This text examines the confusion surrounding the concept of effectiveness; offers practical guidance to help managers explore their performance expectations; and illustrates how clarity of understanding can promote improved performance. It examines the assumptions behind terms such as "personal accountability", "clearly identifiable measures of performance" and, most notably, the belief that "effectiveness" is absolute and universal. It argues that effectiveness is a largely subjective and localized concept and that performance criteria and good managerial practice must be defined within the context of each organization. This is especially relevant for the transfer of ideas and practices from the private to the public sector. This book should be of interest to health-service managers, health professionals and students of business and management.