Public hospital reforms in China: towards a model of new public management?

Abstract

Purpose The purpose of this paper is to explore how far plans to “modernize” hospital management in China are converging toward a global model of new public management (NPM) or represent a distinctive pathway. Design/methodology/approach This paper draws on a systematic review of available secondary sources published in English and Chinese to describe both the nature and trajectory of hospital management reforms in China. Findings In China, while public hospital reforms bear many of the hallmarks of the NPM, they are distinctive in two key respects. First, the thrust of current reforms is to partially reverse, not extend, the trend toward marketization in order to strengthen the public orientation of public hospitals. Second is a marked gap between the rhetoric and reality of empowering managers and freeing them from political control. Practical implications This paper develops a framework for understanding the drivers and obstacles to hospital management reforms in China that is useful for managers, clinicians and policy makers. Originality/value In China, few authors have considered NPM reform in relation to healthcare. This paper contributes in better understanding current reforms taking place in China’s expanding healthcare sector and locates these within broader theoretical and policy debates.