Exploring 30 years of UK public services management reform – the case of health care

摘要

Purpose - This paper offers a personal interpretation of the nature and impact of alternative narratives of public management reform evident in the UK since the 1980s. These reforms are examined through the prism of alternative bodies of public management scholarship. They are applied to the specific case of the health care sector as a concrete focus.Design - A personal overview of various streams of policy reform in the UK health care sector and associated public management scholarship. This is an interpretive essay.Findings - The NPM remains the dominant reform narrative and highly embedded, even if dysfunctionally so. NG reforms have had some enduring influence. DEG has so far had only weak influence. A reprofessionalization counter narrative shows variable and oscillating influence/Originality/value - this paper contributes to a developing narrative based stream in public management scholarship. It also provides a 'big picture' assessment of reforms in the UK health care sector since the 1980s.