Defining governance for pharmaceuticals and healthcare

Sep 30, 2012 by Tim Sandle
 Reason and Science

Growing Rich-Poor Divide Threatens Child Health in Asia-Pacific.
Governance is an important concept for business and healthcare. Listed below are various definitions of governance applicable to different settings. I have compiled these for interests and by way of education. Some of the definitions are applicable to medical, pharmaceutical and healthcare settings.
1. United Nations:
“ the process of decision-making and the process by which decisions are implemented (or not implemented. Governance can be used in several contexts such as corporate governance, international governance, national governance and local governance.”
Source: United Nations Economic and Social Commission for Asia and the Pacific
2. World Bank:
" the exercise of political authority and the use of institutional resources to manage society's problems and affairs."
Source: World Bank
3. Clinical governance:
" a system for improving the standard of clinical practice... Existing activities such as clinical audit, education and training, research and development, and risk management (including complaints) will become part of clinical governance, and it is their resources that will fund it."
Source: Evidence Based Medicine
"Clinical governance is the framework through which all the components of quality, including patient and public involvement, are brought together and placed high on the agenda of each organization."
" Clinical governance is about ensuring that patients are safe and risks are managed."
Source: NHS Scotland
4. Corporate governance:
"How a company is managed, in terms of the institutional systems and protocols meant to ensure accountability and sound ethics. The concept encompasses a variety of issues, including disclosure of information to shareholders and board members, remuneration of senior executives, potential conflicts of interest among managers and directors, supervisory structures, etc"
Source: Financial Times
"The corporate governance framework should promote transparent and efficient markets, be consistent with the rule of law and clearly articulate the division of responsibilities among different supervisory, regulatory and enforcement authorities. In addition:
• The corporate governance framework should be developed with a view to its impact on overall economic performance, market integrity and the incentives it creates for market participants and the promotion of transparent and efficient markets
• The legal and regulatory requirements that affect corporate governance practices in a jurisdiction should be consistent with the rule of law, transparent and enforceable
• The division of responsibilities among different authorities in a jurisdiction should be clearly articulated and ensure that the public interest is served
• Supervisory, regulatory and enforcement authorities should have the authority, integrity and resources to fulfill their duties in a professional and objective manner."
Source: OECD Principles of Corporate Governance 2004
5. Medical governance:
"Medical governance is required to ensure that a medical service remains health-effective and delivers services first and foremost to the public rather than to its providers. This model of participative medical governance specifies a robust system by which the public can ensure that information on health-effectiveness is used to ensure quality of service and it relies on the public's participation at all gradations of service, from the patient and the family caring for the patient all the way out to national policy, in a horizontal framework. Importantly, this model provides the means by which to identify at an early stage the points where intervention is necessary with poorly performing clinicians and administrators, so as to protect the public's health and prevent malpractice."
Source: Tuke Institute
6. Pharmaceutical:
" a concept which is increasing in both scope and importance. We know that there is mounting emphasis on patient safety, and on proactive safety management. We also understand that with emerging market operations growing, so too is the globalization of safety standards. With growing regulator and public scrutiny of company performance and enhanced punitive actions, Medical Governance really is at the forefront of the life sciences industry. Organizations must control and proactively manage medical issues to ensure that the patient and the brand are protected. It is also vital that an organization has oversight of local operations, whilst also ensuring consistent global medical standards are applied. Medical issues must be addressed before they come to the attention of the regulators and the general public."
Source: WCI Group
7. Information:
"Information Governance ensures necessary safeguards for, and appropriate use of, patient and personal information."
Source: National Health Service
8. Business:
"The system by which an organization is directed and controlled, at its most senior levels, in order to achieve its objectives and meet the necessary standards of accountability and probity."
Source: The Cadbury Report
9. NHS:
" The systems and processes by which health bodies lead, direct and control their functions, in order to achieve organizational objectives and by which they relate to their partners and wider community."
As quoted by the Audit Commission , Corporate Governance in Health Organizations, 2002
Source: Audit Commission
10. Integrated governance
"Systems, processes and behaviors by which trusts lead, direct and control their functions in order to achieve organizational objectives, safety and quality of service and in which they relate to patients and carers, the wider community and partner organizations"
Source: Department of Health - Integrated Governance Handbook