Post-NPM Reforms or Administrative Hybridization in the French Health Care System?

Abstract

New public management (NPM) provides an opportunity to analyze a reform trajectory that is influenced by country-specific institutional and social traditions. France adopted its own version of NPM, embracing some of its “traditional” elements such as quasi-markets and performance evaluation and rejecting others. NPM reforms in France pursued a re-centralization agenda rather than a disaggregation of public agencies. Outcomes were below expectations in core areas such as citizen participation and physician professional satisfaction. Subsequent health reforms indicate convergence toward a hybrid system rather than toward a post-NPM paradigm.

Keywords:

• France
• health policy
• new public management
• post-new public management

Notes

¹ Capital.fr Finances publiques: régions et départements sont de plus en plus endettés. 29/12/2011 à 13:18/Mis à jour le 25/01/2012 à 10:41.

² A former specialist in digestive surgery, and subsequently an advisor to the Minister of Health Claude Evin, then a cosmetic surgeon and a consultant to pharmaceutical firms, Cahuzac was appointed as the Minister of Economy, Finance and External Trade under President François Hollande. On March 19, 2013, he resigned due to tax fraud, having held a secret foreign bank account for about 20 years.

³ He resigned in April 2014 due to suspicion of influence peddling when he was inspector at the General Inspectorate for Social Affairs.

⁴ www.senat.fr/dossierleg/pjl08-290.html.

⁵ www.rgpp.mdernisation.gov.fr.