ABSTRACT
This chapter presents analysis across the four preceding chapters to examine the effects of New Public Management on junior and middle management roles and behaviour in UK healthcare. Several senior managers offered a cynical assessment of the purpose of structural changes to the NHS. They argued that the latest structural changes, those enshrined in the Health and Social Care Act 2012, were specifically designed to fail, thus clearing the way for private providers to enter. This Act of Parliament also mandated regular recommissioning of services in its controversial competition clause. National NHS policy, in a less overtly political sense, exerted a powerful influence on junior and middle managers; this tended to be manifested most significantly in the New Public Managerialism with its implications for monitoring, information collection and management and its 'rituals of verification' and 'utopia of rules'. Managers in Millford Care Foundation NHS Trust were commonly identified as either 'NHS home-grown managers' or new 'business managers'.
