Abstract
The French health care system embraced New Public Management (NPM) selectively, and crafted their own version of NPM using Diagnostic-Related-Group accounting to re-centralize the health care system. Other organizational changes include the adoption of quasi-markets, public private partnerships, and pay-for-performance schemes for General Practitioners. There is little evidence that these improved the performance of the system. Misrepresentation has remained high. With the 2009 Hospital, Patients, Health and Territories Act physician participation in hospital governance receded. Decision-making powers and health units were re-concentrated to instill greater national coherence into the health system.
Highlights
The French health care system embraced New Public Management (NPM) selectively, and crafted their own version of NPM using Diagnostic-Related-Group accounting to re-centralize the health care system
The path toward new public management European economic integration with policies dictating that the achievement of supranational objectives prevails over national and regional policies, the adoption of a monetary convergence criteria, and the perception that Keynesianism failed in the 1980s, all prompted French public policy makers to adopt a new market-based paradigm to drive economic policy [1]
Under the impetus of top-politicians, consulting firms [2], and liberal thinktanks [3,4], a new generation of civil servants from the French National School of Public Administration and the “Grandes ecoles” – a “programmatic elite” [5] – who, like the public, wanted a delivering government [4], embraced New Public Management (NPM) [6] in a bid to improve public services delivery
Summary
In The Oxford Handbook of Public Management. Edited by Ferlie E, Lynn Jnr L, Pollitt C. Les producteurs et diffuseurs du New Public Management en France depuis les années 1970. 5. Hassenteufel P, Genieys W, Smyrl M: Reforming European Health Care States: programmatic actors and policy change. 6. Bezes P: The Reform of the State: The French bureaucracy in the age of New Public Management. Edited by Cole A, Le Galès P, Levy J. 7. Spaeth J-M: Les syndicats et l’assurance maladie. Les Tribunes de la Santé 2008, 18:29–37. Bevan G, Hood C: What’s measured is what matters: targets and gaming in the English public health care system.
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