can fail before being implemented or it can be installed but abandoned almost immediately. A high profile example of this would be the London Ambulance Service, who implemented a new dispatch system. However, the system failed within hours, leaving ambulances unable to tend to patients.
- A partial failure: this is when it only fails in one particular aspect. This is common in systems which are installed successfully but are either over budget and behind time.
- A sustainability failure: this is when a system works for a period of time but fails afterwards. These are often systems which have partial failures within them and are never fully used to all capacity.
- A replication failure: this is when a system works wonderfully in one location (generally the pilot location) but cannot be replicated elsewhere and therefore cannot be implemented fully. We often hear about the success of the pilot but not of the failure which occurs afterwards.
As can be seen different systems are prone to failure, and that there is not just a “one-size fits all” attitude to failure but it comes in many forms.