The argument is proffered by Cooke (2000) that while there are a growing number of studies which examines the impact of good HR policies on improved organizational performance, there isn’t a great degree of consistency both in methodology and theory.  Cooke nonetheless examines human resource strategies and their impact on organizational performance within the context of British firms, and argues strongly that not only is there a relationship between policy and performance, but also that “HRM practices can improve company performance” (Cooke, 2000).  This point is also echoed by Guest (cited in Cooke, 2000) who articulated that the following theories, “the theory of human resource management, the theory of performance and the theory about how they are linked”, needed to be reviewed separately to fully appreciate how their interdependence permits a better understanding of factors influencing a firm’s performance.

Suffice it to say, many have come to the conclusion that “there is a definite link between human resource management practices and organizational performance”. (Jan et al.2009, Absar et al. n.d.).

One such proponent also is Singh (2004), who postulates that “the impact of Human Resource (HR) management practices on the performance of firms has been a leading theme of research in the past decade and the results have been encouraging indicating positive association between HR practices and firm performance”.  It does seem that the discussion regarding the impact of HR policies and practices on organizational performance has attracted much debate.

The author recognizes therefore the inextricable link between HR policies and organizational performance, hence the research question which seeks to consider the quantifiable impacts of the gap between the human resource policies and strategies of the GPHC and their implementation in the actual “day-to-day” practices.  It would be advantageous to determine what specific policies and practices best suit the organizational culture and climate, and promote those as the standard of acceptable practices within the organization.  HR policies therefore, must be guided by the specific organizational strategies and vision and must aim to facilitate synergy between policy, practice, and performance.

Rogg et al. (2001) postulates, that while there may not be a significant impact economically, there is however significant impact on corporate outcome and the climate of the organization.  Consequently the climate impacts the organizational outcomes.  This recognition gives support to research question number 4, which recognizes the quantifiable impact of the gap between policies and actual behavior. In reality however, is it possible to attach an economic cost to poor or efficient health care? How do you quantify economically, the cost of a life saved, or a life lost?  It would seem that it is the qualitative impact on health care upon which the HR functions are more likely to have a greater influence.  On a wider scale, concerns regarding the gap between HR policies and practice and its impact, have not escaped such bodies as the World Health Organization (WHO).

In a 2006 WHO report it was recognized that

“Increasing the number of health workers, on its own, will not always improve health system performance or health outcomes. Scarce access to health care in rural areas, insufficient skills of health workers and inadequate support for health personnel, low levels of motivation and performance, and chronic staff turnover are all well documented. Improved HR management and leadership at the local, regional, and national levels can help address these challenges as well as support the recruitment and training of many more health workers.” (Cited in African Medical and Research Foundation (AMREF) and Management Sciences for Health (MSH), 2009).