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Barriers to transformation: Beyond bureaucracy and the market conditions for collaboration in health and social care

Su Maddock (Manchester Business School, University of Manchester, UK)
Glenn Morgan (Manchester Business School, University of Manchester, UK)

International Journal of Public Sector Management

ISSN: 0951-3558

Article publication date: 1 July 1998

1948

Abstract

The post‐1990 health reforms in health and social care have resulted in quasi‐markets, centralized funding and an acceptance of top‐down managerialism.The analysis of contracting within the public sector has focused on the extent to which the market has affected equity, access and choice for users ‐ but it has also had a tremendous impact on staff, staff morale and their relationships. Whilst policy makers demand joint practice in order to deliver continuous care, the market culture has resulted in competitive or depressed behaviour amongst professional managers and support staff. The bureaucratic public administrations were criticized for reinforcing rigid departmentalization and a stagnant culture ‐ the contracting environment and reductionist performance management (NPM and managerialism) appear to be having a similar blocking effect on those staff developing new relationships and working beyond establishment boundaries. This paper outlines what are perceived to be the barriers to social transformation in health and social care services, as relayed by those actively engaged in building bridges across professions and agencies. The research input is based on a mid‐stream ESRC Management Innovation Project.

Keywords

Citation

Maddock, S. and Morgan, G. (1998), "Barriers to transformation: Beyond bureaucracy and the market conditions for collaboration in health and social care", International Journal of Public Sector Management, Vol. 11 No. 4, pp. 234-251. https://doi.org/10.1108/09513559810225807

Publisher

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MCB UP Ltd

Copyright © 1998, MCB UP Limited

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