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On-going change in relation to the management of public services has led to the development of many initiatives in the control of day-to-day resources as the New Public Management¹ (Hood, 1991, 1995) continues its reforms. In this context debates about control of capital expenditure have taken a less visible role despite some earlier and influential comment on the area (Perrin, 1978 for example). Perhaps as the flow of ideas for reform in the management of day-to-day activity have waned, recent attention has turned more systematically to the efficient use of capital resources or infrastructure. This has been accompanied by recognition of the poor state of some of the public sector infrastructure. This chapter is concerned with the implications of the changing approaches to the provision of infrastructure is the U.K. National Health Service (NHS). Its particular focus in the Private Finance Initiative (PFI) and the contractual implications this brings into infrastructure development.

So much has been written about public management and administrative reform in the past decade that in developing the approach for this book we wondered whether there was anything new to say. As is the case for most professionals working in our field, we recognize that the topic of New Public Management has been worked over very thoroughly. New public management is no longer “new” and, therefore, we believe in the future it is better to use the words public management change or innovation when speaking and writing about emerging initiatives in the public sector. And, as most in our field also understand, the topics receiving significant attention at present are networking and a set of issues related to what is termed “governance.” Research on networking has been on-going since at least the 1970s. Many issues related to networks and networking remain unresolved so that continued dialogue in this area is constructive. Renewed attention to governance (versus government) appears to have emerged in the public management dialogue and literature in the past five years or so.