Contemplating a challenging future: a public management approach to health services.

A varying proportion of health services in all societies is delivered by public sector institutions. Managing these public sector service institutions for performance represents a major management challenge. This management challenge is amplified for South Africa as a country which is contemplating major changes while being simultaneously confronted with having to cope with problematic results of the past and the challenges of development. In this article a public management model is used to analyse relevant health trends and provisional management strategies are provided to assist health managers to cope with these challenges. Finally a checklist for personal survival is presented for personal evaluation and future planning.