Alegato sobre la vigencia de la obra de Ignacio Martín-Baró

Legislation may limit dealing in foreign countries to protect its currency value or dealing with rival countries. It may protect some stakeholder rights by enforcing legislation; e.g. imposing high import duty to protect home industries or by imposing licensing requirements to businesses operating in a particular industry requiring some activities or standards which are pre-requisite to get a license. Special consideration to the problems related to the governance of the relationship must be attended to in their early stages rather than having them build up to an unmanageable stage. However, the possibility of legal constraints on the scope of an outsourcing proposal must be identified at an early stage. In their guide for public private partnership, the efficiency unit of government of Hong Kong (2008) identified the possibility of legal constraints on the scope of an outsourcing proposal must be identified at an early stage, to make sure at the outset that they have all the necessary legal and administrative power and authority to embark on the proposed outsourcing. Defining outsourcing best practices for components of healthcare services is difficult. The most important component in achieving a successful outsourcing relationship is adopting a shared service model or one-time service contract model or require vendors to negotiate the full scope and involvedness of outsourcing ( Power et al.,

2013). Similarly, legal obstacles cannot be avoided in any long term relation similar to JV. This is regardless of the tremendous amount of efforts and commitment in building

50 the venture which require great effort especially during the transition stage. In addition, the needs to be planned for any contingencies and flexibility to achieve business stability and success.

According to Barthélemy and Adsit (2003), in the United States and Europe, there are seven deadly sins of outsourcing: outsourcing services that should stay within the organization, selecting the incorrect outsourcing vendor for the job, writing a poor statement of work for the outsourcing service, disregarding employee concerns about outsourcing, permitting the outsourced service get out of control, neglecting to realize the full costs of outsourcing and failing to strategize an exit procedure before terminating the outsourcing contract. In addition to these areas, clients express dissatisfaction with the nature of the contractual document in terms of the underestimation of time and the skills needed for the management of outsourcing contracts, unrealistic expectations concerning outcomes, the lack of ownership clarity, unsatisfactory delivery of services, uncooperative vendor behaviour, the cost of the service being too high and/or the competitive advantage in the market no longer existing (Kliem, 1999; C. Lee et al., 2007; Robers et al., 2013).

It is important to give emphasis on issues related to the cultural differences which also influence the interpretation of what constitutes a “core governmental function” or a “public asset” as explained by Gordon (1997). Individuals in different countries or either in different areas of the same country may have distinctive views as to what constitutes a core governmental function or a public asset and the extent to which the private sector should be involved with these functions and assets.

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2.7 Summary of the Chapter

In summary, the literature reviewed in this section provides an overview of the current research on the outsourcing concept, how insourcing is addressed, an outline of various reasons for outsourcing, how access to knowledge plays a major role in considering outsourcing in particular in developing countries, how organization views core and non- core business in relation to consideration of outsourcing and what limitations are surrounding outsourcing.

The second half of the chapter concentrated on the practical side of the outsourcing and how it is implemented. More specifically, this research study investigates how the outsourcing decisions are made, what are the possible areas to consider for outsourcing and how challenges impact the success of outsourcing.

The next chapter, will explore the outsourcing approach in the healthcare sector and it is rational for use in healthcare services of the LMIC, which is supported by site visits to various countercoups to explore implementation of the outsourcing in the healthcare system. Also, the following chapter will give a particular review of the previous research on the JV concept and how it can be applied for improvement of healthcare systems. The review will look at how organizations build a successful JV performance, what are the key elements believed constitute a successful joint venture and how commitment to a business venture has been considered a valuable contribution in success of any joint venture. Finally, the review will look closely to the culture difference issue, in particular within developing countries and how it can serve as a positive factor that can contribute to the JV success.

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CHAPTER THREE

THE HEALTHCARE OUTSOURING

AND JOINT VENTURE APPROACH

3.1 Introduction

The previous chapter discussed the current research on the outsourcing concept, how insourcing is addressed, reasons for outsourcing and how access to knowledge plays a major role in considering outsourcing in particular in developing countries. Also discussed was how different organizations view core and none-core businesses in relation to consider outsourcing and an explanation of limitations surrounding outsourcing processes.

This chapter covers specific reviews of literature on the healthcare outsourcing concept and its risks and benefits. In addition, the impact on the quality of the healthcare services and the unique challenges that require particulate attention will be discussed. Also this chapter explores how the increase cost of healthcare services and the lack of qualified resources besides other constrains create an opportunity for outsourcing in developing countries.

Finally, a general overview of JV concept, how organizations can build a successful JV performance and what the key elements are believed to constitute a successful JV will be provided. In addition, a discussion of previous research on how commitment to business ventures has been considered a valuable contribution in the success of any joint venture. There will be a closer look at the culture difference issue in particularly within

53 developing countries and how it could best serve as a positive factor that contributes to the JV success.