Barriers to transformation Beyond bureaucracy and the market conditions for collaboration in health and social care

Barriers to transformation Beyond bureaucracy and the market conditions for collaboration in... The post‐1990 health reforms in health and social care have resulted in quasi‐markets, centralized funding and an acceptance of top‐down managerialism.The analysis of contracting within the public sector has focused on the extent to which the market has affected equity, access and choice for users ‐ but it has also had a tremendous impact on staff, staff morale and their relationships. Whilst policy makers demand joint practice in order to deliver continuous care, the market culture has resulted in competitive or depressed behaviour amongst professional managers and support staff. The bureaucratic public administrations were criticized for reinforcing rigid departmentalization and a stagnant culture ‐ the contracting environment and reductionist performance management (NPM and managerialism) appear to be having a similar blocking effect on those staff developing new relationships and working beyond establishment boundaries. This paper outlines what are perceived to be the barriers to social transformation in health and social care services, as relayed by those actively engaged in building bridges across professions and agencies. The research input is based on a mid‐stream ESRC Management Innovation Project. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Public Sector Management Emerald Publishing

Barriers to transformation Beyond bureaucracy and the market conditions for collaboration in health and social care

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Publisher
Emerald Publishing
Copyright
Copyright © 1998 MCB UP Ltd. All rights reserved.
ISSN
0951-3558
DOI
10.1108/09513559810225807
Publisher site
See Article on Publisher Site

Abstract

The post‐1990 health reforms in health and social care have resulted in quasi‐markets, centralized funding and an acceptance of top‐down managerialism.The analysis of contracting within the public sector has focused on the extent to which the market has affected equity, access and choice for users ‐ but it has also had a tremendous impact on staff, staff morale and their relationships. Whilst policy makers demand joint practice in order to deliver continuous care, the market culture has resulted in competitive or depressed behaviour amongst professional managers and support staff. The bureaucratic public administrations were criticized for reinforcing rigid departmentalization and a stagnant culture ‐ the contracting environment and reductionist performance management (NPM and managerialism) appear to be having a similar blocking effect on those staff developing new relationships and working beyond establishment boundaries. This paper outlines what are perceived to be the barriers to social transformation in health and social care services, as relayed by those actively engaged in building bridges across professions and agencies. The research input is based on a mid‐stream ESRC Management Innovation Project.

Journal

International Journal of Public Sector ManagementEmerald Publishing

Published: Jul 1, 1998

Keywords: National Health Service; Public sector; Social Services

References

  • New Agenda for Health
    Coote, A.; Hunter, D.
  • Managing through networks
    Ferlie, E.; Pettigrew, A.
  • The politics of purchasing in the National Health Service
    Salter, B.

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