Public management 'reform' narratives and the changing organisation of primary care

This paper explores how different models of public management affect the changing organisation of primary care. It examines important non-clinical drivers of major organisational change. It uses the concept of a 'reform narrative' to connect public management reform ideas, political doctrines and their effects on primary care organisations. It outlines a set of possible models of public management and their application with primary care settings. It explores what might be the dominant reform ideas of the next decade.