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Contextual, policy and management reforms in the public sector: the case of the National Health Service

Schofield, Clare (2002) Contextual, policy and management reforms in the public sector: the case of the National Health Service. UNSPECIFIED. Manchester Metropolitan University.


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The measurement and management of performance in the public services has become increasingly prominent in the past twenty years, and progressively more so under the New Labour Government. In July 2000, the government devised a ten-year plan for the National Health Service (NHS) to radically reform and improve the performance and cost efficiency of the service. Concerns about high levels of public expenditure and their potentially detrimental effects on national competitiveness had been one of the main drivers of reform. The process of reform has brought significant reorganisation, managers have borne much of the responsibility for that, and their role has increased in both scope and influence. Managers in the NHS play a multidimensional role; they manage service provision, both clinical and support services, they are agents of central government instigating a raft of health reforms and they are taking an increasingly prominent role in managing human resources. This paper examines four key areas: NHS management, NHS manager’s pay, change and NHS management and public sector human resource management (HRM). It identifies a gap in the literature, first examining the awareness of, and extent of, the effect those policies and reforms have had on managers, and second, the manager’s experience of the new performance culture.

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