The pertinence of new public management in a developing country: The healthcare system in Morocco

• Published date: 01 June 2018
• DOI: http://doi.org/10.1002/cjas.1417
• Author: Charles Emmanuelle Cargnello,Youssef Errami
• Date: 01 June 2018

The pertinence of new public management in a

developing country: The healthcare system in

Morocco

†

Youssef Errami*

Groupe ESC Pau, Université de Pau et des pays de l’Adour

Charles Emmanuelle Cargnello

Université de Pau et des pays de l’Adour

Abstract

Morocco has reformed its health systems according to the

New Public Management (NPM) model. Despite several

positive results of the refo, our account and analysis of

events related to the reform, as a chronological narrative

from 2002 to 2012, along with f‌indings of a qualitative study

and semi-structured interviews reveal organizational dys-

function alongside an increase in managerial problems.

The Moroccan case is symptomatic of situations in many de-

veloping countries. It raises questions about the relevance of

NMP in these countries and about the institutional prerequi-

sites for successful public reforms in particular. Copyright ©

2016 ASAC. Published by John Wiley & Sons, Ltd.

Keywords: health systems, reform, New Public Manage-

ment, neo-Weberian State model

Résumé

Le Maroc a enregistré ses réformes des systèmes de santé

dans le courant du Nouveau Management Public (NMP).

Malgré certains résultats positifs, l’analyse du relevé

d’événements liés à la réforme au cours de la période

2002–2012 sous la forme d’un récit chronologique

confrontée aux conclusions d’une étude qualitative par

entretiens semi-directifs dévoilent l’apparition et la repro-

duction de dysfonctionnements organisationnels et

l’amplif‌ication des problèmes managériaux. Le cas maro-

cain est symptomatique de situations rencontrées dans de

nombreux pays en développement. Il nous interroge sur la

pertinence du NMP dans ces pays et notamment sur les

prérequis institutionnels qu’il suppose pour la réussite des

réformes publiques engagées. Copyright © 2016 ASAC.

Published by John Wiley & Sons, Ltd.

Mots-clés : systèmes de santé, réforme, Nouveau Manage-

ment Public, modèle de l’État Néo-Wébérien.

There are three public reform models applied around the

world: New Public Management, the Neo-Weberian State

model, and New Public Governance (Pollitt & Bouckaert,

2011). Morocco has chosen to pilot New Public Manage-

ment in its government departments of health and f‌inance.

Since 2002, major institutional organizational and manage-

ment reform has been undertaken in Morocco’s healthcare

system. As in many developing countries, health policy

has become a priority in a country marked by patchy health

services and by considerable imbalances in care (in particu-

lar the discrepancies between the well-served urban centres,

and rural areas, where health services are nearly nonexis-

tent). Article 31 of the new constitution of the Kingdom of

Morocco, adopted in 2011, recognizes the right to health

and social protection as one of the fundamental rights of

its citizens. The restructuring of the healthcare system was

deemed critical, so that every user may derive the maximum

benef‌its from medical services. The system reforms were

also intended to increase economic eff‌iciency, since

Morocco, like many other countries, has seen health spend-

ing increase in diff‌icult economic times. The reforms clearly

introduce a political will to justify resource management,

with the rhetoric suggesting that public health goals and f‌is-

cal eff‌iciency will be possible only through signif‌icant orga-

nizational and management change. This assumption falls

under the rubric of “transformational change,”which, ac-

cording to Ferlie and FitzGerald (2002), implies multiple,

coordinated changes both horizontally, through the various

components of the public organization, and vertically, across

its various strata. However, the mobilized discourse suggests

†

This paper was reviewed and accepted in its original French and translated

upon acceptance.

*Please address correspondence to: Youssef Errami, Doyen de la faculté,

Groupe Ecole Supérieure de Commerce de Pau, Chercheur au CREG -

Université de Pau et des Pays de l’Adour, 3 rue Saint John Perse –64000

Pau, France. Email: youssef.errami@esc-pau.fr

Canadian Journal of Administrative Sciences

Revue canadienne des sciences de l’administration

35: 304–312 (2018)

Published online 27 November 2016 in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/CJAS.1417

Can J Adm Sci

35(2), 304–312 (2018)Copyright © 2016 ASAC. Published by John Wiley & Sons, Ltd. 304