Are public sector managers a ‘bureaucratic burden’? The case of English public hospitals

Although managers are, globally, a central part of the new public management reform agenda, in recent years, policy makers and the media have raised concerns about their effectiveness and contribution. In some countries, notably the United Kingdom and the United States, this debate has been heavily influenced by Public Choice Theory (PCT), which depicts “bureaucrats” as rent seeking, self-serving individuals. In this study, focusing on the case of acute care hospital trusts in the English National Health Service, we formally test whether public sector managers represent a “bureaucratic burden.” Using a longitudinal database spanning six years (2007–2012) and employing a dynamic panel data model, the findings reveal that, contrary to PCT assumptions, managers do not engage, in the main, in rent seeking behavior and, crucially, appear to have a positive impact on organizational performance. Implications for theory, policy, and practice are discussed.