This paper examines the ‘modernising government' initiative in the UK, and the ‘flexibilities' – lead commissioning, integrated provision, and pooled budgets – introduced in the Health Act 1999. This policy reform, and the associated tools to operationalise it, placed ideas of...

This paper presents a challenge to public sector managers, policy makers and interested academics. In drawing off the findings of previous international comparative studies of New Public Financial Management (NPFM) reforms, it concludes that public services and their providers are caught in an...