Post-New Public Management in Public Healthcare: Recycled, Hybridized, Paradigmatic?
Paper in proceedings, 2019
New Public Management (NPM) is increasingly used pejoratively and claimed unfit for the complex challenges in contemporary societies, for example aging population structures and, as a result, increased number of cancer patients. Consequently, post-NPM gains increased attention. Drawing from a longitudinal case in Swedish cancer care, the present article seeks to pinpoint post-NPM in public healthcare practice. It is revealed that some post-NPM aspects are recycled by combining traditional public administration (pre-NPM) and NPM aspects: the former’s re-professionalisation is combined with the latter’s foci on performance measures, decentralisation, and accountability. Other post-NPM aspects are hybridizing typical NPM aspects with new (post-NPM) aspects: for instance, customer-focus is taken further to include the patient’s active participation in co-designing services, and standardization is reinterpreted to concern meeting-places rather than efficiency. Yet other aspects are replacing NPM shortcomings: for instance, trust is replacing control, and a systems approach is replacing the intra-organisational focus