Community Health Services and Managerialism

Abstract

In this paper, the impact is described of the introduction of the new public management (NPM) on community health services in Australia. From the late 1980s NPM techniques, modelled largely on private sector practices, have been popular with federal and state governments and have affected the management of community health services. Services have been amalgamated, asked to evaluate their work in inappropriate ways and been pressured to a quasi market form of operation. Three fundamantal differences between a primary health care and NPM approach to management are defined and discussed: whether the focus is on individuals or societies, whether it is on public service or profit, and whether it is on meaningful outcomes or those which appear measurable. The paper concludes with a call for the evaluation of the NPM and a return to a more civic and socially focussed public management.