The Reforms Under The Npm Umbrella

5276 Words Jul 7th, 2015 22 Pages
6.04.2015
1.2. Background
Healthcare system across different countries has been affected by NPM reforms. Decentralisation as one of the main reforms under the NPM umbrella has started in different countries from different positions (Pollitt and Bouckaert, 2011, p. 102). For example, central government in the UK has praised the virtues of decentralisation, but in the early 1980s the UK was relatively a centralised country. Administrative decentralisation has been the preferred form. Few new powers have been given to local governments in the UK. In this case decentralisation has transferred authority to a range of specialised administrative bodies. However, the UK did experience a very significant act of political decentralisation when the Blair administration created elected assemblies for Scotland and Wales. When Cameron became prime minister in 2010 he strongly promoted the idea of a ‘big society’ rather than a ‘big government’ (Pollitt and Bouckaert, 2011). The precise implication of this were far from clear, but the general direction seemed to be towards decentralising services and seeking to enlist both commercial companies and civil society association to take over, or at least share in, activities previously performed by public authorities(p.315).
In the NHS, since its formation one of the major debates has been the tension between a national and centralized NHS and a local and decentralized service (Peckham et al 2008). Current debates about the nature and…
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