Health, education, and the virtues of efficiency

Managerialism has been seen in recent times as an answer to problems which fall well outside the boundaries of commercial enterprise. This trend can be seen in both education at university level and health. But there are major risks in transporting the techniques and values of the market into domains which serve non-commercial ends. Many of the most desired achievement of both health and education cannot be costed in monetary terms, and many of the activities that can be costed cannot produce profits. Education and health both have aims that are essentially moral, and the intrusion of managerialism undermines the morality and excuses departures from the central functions of both disciplines. This is not to say that efficiency and cost-cutting may not serve the good of education and health, but they cannot replace functions such as teaching, learning, and healing. There is a cogent argument for redefining the functions and structures of management in order to serve the knowledge workers whose role in health and education is indispensable, rather than to devolve increasing responsibility for management to them. The freedom of knowledge workers to practise their professions, to teach, to do research, and to reflect should be increased, rather than diminished progressively by institutional demands for more and more commitment the minutiae of management.