The new management of healthcare: ‘Rational’ performance and gendered actors

Abstract

In many countries across the world, and especially in Europe, we have seen an increasing concern with management as a key component of new governance and policy reforms in healthcare (Dent, 2003). In this chapter we focus on the new management of healthcare and the gendered actors who work to deliver the human services involved. By ʼnew’ management, we are referring to what has been called New Public Management (NPM), thought to have developed in many countries around the world from the 1970s onwards with the purpose of reducing costs, increasing efficiencies and accountabilities, and generally enhancing the quality of human services and experience of users (see Chandler et al., 2002; Dent et al., 2004; McLaughlin et al., 2002). Accordingly, our focus is on the management and implementation of healthcare, and of those involved in its delivery. In the middle of these processes are the new managers, often professionals, charged with responsibility for delivery. This is not to suggest that healthcare, like other human services within the public realm, has not been managed and organized in the past. It is rather to point to the growth of a new group or cadre of workers involved in the implementation of the new work regimes who draw on private sector management techniques and mindsets in their attempt to achieve the desired ends. We consider these changes with particular reference to gender (Barry et al., 2003).