The Nature and Structure of Teams [A Case Study of Interdisciplinary Teamworking in Primary Care

Considerable attention has been placed on how interdisciplinary teams can improve quality of care, professional relationships and collaboration. Consequently, improved teamwork is becoming an aspiration of health and social care practitioners, managers and organisations. In order to better understand teamwork in health care and how they function in a segregated organisation, a study of perception, structure of interdisciplinary primary health care teams and human resource practices was conducted. The thesis goes through an intensive programme of qualitative research in Riyadh City the capital of Saudi Arabia. It covers six cases, drawing on 47 interviews of teams in interdisciplinary primary care centres that varied in their Ministry of Health administrative standards evaluation. The research critically examines the HRM system and it links to teamwork policy, which resulted in tension between interdisciplinary members in the team. The key contribution is that there is little research on how health professionals work under segregated conditions and how they function.
The research explores and emphasizes the traditional nature of management and HRM within the Saudi Arabian public sector. HRM practices have historically been concerned with tight managerial control through close direction. Control in this perspective is mostly focused on performance systems, performance management and tight control over individual activities. The objective of tight control, historically, has been to reduce direct labour costs and improve efficiency, through requiring employee compliance with specified procedures and rules and basing
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rewards on some measurable output criteria. Thus, managerialism in the Saudi context remains highly influenced by Taylorist scientific management concepts, in which standardization and efficiency by the separation of execution and conception of tasks are emphasised. Maximum control over employees has been achieved through narrowly specified jobs supported by task focused training, payment systems and selection.
The thesis reveals how some healthcare teams may exist as teams in name only, showing little actual evidence of collaborative working. Such inequitable payment and reward systems, and on-going perceived hierarchical differences between team members.
Furthermore, the thesis explores in detail the implementation of teamworking within workplaces that remain segregated by gender, and examines the crucial role of the female supervisor, as line manager to female team workers in healthcare settings, to the implementation and success or failure of teamworking.