What impact has managerialism had on a New South Wales area health service?

Abstract

In a perfect world, the health public sector would be completely efficient and effective. In reality, managers, policymakers, politicians, academics, public sector employees and business representatives are constantly searching for new ways to orientate the public sector towards being more cost-effective, accountable, results- and outcome-orientated, task-specific and better organised and structured. In New South Wales (NSW), this has been most apparent in endeavours to bring about a change towards the philosophy of 'new managerial thinking' or corporate management. This paper explores the hypothesis that managerialism has significantly influenced the culture of the New England Area Health Service (NEAHS) and its relationship with its staff. To test this hypothesis, between 1996-1997 a self-administered questionnaire survey form was sent to a sample of the NEAHS staff across all work sites and all levels. It is concluded that during this time, the organisation was struggling with change management issues and the successful implementation of managerialist philosophy and its elements as evidenced by staff confusion, doubt and 'cultural shock'.