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The author offers a critical evaluation of new public management (NPM) policy in the United Kingdom over approximately two decades, applying paradoxical systems theory. Two fundamental polarities in public management are suggested: the first between centralization and accountability and decentralization and involvement; the second between rational choice and decision making and judgment and compromise. Combining these two paradoxical sets, the resulting four “types” represent the four paradoxical models that underpin the UK’s NPM: let the politicians decide, managers manage, customers choose, and stakeholders participate. The tensions between them will not go away; the only real issue is how best to manage these tensions.