The Rational Actor Reform Paradigm

This paper discusses the impact of an important trend in service delivery in response to the substantial pressures that now face European welfare states: the New Public Management, combining centrally imposed targets and the promotion of market systems within state services. It traces the logic underlying the reform back to the rational self-regarding actor theories of human behaviour of the Enlightenment. Using the example of the UK NHS, recently reformed in a way that follows the rational actor paradigm, it considers the impact on long-term public trust.