While service quality has received considerable attention over the pas
t decade, there is a relative dearth of research into service initiati
ves in the public sector. Similarly, relatively little attention has b
een given to the service quality of professional services. This paper
looks at a service initiative in the public health sector. Particular
attention is paid to the service quality of medical professionals. We
argue that the historical and environmental contexts within which qual
ity initiatives operate differ fundamentally between commercial and pu
blic sector organizations. Me illustrate this by looking at a quality
initiative in the Irish health sector. A series of in-depth interviews
provide the basis for a discussion of the antecedents of service qual
ity initiatives in the health sector in the 1990s. We also chart the e
mergence of a managerial quality model which we present in the context
of power relations between medical professionals and hospital manager
s.