A public management approach to the NHS

This paper considers a public management perspective on management in the public sector. It begins by setting out two contrasting perspectives, those of business management and of public administration. It contends that the present Conservative government has strongly backed a business management approach to the public sector, with the emphasis being placed on the 'Five Es' of economy, efficiency, effectiveness, excellence and enterprise. However, it notes the relative neglect of effectiveness in favour of a rather narrow and short-term concern with economy and efficiency. The paper considers the public administration approach which emphasises the normative differences between the public and private sectors. The paper concludes with an examination of the emerging public management perspective which aims to combine the instrumental insights of business or generic management with the normative orientation of public administration.