From tender care to tendered care: The case of the Victorian Maternal and Child Health Service

Restructuring the public sector along market principles has been a major policy development of the late twentieth century in most western countries. This paper examines the impact of recent political and administrative change on a Pictorian universal primary health program, the Maternal and Child Health Service (MCHS). The first section establishes the development of the service in the years when an interventionist state provided bureaucratic support for the expansion of public health activities. In the next significant period of organisational change, the 1980s- early 1990s, key interest groups articulated their positions in view of the administrative imperatives of corporate managerialism. Dramatic 'marketisation' of the service then occurred with the impact of compulsory competitive tendering (CCT) in the mid-1990s. The paper argues that attention to the complex processes of change shows the interplay of interest groups, discursive positions and administrative regimes, with new strategies emerging to counter the contracting state.