Content area
Full Text
Introduction
This paper is concerned with the impact of implementing new public management (NPM) practices on public sector managers. In this paper we present evidence that the implementation of recent changes in the UK National Health Service (NHS), informed by the principles of NPM, have placed a series of pressures on managers which have resulted in them experiencing high levels of stress. Specifically, we show a link between changes designed to foster a more “business like” environment in the management of healthcare and stress experienced by managers. We find that this relationship is mediated by a number of work outcomes emanating from these changes, such as expanding responsibilities, extended working hours and workloads which are perceived as unmanageable.
In recent decades there have been significant attempts to reform the public sector in many parts of the world (Lynn, 2007) and much of this reform has been driven by the NPM agenda (Pollitt and Bouckaert, 2000). NPM is concerned with increasing efficiency in the management of public services by the introduction of competition for service provision; private sector style management practices and the more explicit management of performance (Hood, 1991). In essence, NPM represents an assertion of management over bureaucracy (Lynn, 2007) and attempts to “liberate” managers in the public sector to behave more like their counterparts in the private sector. However, in practice it has been observed that this apparent liberation is also often accompanied by the increasing use of benchmarks and performance monitoring (Meier and Hill, 2007). Noordegraaf and Abma (2003) observe the rise of “management by measurement” in the public sector and the use of business like measurement models to assess public sector performance. Thus, whilst public service managers may have greater freedom to choose how they operate, they are at the same time held accountable for the outcomes delivered. As a result, managers might focus on “producing numbers” (Hall et al., 2003) and a decline in bureaucracy related to service delivery may be replaced by an increase of bureaucracy of control.
The premise of NPM is that private sector style management practices can be introduced into the public sector with beneficial effect. However, it can be argued that management roles in the public sector differ from those in the private sector...