A Public Management Approach to the NHS

Abstract

This paper considers a public management perspective on management in the public sector. It begins by setting out two contrasting perspectives, those of business management and of public administration. It contends that the present Conservative government has strongly backed a business management approach to the public sector, with the emphasis being placed on the 'Five Es' of economy, efficiency, effectiveness, excellence and enterprise. However, it notes the relative neglect of effectiveness in favour of a rather narrow and short-term concern with economy and efficiency. The paper considers the public administration approach which emphasises the normative differences between the public and private sectors. The paper concludes with an examination of the emerging public management perspective which aims to combine the instrumental insights of business or generic management with the normative orientation of public administration.

A local authority management development programme

“…Having carefully considered such factors, it was felt that a more general management development programme which incorporated private-sector as well as public-sector managerial learning would be more appropriate in order to enhance the client's ability to survive and prosper in this new, more competitive context. Gunn [1] argues that a synthesis of the old style "public administration" model with "business management" -"public management" is now more appropriate. This new approach emphasizes effectiveness, that is the ability to achieve intended results.…”

Corporate Governance in the NHS – an Assessment of Boardroom Practice

“…R eform in the public sector has been endemic for more than a decade. Gunn (1989) describes a process of transition from public administration through business management to public management. Hood (1991) characterises this``new public management'' as a doctrine, a feature of which includes a stress on private sector styles of management practice.…”