MARKETIZATION, MANAGERS AND MORAL STRAIN - CHAIRMEN, DIRECTORS AND PUBLIC-SERVICE ETHOS IN THE NATIONAL-HEALTH-SERVICE

Survival of the public service ethos in Britain has been called into q uestion following introduction of the 'new public management' and mark etizing reforms in much of the public sector. This article examines ho w these developments have occurred in the NHS, using survey data to an alyse NHS board members' substantive ethical values. Unexpectedly the results suggest that NHS board members with a predominantly NHS backgr ound appear less ethically conservative, more flexible and less risk-a verse than those recruited from non-NHS backgrounds; and that as yet t he NHS management 'culture' is not very homogenous in respect of 'busi ness ethics'. The NHS reforms also appear to accentuate the tensions b etween transparent public accountability in NHS management and incenti ves not to publicize certain types of information. Recent codification of NHS 'business ethics' can be understood as an attempt to buttress the public set-vice ethos against the increased moral strains of a qua si-market.