Inadequate management arrangements have often been identified as the root cause of the problems of the NHS. During the 1970s, as shown in Chapter 4, governments sought to address these issues mainly through structural reorganisation, accompanied by management reform and the development of new planning procedures and coordination mechanisms. In the following decade, the emphasis was increasingly upon business-style managerialism, with government drawing heavily on ideas imported from the private sector. The 1990s brought further initiatives: some extended the managerialist ethos, others sought to reconcile the new regime with traditional public service values. This chapter examines the reforms of the last two decades and their impact on various aspects of health service management.
KeywordsHealth Authority Total Quality Management Clinical Audit Management Reform Audit Commission
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