|Harris, Howell John||2013|
Keywords: Department of Health (DH), England, healthcare competition / cost effectiveness / innovation / management / objectives / roles and responsibilities / quality, market principles, National Health Service (NHS), organisational complexity / logic, patient choice, ‘permanently failing organisations’, private / publicly funded healthcare, The Health and Social Care Act 2012,
Abstract: This article outlines the radical management changes introduced by The Health and Social Care Act 2012 (HSCA) in the English National Health Service (NHS) in 2013 and discusses their possible effects on NHS as an organisation. This article argues that the HSCA reforms—designed to enhance market principles—represent a political solution to management problems, driven by financial and ideological priorities. Because of conflicting objectives, unclear distribution of authority, organisational complexity, and lack of sensitivity to the NHS’ historical culture and structure, the outcome may be a ‘permanently failing organisation’.