The Impact of CEOs in the Public Sector: Evidence from the English NHS

by Katharina Janke, Carol Propper, and Raffaella Sadun

Overview — To what extent do CEOs impact their organizations? This study finds little consistent evidence of any CEO effect on the large set of production metrics examined in hospitals averaging 4,500 employees in the English National Health Service. This result stands in stark contrast with earlier findings of a CEO effect in the private sector and smaller public sector organizations.

Author Abstract

We investigate whether top managers affect the performance of large public sector organizations. As our case study we examine CEOs of English public hospitals, which are large, complex organizations with multi-million turnover. We study the impact of individual CEOs on a wide set of measures of hospital performance, intermediate operational outcomes and inputs. We adopt two econometric approaches: a parametric approach that exploits the movement of CEOs across different hospitals and a non-parametric difference-in-difference matching estimator. Overall, we find little evidence that individual CEOs have an impact on a large set of measures of hospital performance. This result is not due to the allocation of good performers to poorly performing hospitals.

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