This dissertation focuses on the impact of the restructuring of the Irish health system on the performance ofa· hospital. The general context of the research relates to the modernisation of public services, in particular health services, and the impact of resulting changes on managers and consultants. The theoretic perspectives inform the nature of the modern welfare state in the p.rovision of public services, health policy. formulatiQn and implementation; organisational design and organisational change; and the tensions that exist between managerial and professional staff. The methodology used generated multiple data streams - quantitative data on corporate and hospital performance pre and post restructuring and qualitative data provided a narrative on the impact of restructuring on the hospital, as perceived by consultants and managers. The findings show that the change expected by staff did not materialise and that the performance of the hospital, in terms of output, cannot be said to have been influenced by general organisational changes. However, bureaucratic changes imposed by the· new corporate management did cause irritation at hospital level and a loss of overall corporate reputation. The research also demonstrate~ that organisation type needs. to be factored into the design· of. national. reform· and transformational programmes if they are to be successfully implemented i.e. if the desired behaviour changes at hospital level are to be achieved and the services delivered by the hospital are to be improved. Some recommendations for future research are made.