The rational actor reform paradigm: delivering the goods but destroying public trust?

This paper discusses the impact of an important trend in service delivery in response to 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.

The puzzle with the NHS reform is why, despite the fact that objective service standards have improved in a number of prominent areas, public satisfaction with and trust in the service has declined abruptly. Discussion of theories of trust across a range of social science and of attitude survey data indicates that the answer lies in the nature of trust. Trust involves both rational and value components and the reforms do everything fort the former and nothing for the later. The risk for social quality is that new policies driven by a rational actor logic much favoured by Treasury departments, undermine the value side of trust and lead to a deterioration in public support for state welfare.