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Table 2 Perceived weaknesses in priority setting in the PHSA

From: Priority setting in the provincial health services authority: survey of key decision makers

Systemic Internal
  Central decision making creating a feeling of disempowerment among managers
  Lack of true accountability to conserve resources
  "Do it all" mentality that prevents the organization from identifying disinvestments
  Incentive to overspend because efficiency is not rewarded
  Lack of structural and cultural integration due to the recent creation of the PHSA
  External
  Confusion regarding role and authority of the BC Ministry of Health and the PHSA
  Limitations in priority setting due to provincial mandate and global priority setting
Individual Lack of priority setting skills and tools which support resource re-allocation
  Unwillingness to release resources from own budgets to fund investments elsewhere
  Fear of being explicit in priority setting
  Decision makers jaded to change processes because of too much change in the institution
  Lack of management training for physician-leaders