ABSTRACT

Scholars of public administration have noted that during the last 20–30 years, hospital reforms have become a global phenomenon. More recently, they have also noticed that healthcare is in a state of permanent ‘dis-reorganization’ (Stambolovic 2003, Pollitt 2007b). This chapter starts with the assumption that although New Public Management (NPM) refers to a rather diverse set of reform ideas, it is nonetheless meaningful to use the label as a point of departure for analysing the reforms that have been undertaken in healthcare since the 1980s. The chapter will outline a few common characteristics of such reforms and use them as the starting point for presenting and discussing alternative frameworks for understanding and making sense of recent reform trends. It will then discuss what happens when these frameworks and the empirical realities to which they refer are challenged by NPM.