Public accountability in higher education and health: an international perspective

Hospitals and universities in British Columbia (BC), and indeed in Canada generally, face a serious loss of faith in the self-regulatory model of funding and external governance whereby, essentially, they are given resources and the autonomy to use them as they see fit. Generally, the last two decades in Canada have been a period of scarce resources, loss of external confidence, general funding limitations, some additional pressures in the form of increased controls and accountability requirements, but little evidence that hospitals and universities are willing to respond positively to these new pressures. The argument of the paper is that responding to pressures for improved accountability reporting may be the price of preserving autonomy and relative funding levels. An active, cooperative response to external concerns about information will enable hospitals and universities to shape the information agenda to their advantage--at the very least, having it reflect reasonably accurately their circumstances and performance. The paper argues further that hospitals should begin by addressing patient care measures and universities should begin by dealing with measures of teaching performance.