This paper is concerned with competencies and skills that enhance the capacity of health service managers to handle changes that medical technology and other factors have brought about. The paper takes a strategic rather than an all encompassing approach to identify the systemic changes that have taken place in the last decade. Statistical analysis and other information available were used in this process. One of the reasons for this approach is to take a real-world perspective of contemporary health management issues as the underpinning of the research. The salient systemic changes identified are classified under three major categories: practice evolution, service capacity and inputs and structural changes in public sector administration. The methodology involves a framework that led from systemic changes to related management issues and thence to competencies and skills of relevance. The latter relied on the inventory of health service management competencies and skills identified by academic research. The framework structure took into account the competence/skill domain and context. It led to groups of predisposing, enabling and transforming competencies and skills related to the management issues arising from the systemic changes identified. The findings will help examine strengths of current post-graduate courses in health service management. They also provide an agenda and opportunities for continuing education by relevant professional organisations.

Although competencies in innovation, creative and innovative thinking have been shown to be required by health managers and leaders, studies suggest that formal postgraduate health management programs do not include many of these required proficiencies. In this study, we undertook a content analysis of the syllabus information available on the public domain for each of the postgraduate Health Management programs delivered by universities in Australia. The results showed that, in the courses examined, there was a shortage of content concerned with creative and innovative thinking and innovation. The dilemma faced is how to incorporate this much needed content into the program. This is an issue since the curriculum is often characterised by a shortage of relevant and available health-related material, and is generally packed with so much content that there is little room to add any further matter. An important consideration is whether these competencies are best enhanced through formal academic courses or through other modes such as professional development programs, on the job training, or mentoring programs. Should consideration also be given to sourcing such teaching material from the available and relevant nonhealth environment? In addition, in some cases could current content at the postgraduate level be substituted, at least partly, by prerequisites at the undergraduate level? It could be said that both academics and health managers share a common but difficult challenge: whether to keep the status quo or dare to innovate in the face of changing health service practices.