ABSTRACT
Previous chapters have indicated that individuals working in schools and hospitals in the public sector are increasingly facing dilemmas or difficulties caused by their institutions moving, or being moved, into a marketplace situation. One might assume, then, that individuals working in the private sector, because they face a fully competitive scenario, would feel these difficulties even more acutely. Certainly, it was apparent from the chapter on private hospitals that while those working in them were as committed to the care of their patients as any working in the NHS, nevertheless there was a very clear recognition that the medical agenda was driven primarily by financial considerations. However the interview data in that chapter also indicated that a more explicit market agenda in fact contributed to the creation of a culture within which some of the ‘dilemmas of decentralization’, such as worries over a lack of co-operation between institutions, were de-emphasized, or even seen as normal. In this situation, questions do not then revolve around dilemma resolution, but rather about whether there are issues of which those in this sector need to be aware.
