There has been much speculation about the introduction of the contract culture in the public services and its consequences for those involved (including service users). This book, which is based on original research, sets out to examine the impact of contracts in three areas of the public service: health, social services, and other government activities. These findings are set in the context of policy development for the public sector as a whole. Detailed case studies in selected areas reveal the varying different patterns that have emerged. A study of the attitudes of those involved illuminates the different perspectives of participants. In the concluding chapters the authors review the policy implications of the study and identify likely future developments.

Sweeping changes have taken place in many parts of the world in the provision and organisation of health care, welfare and other 'public' services. The UK's National Health Service (NHS) has been a prime example of this. This multi-disciplinary collection of essays reviews recent evidence from a major research programme, commissioned by the Economic and Social Research Council (ERSC), into the evolution and impact of contracting in the NHS. Each chapter examines a particular aspect of health and social care, including competition between hospitals and the effects of GP fundholding, and discusses the important theoretical implication of experience in the NHS quasi-market. It will be essential reading for anyone interested in the contemporary debate surrounding the issues.

This book analyses the way in which the Japanese Civil Service has contributed to Japan's economic growth and the lessons that experience may offer for other developing countries.

Managers face a complex and seemingly overwhelming set of decisions in their work lives. Investigating exactly what managers do on the job, this study presents a wealth of new evidence to analyze why managers act in the ways they do, what influences their focus of attention, and which issues and other actors in an organization they tend to find attractive and which they tend to avoid. In short, it describes how managers in the real world make decisions.

This is a memoir covering some 50 years' involvement with delivering public services in a wide range of roles: civil servant; local government; chairing inquiries and public bodies; special adviser; Minister; and Parliamentarian. The book's topic areas include the NHS, social services, social care, welfare benefits, human rights, criminal justice and constitutional issues like House of Lords reform. It starts with a government apprenticeship in the 1960s and ends with Brexit and Covid19. It covers successes and failures; and identifies the limitations of our institutions. The book ranges over 1970s political battles; Thatcher's efficiency drive; social services and community care reforms of the 1980s and 90s; and tackling child abuse. A diary kept for the 1997 Election year sets out what it was like taking over government after a long period in Opposition. A major reform of the youth justice system is described, along with developing the Blair government's family policy. Much of the book is concerned with the NHS and its shortcomings as well as its iconic status in the UK. There are chapters on life as the pharmaceuticals Minister; implementing NHS targets and cutting its bureaucracy; and trying to instal a mega NHS computer system. The chapters on implementing Tony Blair's NHS reforms with more patient choice and competition illustrate how difficult public service reform is. The book poses the possibility that the NHS in its present form is unsustainable; and explains the failure to fix the funding of social care. Life in the House of Lords is described and why it needs major reform. The book concludes with some ideas on how the Government could build back better after Brexit and Covid with public sector reform.