New Public Management (NPM) has enjoyed centre stage within the UK public services for well over a decade. There has been much written on the subject and much of it was concerned with establishing the presence and charting its development as well as considering the implications for the public sector (e.g. Hood, 1991, 1995; Ferlie, Ashburner, Fitzgerald and Pettigrew, 1996; Clarke and Newman, 1997; Exworthy and Halford, 1999; Hood et al 1999; Pollitt and Bouckaert, 2000). In this process there has been a tendency to see the NPM movement as a more integrated and uniform than it perhaps really is for we would argue that NPM is in practice not one unified set of practices but a theme which has distinct variations within the different sectors (e.g. health, education, social services): it varies across sectors, it varies within sectors and it varies according to the outcomes of specific management-professional settlements. Firstly, we contend that not only is NPM manifested in a variety of guises but also, its form varies across sectors. Beyond the general pressures to be cost effective, accountable and market-friendly the implementation of the NPM across, for instance, health, social services and education, has been quite variable. We would suggest, for instance, that schools were less directly affected by the introduction of the quasi-market than were hospitals, even if the rhetoric was similar. Conversely the impact of audits has had a far more direct and immediate effect earlier on within schools than in health care, although this has begun to change with the introduction of Commission for Health Improvement. Secondly, despite its underlying themes, NPM does not offer managers any âmagic bulletâ or toolkit, for it is a hydra-headed phenomenon, not a single instrument but a collection of management tools that have been adapted and modified over time. During the early 1990s the disciplinary force of the âquasi-marketsâ was expected to be, more or less, sufficiently effective. By the late 1990s, however, accountability and audits came to dominate NPM practice (Power, 1994; 1997; Jary, 2002) as it became clear that the quasi-market had failed to deliver and the model became politically less attractive in the wake of âBlairismâ, or the âThird Wayâ. Instead of quasi-market competition the emphasis was now even more clearly on managerialism, even so, the newer versions of NPM have continued to embrace private sector involvement as, for example, in the cases of public/private partnerships and the Private Finance Initiative (PFI). Thirdly, we would argue that NPM is very much a contested terrain on which a reconfiguration of management-professional relations has been forged. It has not offered an easy victory for managements, nor have the professions remained unscathed. Rather than the new managerialism undermining the public sector professions in any direct way what is to be seen is a reconfiguration of expertise and its management, a process that is redefining both managerial and professional work and their organisational relationship. Certainly this is a process that seriously challenges these professions but it is not a process that is leading to their âdeprofessionalisationâ or âproletarianisationâ but instead, is redefining professional autonomy in ways that make it compatible with the new managerialism. Whilst many public sector professionals view NPM as a threat to their autonomy and authority they cannot openly condemn its implementation given the public claim that it will improve the service to the public/client/consumer. Instead, therefore, they broadly accept NPM and look for ways of ameliorating its impact. This, the professionals attempt to achieve in one or more of three ways:
1. Colonisation: claiming their professional right to take on the responsibility for the activity and thereby if not dictating certainly influencing the measures for success and failure. This is particularly evident within higher education
2. De-coupling: minimising the impact of NPM on their work by treating it as a formal requirement that has little practical importance for their real work (i.e. decoupled cf. Meyer and Rowan, 1991), for example in teaching and medical work. Doctors, for instance, have long adopted this technique in relation to medical audit (Power, 1997: 106).
3. Reconfiguration: a combination of both previous strategies in an attempt to retain control over the organisation and delivery of their services.
At the same time, some managers have felt threatened by the âiron cageâ of accountability and audits experiencing these as an attack on their traditional ethos of public service. But in general, management lacks a credible independent base from which to resist NPM and have to learn the new âscriptsâ and adapt to the new ethos which increasingly draws on a revised form of professionalism which has more to do with the âresponsibilisationâ of labour (Fournier, 1999) than with legitimating the autonomy of particularly groups of expert labour. All these issues are taken up within the chapters that make up this edited collection and together provide a critical assessment of the phenomena of New Public Management.
The authors draw on a range of sociological and organisational theories in their analyses of a range of case studies and evaluations. The body of the book starts, however, with a detailed and theoretical analysis of NPM and the public sector professions (Part I), provided my Dent and Barry. This is followed by three sections each one dealing with one of the characteristics of the NPM movement: variation; variability; contestability. Variation is the focus of Part II (Variations Between Sectors), which comprises of four chapters that relate to the issue of variation between sectors. It covers local government, social care management, social work and the police and each chapter documents the growing emphasis on the imposition of new âstandardsâ and chart the variation of responses across the public sector. While each report conflicts and dilemmas for managers and professionals the impact of NPM and the response to it varies considerably. In Keenâs chapter on âBest Valueâ in local government she draws on case study research to examine the range and variation of responses of middle managers to NPM and, in particular, the âbest valueâ policy initiative. Henderson and Seddonâs study reports on the experience of first line managers in social care and the challenges they face in meeting the new demands to work in multi- and cross-disciplinary teams to provide the âseamless careâ promised by government. Garrettâs study is of social work and emphasises more the challenges of standardisation within professional practice. He examines and analyses the increasing demands on social workers to work âwithin centrally devised schedules, checklists and proformaâ and the implications for social worker/ client relations. Metcalfe concludes this section with her study of an English police force and the challenges it faced in introducing a new performance appraisal policy. The study, which draws on a large survey as well as participant observation, identifies problems associated in introducing NPM-type organisational changes without taking sufficient account of organisational and professional cultures.
Variability is the subject of Part III (Hydra-Headed NPM: The Case of the National Health Service) and here there are four chapters each reporting on original research that demonstrate the variations of NPM and its implications within just one sector, the National Health Service (NHS). Linstead and Catlow open with a study of the experience of women in senior management and the extent to which the new managerialism has challenged the dominant discourse of masculinity. This contribution continues with concerns raised in the previous section and contrasts with the other three contributions, which focus on specific organisational and policy initiatives. Howorth, Mueller and Harvey draw on the concept of the âlearning organisationâ in their study of the adoption of an NPM system of âPatient Focused Careâ within a hospital trust. Ruanneâs case study examines NHS Trust managersâ ambiguous perceptions of the Private Finance Initiative (PFI) while Alferrof and Dentâs study of âOut of Hoursâ care presents an account of the complexities and variations in the working relations between general practitioners and Accident and Emergency units in developing services that were consumer/patient focused.
The discussion of the contested nature of NPM is the subject of Part IV (NPM as a Contested Terrain) and it is here that the issues of adaptation, negotiation and struggle with NPM are examined. Berg, Barry and Chandler begin this section with a chapter reporting on studies that examines the insecurities and stress for academics within higher education in Britain. The chapter is as much a critique of the psychology of stress as it is a report on staff responses to work pressures and shows how the reach of management extends to the control of emotional responses. This is followed by Boltonâs study that demonstrates how at least one occupational group resist the disciplinary mechanisms of NPM. The focus here is on a particular mode of resistance as employed by nurses â humour. Drawing on a longitudinal study Bolton demonstrates how humour can be applied as âa potent negotiative deviceâ one that can change the balance of power and defy the âtaken for grantedâ patriarchal assumptions of much of their work. In short, ensures the nurses retain their practical autonomy within the work terrain even in face of pervasive NPM driven organisational change.
Part V, The Limits of NPM, provides an overall assessment, comprising two chapters, each setting out a âscore cardâ for NPM. Jones provides an evaluation of the evidence from New Zealand and Singapore, countries selected because both are keen players in the NPM game. The chapter provides evidence that suggests the gains of the much-vaunted new managerialism are less easily won than many of its proponents had led us to expect. Finally, Cutler provides the coup de grace with an incisive critique of the rhetoric that has attached to the new managerialism in the public sector despite pre-existing evidence of poor performance within the private sector.
References
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