1: Clinical Leadership in Context: New Public Management, Horizons of the ‘New Normal’, and Corporatisation of Health Organisations

Health system security and health organisation sustainability have dominated the public debate for the past 30 years (1). The new public management approach many European countries implemented in the 1990s placed emphasis on the financial management of healthcare organisations. Finances came under closer scrutiny, and austerity measures were widely adopted in the aftermath of the 2008 recession.

Though of no surprise – primum vivere, deinde philosophari – according to the Romans, the predominance of economics led to a cultural shift, an inversion of ends and means, in which cost management was ‘the one and only issue’. As a consequence, healthcare systems and organisations were often reconfigured, transformed, downsized, merged, redesigned and streamlined in an effort to improve their cost management capacity, and basically to reduce costs.