Healthcare reforms and restructuring have been a global phenomenon since the early 1980s. The major structural reforms in the healthcare system in New South Wales, Australia, heralded a new era in management responsibility and accountability. This book examines how reforms in the NSW Health public sector affected its senior executive workforce between 1990 and 1999 in terms of their roles and responsibilities, the competencies required, and the challenges they faced. It also provides indications of the managerial educational needs for future senior healthcare managers. Most significantly, the study has developed a clear analytical framework for understanding the pyramidal relationships between tasks, roles and competencies and piloted a new competency assessment approach for assessing the core competencies required by senior health managers. This book will be beneficial to healthcare managers and policy planners who are facing the challenges of constantly changing healthcare systems, and to academics involving in the provision of healthcare management training and education.".