The New Public Management Theory and the Reform of European Health Care Systems: An International Comparative Perspective

The New Public Management (NPM) Theory is a rhetorical construction with diverse intellectual roots. That diversity means that it is open to reinterpretation and shifts in implementation across countries (Sahlin-Andersson, 2001; Smullen, 2007). This overview article critically investigates NPM application in various EU health care systems. NPM led to a greater focus on market forces and competition and improved information sharing and cooperation among health care networks, and changed the way care is delivered. This article also identifies significant misfits between policy announcements and NPM implementation. NPM has taken root much more substantially in the United Kingdom (UK) than in France and Germany. The variety of capitalism and institutional systems provides an explanation for divergences in NPM implementation.