The role of top managers in the public sector: evidence from the English NHS
File(s)
Author(s)
Propper, Carol
Sadun, Raffaella
Janke, Katharina
Type
Journal Article
Abstract
Governments have reformed public services by adopting private sector governance models that grant top directors greater autonomy, responsibility for meeting key targets, and performance-based rewards. We examine a central plank of this approach–that directors can impact the organizations they run–in the context of English public hospitals, complex organizations with multi-million turnover. Our findings reveal that top directors have at most modest effects on hospital production. In contrast, pay varies systematically between directors but is not correlated with their effect on performance. These findings suggest that transplanting private sector governance arrangements to large public hospitals may yield limited performance gains. (JEL H51, I11, L32, M12)
Date Acceptance
2026-07-15
Citation
Management science
ISSN
0025-1909
Publisher
Institute for Operations Research and Management Sciences
Journal / Book Title
Management science
Copyright Statement
Copyright This paper is embargoed until publication. Once published the author’s accepted manuscript will be made available under a CC-BY License in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy).
License URL
Publication Status
Accepted