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

Abstract

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 theconcept of a 'reform narrative' to connect public management reform ideas, political doctrines andtheir effects on primary care organisations. It outlines a set of possible models of public managementand their application with primary care settings. It explores what might be the dominant reform ideas of the next decade. © 2010 Royal College of General Practitioners.