Post-New Public Management (NPM) and the Reconfiguration of Health Services in England

The introduction of New Public Management (NPM) in the UK transformed the public sector in the 1980s, blurring the boundaries between the public and private spheres. However, from the late 1990s, it was clear that NPM techniques were showing some limits. Without retreating from governance back to government, some efforts were made to solve the problems that had arisen from greater vertical and horizontal specialization. The restructuring of the National Health Service (NHS) is the perfect illustration of how the role of the state in the world's largest publicly-funded health service has been redefined by post-NPM reforms. The focus will be specifically on reforms in England because Scotland and Wales took quite different reform paths after devolution. This paper thus explores how modernist governance has transformed the organization and delivery of public health services in England. It will consider the limitations of reconfiguring the NHS to comply with a business-like and consumer-oriented model, with particular attention given to the post-New Public Management reform wave which began in the late 1990s.