This paper examines long-term trends in the organisation and management of health care, and assesses whether there is evidence for an 'archetype' shift taking place in organisations that will develop over the next 20 years. Part of the Policy futures for UK health - Pathfinder Technical Series.
In this research paper, Ewan Ferlie looks at the factors involved in long-term trends in health care organisation, such as the change from a professionally dominated to a more managed and externally regulated system, a move to more private-sector-style organisations, and the promotion of business-like values that stress efficiency and entrepreneurship within the health care organisations in support of the shift.
He also looks at the possible consequences of change. For example, what are the control and accountability implications of the expansion of the Private Finance Initiative (PFI), what new roles will ministers, politicians and local agents play in changed organisations, and what effect will changing value systems have on organisational style?