Motivation and incentives

Some people associate the private sector with strong incentives, and weak incentives with the public sector. A common belief is that in the private sector, there’s a strong relationship between people’s pay and their productivity, that staff are quickly rewarded for doing good work, and that there is good measurement of productivity. Similarly, people may perceive the public sector as failing to respond to health worker effort with reward, and promoting staff on the basis of length of service rather than their performance.

This view of health sectors tends to describe health workers in the public system as unproductive, unmotivated and inefficient, whereas health workers in the private sector are described as hardworking, motivated and efficient.

What’s your view? Does this match your experience? Please comment below on how you see the incentives and performance in the public and private health sectors in your country.

In my view, we do find examples of these stereotypes in real life, but we also find their opposites. Especially, we often find dynamic and motivated individuals in the public sector, but we can also find private sector health workers who are not motivated to provide a good quality service.

It’s worth considering whether the motivational theories can explain this, and whether the incentives actually influencing health workers are the same as the ones we might predict from our knowledge of private and public sector working conditions. For example, it could be that dynamic and motivated public employees are strongly motivated by purposive incentives which overcome disincentives in other areas, such as a lower salary. Or it could be that the public sector is not as bad at rewarding performance as it’s made out to be. Perhaps, for example, the ability and hard work of staff is recognised by promotions in the public sector.