Public management reform and citizen perceptions of the UK health system

The United Kingdom (UK) instituted a performance framework for the National Health Service (NHS) in the late 1990s that, inspired by the New Public Management (NPM), employed performance measurement and management in an effort to improve the quality of health services to citizens, in addition to realizing efficiency goals. Using data from the 1996 and 2002 Eurobarometer and a difference in differences analytical approach, we evaluate the impacts of these performance reforms by comparing the UK to other European Union countries in terms of overall citizen satisfaction with the health care system and perceptions of how well the health care system performs. In general, our results suggest that citizen satisfaction and performance perceptions in the UK were more favorable after the reforms than what would have occurred, absent the implementation of the reforms. The estimated improvement in satisfaction and perceived performance is both statistically and substantively significant, and thus provides evidence that the UK's NPM-inspired performance framework did accomplish at least some of its goals.