Vertical alignment, elite power, and the democratic recess in the French health care system
By: Simonet, Daniel
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Material type: 
BookPublisher: 2018Description: p.1095-1106.Subject(s): Administrative reforms | Public administration | New Public Management
In:
International Journal of Public AdministrationSummary: The article critically examines administrative restructuring of the French health care system. Despite calculated benefits of New Public Management (NPM) reforms, conflicts between values escalated. NPM-endorsed decentralization never took off in France. Instead, a re-concentration of health policy decisions benefited a Ministry-level welfare elite that sought to restore fiscal discipline rather than responsiveness to users. That process triggered a clash of culture with the medical profession and was at the expense of democratic participation. The role of citizens as reform overseers, although initially contained in the NPM doctrinal puzzle, never materialized. Key issues such as greater accountability and responsibility remain unresolved. - Reproduced.
| Item type | Current location | Call number | Vol info | Status | Date due | Barcode |
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Articles
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Indian Institute of Public Administration | 41(13), Oct, 2018: p.1095-1106. | Available | AR119669 |
The article critically examines administrative restructuring of the French health care system. Despite calculated benefits of New Public Management (NPM) reforms, conflicts between values escalated. NPM-endorsed decentralization never took off in France. Instead, a re-concentration of health policy decisions benefited a Ministry-level welfare elite that sought to restore fiscal discipline rather than responsiveness to users. That process triggered a clash of culture with the medical profession and was at the expense of democratic participation. The role of citizens as reform overseers, although initially contained in the NPM doctrinal puzzle, never materialized. Key issues such as greater accountability and responsibility remain unresolved. - Reproduced.
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