The article analyzes changes in the UK public services, focusing on the restructured NHS. It looks at how private sector models have been applied, how change is managed, and how roles have shifted. The authors question if a New Public Management approach has emerged and if it has international significance. They explore the nature of change in UK public services, the rise of quasi markets, and the evolving roles of local Boards and professionals. The article also delves into the issue of accountability and contributes to the development of a theory of New Public Management.