A review of rural health restructuring in the New South Wales.

In 1993 the delivery of rural health services in New South Wales was restructured by the establishment of 23 district health services with the aims of diverting resources from administration to clinical services and enhancing decision-making at the local level. Implementation of the restructuring in its infancy was examined by structured interviews conducted with five general managers and 15 of their second-tier appointees. The organisational structure of the districts, the managerial attributes required of senior staff and approaches to change were emphasised. Political constraints on organisational decision-making such as organisational design were acknowledged and the importance accorded to demonstrable achievement in managing change and incorporating consultative techniques was recognised.