Leadership in Healthcare

This article discusses the historical background of leadership in healthcare and its relevance in the modern healthcare industry. It explores the qualities of transformational leadership and how they contribute to effective leadership in healthcare. The article also highlights the need for transformational leadership in the healthcare industry and its potential to bring about positive change.

Leadership in Healthcare
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Introduction
The keystone of the first Labor government's benefits platform, the Social Security Act
overhauled the pension scheme and stretched benefit for kinships, patients, and the jobless. From
the late 19th century, New Zealand had received an acknowledgment as the "world's social lab"
and "a paradise for working men", but this standing was seriously defied by the severe economic
situations of the Great Depression in 1930 (Bryfer and Steward, 2015). Increased joblessness,
unattractive work sites, and queues at soup kitchens surprised may New Zealanders. Labor
emergent the 1935 poll winner in dispute that all New Zealanders had a right to a considerate
living standard. The community was accountable for guaranteeing that individuals were not
overcome by conditions contrary to which they were unable to defend themselves. Labor's final
reaction to the Great Depression was the Social Security Act. The Act integrated the institution
of a free-at-the-point-of-use health structure with a wide variety of wellbeing benefits. It was
funded by a tax additional charge of one shilling in the pound, or 4.9%. Followers envisioned a
system that would defend New Zealanders "from the crib to the grave". This paper discusses the
historical background of the September 14th, 1938 and its impacts on New Zealanders, and
transformational leadership theory and its relevance to healthcare. It further addresses the
qualities of the transformational leadership theory and how and why they are important in the
promotion of effective leadership in contemporary healthcare.
Up until 1938, New Zealand's pensions were limited to the elderly, patients, widows,
miners, and the blind, with a confined scheme of family grants. The Social Security Act brought
about a fresh idea, that each citizen had a right to a rational living standard and that it was
societal accountability to guarantee that its members were protected from the economic issues
which they were unable to defend themselves from. Gauld (2012) denotes that the motivation for

the Social Security Act was the resolve to bring poverty to an end in New Zealand. A widespread
scheme of benefits was therefore put in place encompassing all the major economic threats
which had been the cause of poverty in the past. The 1938 Act had three key objects which are to
alternate for the present scheme of non-contributory pensions in a scheme of financial welfares
to which residents would contribute based on their abilities and from which they could draw
based on their need; to offer a general retirement, and to initiate a general scheme of health care
advantages.
The Act set up a division of State referred to as the Social Security Department under the
supervision of a committee consisting of at most three members to oversee the financial benefits,
while the healthcare benefits were to be managed by the Department of Health. Expenses for
money benefits, medical services, and management was to be funded on the present cost
foundation from the Social Security Fund which gets the output from 7.5% social security
income tax on salaries, wages, and other grants and income from universal taxation (Bruton,
2019).
The Act provides for five universal categories of benefits; pharmaceutical, medical,
maternity, hospital, and supplementary benefits that are considered necessary to guarantee the
active operation of the benefits mentioned before or if not to uphold and endorse public health.
Under the General Medical Services system initiated on November 1st, 1941, a physician is
funded from the Social Security Fund for every consultation at their surgery or at an invalid’s
residence, with extra payments for Sunday and night calls distance charges. A patient may pay
the physician his full usual charge and then claim the correct refund from the Fund or they may
pay the physician the remainder of his charge over the social security reimbursement, the
physician then claims the correct sum from the Fund.

Starting from May 15th, 1939, health services encompassing maternity work, comprising
equally antenatal and postnatal therapy, have been funded for at an approved measure by the
Department of Health, even though formally identified obstetrical experts might charge the
patient extra fee. Mothers might have, free of pay, either communal maternity hospital care or
the provisions of an obstetric nurse in the course of labor and two weeks after delivery
(Fitzgerald, 2004). Each private maternity hospital accepts the conventional rates as partial
payment of their fees. For inpatient, these welfares were established on July 1st, 1939, and for
outpatient therapy on March 1st, 1941. Patients get free inpatient and outpatient therapy in
communal hospitals. For those who organize for therapy in private facilities, the benefits
reimbursements usually cover only part of the fees, the remainder being funded by the patient.
Pharmaceutical benefits were initiated on May 5th, 1941 and offer for the free supply of
drugs and medicines on the recommendation of any enumerated health specialist. The system is
conducted by agreements between individual chemists and the Minister of Health who uphold
the claim with the recommendations which have been signed by the patients as proof of receipt
of the medicine. According to McAroy and Coster (2005), supplementary benefits that were
inaugurated gradually from August 11th, 1941 include physiotherapy treatment, dental benefits,
domestic aid during disability for several reasons of a mother or in cases of unnecessary
sufferings, a free district nursing service, free lab diagnostic services, and free x-ray diagnostic
services in New Zealand.
Transformational leadership is outlined as a course in which members like, and respect
their leader, and are, therefore, inspired to do more than they were initially anticipated to do
(Men, 2004). Hamad (2015) denote that the leadership style involves the leader focused on

determining the necessary reform through motivation and implementing the change alongside the
devoted followers of the group.
Why and How it is Relevant
According to Germain (2017), transformational leadership is of specific relevance to the
healthcare industry. In the modern world of a health care industry with status as being unfeeling
and unfriendly towards patients, a fresh model of leadership is seriously required. Individuals
today are not only irritated with the objective and often severe treatment they receive from
persons in the healthcare industry; they feel like merely a number to healthcare practitioners
rather than a human being. This is not just an issue in patient discernment. A big number of
medical errors are being made nowadays than ever before, and nurses are performing extra hours
and accounting more stress. These many hours and hectic working nursing environments are
having a clear impact on the quality of care patients get, and patients are observing it. Owen
(2014) asserts that transformational leadership is solely what the health care industry requires.
Duygulu and Kublay (2010) point out that in the healthcare industry, nurses are usually
looked upon as the leaders in any healthcare amenity. Nurses are, after all, the ones who are most
educated and trained in the industry, and the ones who conduct tests and do the most complex
work. Thus, it falls to the nurses to look into their styles of leadership and learn to make the
required modifications in order to enhance the morale of their juniors and thereby escalate the
quality of care for the patients (Levine, Muenchen, and Brooks, 2010). And because the nurses
are very busy and lack much time to learn styles of leadership, the healthcare industry has
continued to be run by an outdated hierarchical scheme. This outdated system has caused the
stagnation of the healthcare system while other industries that have restructured their styles of

management and transformed with the times have prospered. Consequently, there is a need for
the adoption of transformational leadership in the healthcare industry.
Transformational leadership is particularly required in the healthcare industry due to the
negative public image and increased cases of patients’ dissatisfaction as pointed out by
Hutchinson and Jackson (2012). Nurses in the healthcare industry are as the nursing setting is
going through a lot of negative media currently, and too much patient discontent with the quality
of care they get. Beck-Tauber (2012) alludes that the individuals who work in the healthcare
industry are going through distress and exhaustion. A lot of these issues are as a result of the lack
of progress in the healthcare industry. The healthcare industry is still stuck in an outdated system
of hierarchy and procedure and correct passages to follow. Its structure is still very unyielding, as
far as its work setting goes. This unyielding scheme is putting too much strain and stress on
workers, and, consequently, the quality of care for patients is suffering.
Transformational leadership may change all the issues mentioned above for the
healthcare industry. Transformational leadership allows nurses, who are usually the leaders in a
healthcare setting, to get closer to their workers on a proficient level, which would result in more
honesty in the place of work (Wells, Peachey, and Walker, 2014). This directness would result in
conversations between employees and physicians as to what everybody involved envisages the
practice to be and what every individual perceives their duty in the practice to be. This
meaningful conversation would result in a calmer environment in the workplace, and this is only
a beginning.
In addition to cultivating a more direct working setting, the application of
transformational leadership in the health care industry is easy. Its adoption is the result of
breaking down the conventional hierarchical structure that has kept nurses detached from their

workers (Berkovich, 2018). In other words, when nursing leaders start showing their workers'
personal consideration and concern, and start appreciating the dissimilarities amongst them,
worker contentment will increase. This will lead to superior allegiance from workers, which in
return will result in nurses being able to give patients bigger confidence and more independence
in taking advantage and dangers in the place of work. This initiative and the possibility being
taken would naturally result in much advancement in the general process of the practice.
According to Effelsberg, Solga, and Gurt (2014), nursing professionals using a transformational
leadership style will be able to communicate a distinct image of the goals of practice, which
workers will be glad to follow, as they will be allowed the space they required to be people in the
functioning of the practice. This results in bigger worker contentment and bigger patient
contentment. This is, definitely, is the major need of the health care industry currently.
Transformational leadership, when used in its true type, has the ability to reform the healthcare
industry for the best.
The four major attributes of transformational leadership are intellectual stimulation,
individual consideration, inspiration and charisma (Zastocki, 2015).
A transformational leader in the healthcare industry trusts their workers and gives them
the space they need to do their work in their personal manner. This is the concept of individual
consideration as a transformational leadership attribute. Each individual has an exceptional and
different manner of getting things done, and what might work perfectly for the lead nurses may
not work very well for a receptionist or nurse. Top, Akdere, and Tarcan (2015) denote that under
traditional modes of getting things done, the nurse would pressure those who worked in their
office to imitate their manner of doing things, from association to time managing to how to
address a patient. By granting workers the independence to do things in the manner that best

suits them, the lead nurse is stimulating bigger productivity, lesser errors, and bigger worker
loyalty. Greater efficiency, minimal errors, and greater employee loyalty are essential in the
contemporary healthcare settings.
A transformational leader in the health care industry would appreciate the labor force at
their institution or office, and would celebrate in the multiplicity there; this multiplicity would
not just be in gender or race, but in the manner of working, modes of learning, and personalities
as well (Sturmberg and Njoroge, 2017). This is the inspirational and charismatic aspects of a
transformational leader. A transformational leader would address all of these things as each adds
something exceptional and significant to the practice. By fostering this attitude, the nurse leader
would normally reach out to and inspire all nursing staff in their distinct efforts at the practice,
thereby encouraging them to do well and to accomplish bigger things than they could have
attained previously.
A transformational leader in the healthcare industry similarly endeavors to eliminate any
perceived obstacles between themselves and workers (Hillen, Pfaff, and Hammer, 2017). This
would imply bringing down outdated hierarchical systems that made the nurse leader unfriendly
or threatening to other nurses. By eliminating these obstacles, the nurse leader will be successful
in making the practice a more hospitable and open place for nursing staff, one in which they may
feel contented articulating themselves, questioning, expounding goals, and seeking assistance if
they require it. Karakitapoglu-Aygun and Gumusluoglu (2013) denote that a practice minus
institutional obstacles between the leader and the workers is a calm, yet more contented and
more operational organization and necessary in contemporary healthcare settings.
A transformational leader in healthcare similarly stimulates innovation and permits their
workers to take risks. Syrek, Apostel, and Antoni, (2013) assert that given the proper conditions

and having the right to try, ordinary individuals will achieve bigger things. In the contemporary
healthcare system, innovation is essential and it necessitates taking risks. The transformational
leader generates these conditions. Minus the freedom to take risks, workers will continue to
perform in similar outdated ways, and this may be harmful to the healthcare industry, particularly
now, when it is in such a dire need for reform. When given the freedom to try out innovations,
workers in the healthcare industry will frequently generate perfect solutions to long-term
problems. Even when a fresh innovation from a worker fails to work out in the scope of the
practice, the transformational leader will encourage the worker who initiated it and direct them in
a direction that might be improved fit for the practice, enabling that worker to come up with
individual details, and giving that worker the independence to try. Settings like these in
contemporary healthcare create the optimum kind of reforms, and the ones that do the maximum
good to the healthcare industry in general (Schopman, Kalishoven, and Boon, 2017).
In conclusion, the Social Security Act of 1938 presented no fresh concept into the New
Zealand mode of life but was a natural advancement towards which the expansion and
association of the nation itself and of its political knowledge and social conscience had been
heading for years. This growing course is consistent and the rate of company accountability
accepted by the individuals should grow harmoniously. It may be anticipated that the social
security program will be stretched and adjusted as conditions allow to meet the varying needs of
the individuals. According to Kranabetter and Niessen (2017), transformational leadership does
good things to the healthcare organization such as reduces worker distress and increases
wellbeing, increases worker confidence in management, improves worker contentment with their
occupations and leader, increases worker dedication to the organization, and increases
organizational performance and client contentment. Leadership is among the very essential

features and need of human life within the nursing environment. From the past ages, some
individuals require somebody who leads and enhances them. Therefore, some individuals lead
others, and the individuals who lead organizations and communities within the clinical
environment have the responsibility of ensuring safety and performance. Such nursing leaders
are very crucial for organizations, patients, and the general community.

References
Beck-Tauber, D. (2012). Transformational Leadership: Exploring its Functionality. University of
St. Gallen, Business Dissertations, 1–141.
Berkovich, I. (2018). Will it sink or will it float. Educational Management Administration &
Leadership, 46(6), 888–907.
Bryder, L., & Stewart, J. (2015). “Some Abstract Socialistic Ideal or Principle”: British
Reactions to New Zealand’s 1938 Social Security Act. Britain & the World, 8(1), 51–75.
Duygulu, S. and Kublay, G. (2010). Transformational leadership training programme for charge
nurses. Journal of Advanced Nursing, 67(3), pp.633-642.
Effelsberg, D., Solga, M., & Gurt, J. (2014). Getting Followers to Transcend Their Self-Interest
for the Benefit of Their Company: Testing a Core Assumption of Transformational
Leadership Theory. Journal of Business & Psychology, 29(1), 131–143.
Fitzgerald, R. (2004). The New Zealand health reforms: dividing the labor of care. Social
Science & Medicine, 58(2), 331.
Gauld, R. (2012). New Zealand’s post-2008 health system reforms: Toward re-centralization of
organizational arrangements. Health Policy, 106(2), 110–113.
Germain, J. (2017). Reflections on Leadership: Theory, Experience, and Practice. Quest
(00336297), 69(2), 169–176.
Hamad, H. (2015). Transformational Leadership Theory: Why Military Leaders are More
Charismatic and Transformational?. International Journal on Leadership, 3(1).

Hillen, H., Pfaff, H., & Hammer, A. (2017). The association between transformational leadership
in German hospitals and the frequency of events reported as perceived by medical
directors. Journal of Risk Research, 20(4), 499–515.
Hutchinson, M. and Jackson, D. (2012). Transformational leadership in nursing: towards a more
critical interpretation. Nursing Inquiry, 20(1), pp.11-22.
Karakitapoglu-Aygun, Z. and Gumusluoglu, L. (2013). The bright and dark sides of leadership:
Transformational vs. non-transformational leadership in a non-Western
context. Leadership, 9(1), pp.107-133.
Kranabetter, C., & Niessen, C. (2017). Managers as role models for health: Moderators of the
relationship of transformational leadership with employee exhaustion and
cynicism. Journal of Occupational Health Psychology, 22(4), 492–502.
Levine, K., Muenchen, R., & Brooks, A. (2010). Measuring Transformational and Charismatic
Leadership: Why isn’t Charisma Measured? Communication Monographs, 77(4), 576–
591.
Men, L. (2014). Why Leadership Matters to Internal Communication: Linking Transformational
Leadership, Symmetrical Communication, and Employee Outcomes. Journal of Public
Relations Research, 26(3), 256–279.
Owen, C. (2014). “Forget everything you have ever learned about art, and start from the
beginning”: Charismatic leadership and art school teaching. Art, Design &
Communication in Higher Education, 13(2), 201–214.
Schopman, L. M., Kalshoven, K., & Boon, C. (2017). When health care workers perceive high-
commitment HRM will they be motivated to continue working in health care? It may
depend on their supervisor and intrinsic motivation. International Journal of Human
Resource Management, 28(4), 657–677.

Sturmberg, J. P., & Njoroge, A. (2017). People-centred health systems, a bottom-up approach:
where theory meets empery. Journal of Evaluation in Clinical Practice, 23(2), 467–473.
Syrek, C. J., Apostel, E., & Antoni, C. H. (2013). Stress in highly demanding IT jobs:
Transformational leadership moderates the impact of time pressure on exhaustion and
work–life balance. Journal of Occupational Health Psychology, 18(3), 252–261.
Top, M., Akdere, M., & Tarcan, M. (2015). Examining transformational leadership, job
satisfaction, organizational commitment and organizational trust in Turkish hospitals:
public servants versus private sector employees. International Journal of Human
Resource Management, 26(9), 1259–1282.
Wells, J. E., Peachey, J. W., & Walker, N. (2014). The Relationship Between Transformational
Leadership, Leader Effectiveness, and Turnover Intentions: Do Subordinate Gender
Differences Exist? Journal of Intercollegiate Sport, 7(1), 64–79.
Zastoki, D. K. (2015). Board Governance: Transformational Approaches Under Healthcare
Reform. Frontiers of Health Services Management, 31(4), 3–17.