MEMBERSHIP OF THE ‘NEW STYLE’ HEALTH AUTHORITIES: CONTINUITY OR CHANGE?

The 1989 White Paper 'Working for Patients' continued the process begun by Griffiths of managerial reform and the introduction of private sector concepts into the NHS. One of the new proposals was to change the composition and constitution of health authorities, both to avoid the assumed weaknesses of the existing format and to emulate the pattern found in the private sector.
The essence of the change was the removal of the representational elements on authorities, both of medical professionals and nominees from the local authority. The health authorities were reduced in size to just eleven members and for the first time executives were included. Previous attempts at reform within the NHS have been judged to have resulted in more continuity than change. This article examines in detail who the new members are and assesses the balance between continuity and change.
Despite a high level of continuity of membership, there are signs of more fundamental change. There is a significant increase in the proportion of non-executive members from the private sector and with the inclusion of executives, a stronger managerial role is emerging. The article concludes by assessing what the implications of these changes maybe.     

Communities of scholars and communities of practice

This article is a contribution to the occasional series dealing with a major book that has influenced the author. Previous contributors include Stewart Macaulay, John Griffith, William Twining, Carol Harlow, Geoffrey Bindman, Harry Arthurs, André‐Jean Arnaud, Alan Hunt, Michael Adler, Lawrence O. Gostin, John P. Heinz, Roger Brownsword, Roger Cotterrell, Nicola Lacey, Carol J. Greenhouse, David Garland, Peter Fitzpatrick, and David Nelken.     

CORPORATE GOVERNANCE AND THE PUBLIC SECTOR: SOME ISSUES AND EVIDENCE FROM THE NHS

The 1990s have been marked by a resurgence of interest in questions of corporate governance in both public and private sector settings. The 1990 reorganization of the NHS is taken as an example of a recent attempt to‘reform’arrangements for corporate governance in the public sector based on a board of directors’model. The policy background is reviewed and the salient features of the NHS reorganization outlined. Empirical case study evidence is adduced which enables us to make an assessment of the advantageous and disadvantageous effects of the 1990 reorganization. Some unresolved questions are outlined in the concluding discussion.