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Queensland Health Case Study


This paper provides a critical analysis of power and Decision making at Queensland Health. This research paper first provides an overview of power and decision making in organizations. The concept of power is demystified i.e. the negative connotations associated with the word are discussed and dispelled.

The paper then looks critically into the exercise of power in the Queensland Health case and how the same influences or directs decision making. Based on the analysis, recommendations are made in terms of how to improve power structure in the organization thus improve decision making efficiency and effectiveness.

Power in Organizations

In often cases, the mention of the word ‘power’ makes individuals think dictatorship, bullying, cruelty, manipulation, lording over others and general unjustified social inequality. It is latently believed or subconsciously held, in many cultures around the world, that power makes individuals exploit, mistreat malign and even enslave others (Clegg et al, 2006, p. 40). It is for this reason that many find the saying “power corrupts but absolute power corrupts absolutely” to be an unchallengeable truth.

However, on thinking about it, it should occur to individuals that power in itself is an admirable thing or quality. Each individual has some form of power or capacity within himself (Thomas, 2003, p. 7). Power in itself is not a negative word. The word refers to or is synonymous to authority, influence, clout and control.

Having power over others does not mean having lee way to coerce, manipulate and dominate. In the real sense, power only means one has capacity, a talent, a skill, knowledge that others can rely on. Therefore, the individual can provide direction or influence others positively towards a goal.

The basic roles of managers in an organization are planning, controlling, organizing or coordination and directing or supervising operations (DuBrin, 2008, p 112). Managers rely on different management skills to instate plans, control measures, organizational structures and directions that are accommodative of all. The control measures are very vital as they reinforce a power balance in the organization.

Organizations cannot survive without control. Control, which is one of the fundamental functions of management, ensures everything in an organization is done in an orderly way. It is only through managing power in organizations that control is achieved. Proper management of power in organizations means that each employee understands his or her position in the organization. Therefore, power distribution largely depends on the organizational structure.

The organizational structure adopted by an organization is largely dependent on what the management believes about employees. Traditionally, scientific managers focused on providing controlled measures to maximize output (Koontz & Weihrich, 2006, p. 13). They focused on time and motion studies so as to discern the best combinations that would get the best out of the employee.

In management these days, managers focus more on building the right teams and power is more decentralized (Kurtz, 2008, p. 125). Decentralization of power stems from realization that no one holds monopoly over thinking. Secondly, the influence of situational and relativist theorists has led to the understanding that there is no one solution that can fix management or organizational problems always or everywhere.

Decision Making In Organizations

Given power is decentralized in modern organizations, so is the decision making process (DuBrin, 2008, p. 11). Traditionally, decisions were made by a few top officials and implemented by the rest of the employees. Although strategic planning remains the preserve of top management, the role of management is more of facilitative one (Woodall & Winstanley, 1998, p. 41). Decision making has been decentralized and team or group decision making processes are the norm in modern organizations.

In an organization, there are decisions made by individuals while some decisions are dependent on consultative efforts within groups or teams. Group decisions, in an organization, are often very advantageous. When a group of workers make a decision by themselves, they are more likely to commit themselves to the decision than when an individual makes a decision for the group (Parnes, 1986, p. 6).

Awesome results are registered in a group after a group decision because all members understand the course of action to be taken. Group decisions also benefit from the diverse strengths of the members and are more likely to be better informed than individual decisions. Consequently, due to the diversity, perspectives on issues by the different members are broadened leading to discarding of biased positions (Parnes, 1986, p. 12).

Whichever the case, individual or group, decisions are only validated by power or mandate of the decision makers (Müller & Kieser, 2003, p. 56). Therefore, well functioning organizations are clear on what kind of decisions each level of employees can make. Employees are clear about reporting structures and information flow is streamlined. If roles and reporting structure is confused, power imbalances become an issue or a problem and generate into conflicts among employees.

Queensland Case Crisis

Queensland Health is a governmental body in Queensland charged with providing or ensuring delivery of public health care in Queensland. From the report by the review team, a number of problems bedevil the health body. What comes out clearly, from the report, is that improper use of power and poor decision making are a key contributor to the woes in the body. Due to power related problems, the otherwise dedicated staff finds itself unable to function optimally.

According to the review, Queensland Health has a hierarchical organizational structure. In a hierarchical structure power tends to be concentrated at the top. In a hierarchical organization, one entity sits supreme over all others and others follow in supremacy, layer after layer until the lowest cadre of subordinates (DuBrin, 2008, p. 24).

Power in such organizations is distributed depending on level at which one is. Individuals have close to absolute power over subordinates and relations are much formalized. In hierarchical organizations power is given by position as opposed to individual charisma or capacity.

These kinds of organizations are much bureaucratized. Communication in a bureaucratized or hierarchical structure follows a stipulated line i.e. one can not communicate with any other officer without passing through his or her immediate up line manager, supervisor or boss.

As the review team found out, due to bureaucracy and red tapism, decision making is affected. Decision making is centralized i.e. only topmost organ makes decisions or ratifies action. A healthy system ought to be flexible and responsive to situations as they arise. However, due to hierarchy, the junior employees, who are in touch with situations can not make any decisions and have to wait long to get responses; communication goes through bureaucratic steps to reach top management or right department for decision to be made.

Secondly, position power given by hierarchy unless it is supported by personal charisma, knowledge and skills is counter productive (Clegg et al, 2006, 346). As reported by the review, staff is resentful towards seniors because they are bullies. This implies that the seniors influence merely by formal or position rather than by personal excellence.

When subordinates go to seniors in need of necessary facilitation, they meet with insensitivity. This augments the idea that real power is personal power and position power should be reflective of personal power. For example, if the seniors have more expertise, they should be able to guide their subordinates rather than using their positions to intimidate.

Power is understood very negatively by seniors in Queensland Health. It is reported that the organizational culture is characterized by intimidation, bullying and secrecy. Bullying and intimidation imply seeing power as license to coerce and sort of exploit others. Secrecy implies lack of openness and trust.

Secrecy in a public institution is only but an indicator of malpractice. Hiding information in secrecy is a way of gaining illegitimate power over others i.e. continuing to control them because they do not know the whole truth. Decision making is only possible or made easier when one has access to information (Kurtz, 2008, p. 99). Secrecy or hiding information in Queensland Health only points to wrong decisions being made over and over again.

There is a great advantage in decentralizing processes. Problem solving should be the concern of each employee rather than remaining the preserve of top management or seniors. The review team found out that in Queensland Health, the leaders and managers had cases they could not solve.

However, instead of involving the rest of staff in search of appropriate solution, they sat on the problems. This results from fear that by engaging junior level employees, they get empowered. What is clear in this case is lack of appreciation of individual capacity. People are appraised based on level in employment and senior management’s whims. Lack of other staff participation in problem solving does not favor organizational growth and development


There is need to change the management philosophy embraced by Queensland Health. It is clear that all the aspects of the organization need revamping. However, management has to rethink its position in the organization. From reading the review report, management at Queensland seems to be concerned about personal safety and perpetuation at the expense of organizational goals.

Management has to learn to put the organization above personal interests. Therefore, rather than power being vested in individuals, power should be vested in organizational transactions. If such a shift in philosophy is achieved, focus moves from who makes decisions to what kind of decisions can be made under given circumstances.

Decentralization of decision making can be very beneficial to the organization. For example, when it comes to finances, each section or department should come up with its own budget. Once ratified by top management, they should be able to manage their own finances. Decentralizing decision making and empowering junior employees will boost morale but also help towards quality processes in the organization.

Finally, I recommend re-training of all the senior employees at Queensland Health. The training should focus on organizational dynamics and new management perspectives. If they got exposed to new management theories and perspectives, they are likely to appreciate why they need to adopt new models of management. As Thomas (2003, p. 112) urges, wisdom consists in humility to learn. By adopting new management models, they will appreciate why treating junior positively is more productive than being negative.

They will also appreciate why employing teams in problem solving is more beneficial than relying on expertise of top manager. As Clegg et al (2006, 364) point out, social order is changing and has changed. Companies have to reflect reality in society. If perspectives can change in the way, especially managers and supervisors at Queensland Health, look at the organization and fellow employees, the organizational culture will change leading to customer delight.


Clegg, S., Courpasson, D., & Phillips, N 2006, Power and Organizations, SAGE, London

DuBrin, A., J 2008, Essentials of Management, 8th Ed., Cengage Learning, London

Koontz, H., & Weihrich, H 2006, Essentials of Management, 7th Ed. Tata McGraw-Hill: Delhi

Kurtz, D., L 2008, Contemporary Marketing, 13th Ed., Cengage Learning: New York

Müller, A., P., & Kieser, A 2003, Communication In Organizations: Structures And Practices, P. Lang, New York.

Parnes, M 1986, Innovations in Social Group Work: Feedback from Practice to: Proceedings of the Annual Group Work Symposium. Routledge: New York

Thomas, K., J 2003, Personal Power, Kessinger Publishing, New York

Woodall, J. & Winstanley, D 1998, Management Development: Strategy and Practice, Wiley-Blackwell: New Jersey

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