ABSTRACT
The statist conception of the public sector, in the ascendant after 1945, gave way to one where public and private are seen as less distinct and where, the public sector has been expected to learn from the private. In the health care field this change has been seen with the embedding of a managerialist culture. Private and public health care systems have therefore existed side by side with links between them. To return to the continuum mentioned earlier, the growth and diversification of the private health sector do imply a shift away from the public end, but it is only a shift, and health care for most people, for most of the time, continues to be publicly provided. The embedding of a managerialist culture carried with it an imperative to measure and quantify, but it is arguable that policy-makers came to place too much emphasis on efficiency and enough on effectiveness.
