Steering whilst rowing: governing and managing health services from the centre.
Journal of Health Organization and Management, 25(6) pp. 625–644.
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The article explores the practical and theoretical implications of the ways in which senior figures in the NHS interpret the role of the centre in relation to the delivery units of the health service. This is important in the light of recent plans for re-organisation of the NHS advanced by the new Conservative-Liberal Coalition government. The article is based on interviews with civil servants and NHS staff at senior levels in the centre and in the Strategic Health Authorities. It is found that, in practice, despite numerous attempts to separate out policy-making from implementation and management that the two continue to be closely coupled and intertwined. Central staff and regional officials are found to be both steering and rowing.
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