Investment returns are not guaranteed year on year, and commercial activities are subject to market dynamics, which can have a positive or negative impact on income. Governments usually generate revenue through taxation (e.g., income tax, value-added tax) and non-taxation activities (e.g., borrowing, fees, fines, investment returns, commercial activities).6 Although the needs of citizens continue to increase, there is usually very low appetite for increased taxation, fees, fines and sovereign debt. There are three reasons why income generation should be seen as a key pillar in the fulfillment of the obligation of public sector healthcare organizations diversification of revenue sources, creation of a mind-set that pursues efficiency, and improvement of the quality of care.

To deliver services that meet the expectations of the people they serve, public sector healthcare organizations need to consider income-generating activities, seeing these initiatives as supportive of serving the public good. Public sector organizations are still expected to provide services to a very high standard.3 This situation is particularly evident in public sector healthcare, in which demands on the system have continued to outpace investment/ spending,4 but patients still expect healthcare services to deliver improved health outcomes.5 This conundrum calls for rethinking how public sector organizations should fulfill their duties. The main purpose of public sector organizations is generally considered to be serving the public good.1 This purpose is usually contrasted with the purpose of private sector organizations – to maximize profits and shareholder value.2 Although government resources are finite and the public need continues to grow, expectations on the public sector are not diminishing.

Bcg matrix for healthcare industry