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To introduce the articles in this special issue, discussing emotion in the in health‐care organisations.

Discusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff.

Health care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent.

The papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.

This article discusses the attempts by the National Health Service (NHS) to develop medical managers, following the introduction of general management in 1983. It suggests that problems have arisen because, so far, it has been organisational considerations and not those of individual career paths which have informed these developments. It is suggested that this new approach could lead to the development of the NHS as a learning organisation within the context of the original policy objectives.

Argues that there is a risk of alienating members of the new boards of the trusts in the reformed NHS, who are initially in sympathy with the ideas of reform but who, often successful in their own professions, expect to control the environment in which they operate. The increasing move towards centralist control works against the political rhetoric of decentralization and consumerism. This is exemplified in the cash releasing efficiency savings (CRES) mechanism.

In a recent research study of the effects of management training for doctors working in the UK National Health Service, it has become apparent that identifying the transition from doctor to manager does not involve just a change in skills, knowledge and attitudes to the differing roles of doctors and managers. Added validity is given to this change by an acceptance, on the part of the participating doctors, of the different research techniques required of management research, compared with the standard techniques used in the practice of medicine. Positivist versus phenomenological perspectives are compared in relation to the research process itself focusing on the triangulation of methods employed and their differing outcomes. The effectiveness of the various methods are then compared in relation to the research outcomes and the changes observed.

This paper looks at the current portrayal of emotion in healthcare as delivered within formal organisational settings, notably the UK National Health Service (NHS). Its purpose is to set out some examples of the problems and suggest new ways of conceptualising issues that will assist healthcare organisations in gaining a better understanding of the role of emotion and its impact, using appropriate examples. Developing understanding of the location of emotion and its differing constructions indicates that interdisciplinary and interpersonal boundaries differentiate interpretations of emotion, often for instrumental purpose as examples drawn particularly from the Public Inquiry into Paediatric Cardiology at Bristol Royal Infirmary (The Kennedy Report) demonstrate. The privileging of rationality over emotion as part of the dominant paradigm within the healthcare domain is shown to affect outcomes. However, the boundaries between organisations and individuals are changing, so are the location, access, technologies and timing of activities, and these are reconstructing healthcare organisation and the patient's experience of healthcare at both rational and emotional levels. It is suggested that in healthcare it is the patients’ journey through their lives (the macro context), as well as their individual encounters with the system at different times of need (the micro context), that iteratively constitute the construction of the emotional terrain. The conclusions drawn could have wider implications for the development of emotional understanding, across organisations that are subject to similar changes.

To describe the meaning of emotion.

Describes how emotion has recently become a popular concept for discussion, but it is not often recognised that human beings are, in essence, meaning‐creating creatures and that emotion is one of the forms of meaning they create.

What one experiences as “I”, “me”, “myself”, that is, one's sense of being a person, is a meaning‐structure, which has developed through one's interaction with one's environment. One's physiological make‐up is such that all the meanings are guesses about what is going on. Consequently the sense of being a person is always in danger of being invalidated by events. Emotions are meanings, which relate to the validation or invalidation of one's sense of being a person. It is necessary to survive both physically and as a person, but, if there is to be a choice between these two ways of surviving, one almost always chooses to survive as a person and let one's body go. This is seen in acts of heroism and in suicide.

Emphasises how the need to survive as a person is so important that children as young as 16 months are able to understand and respond to the emotional meanings of their parents and siblings even though they do not develop an intellectual understanding of the theory of mind until they are about four years old. All interactions between people in health‐care management involve validation and invalidation.

The need to understand chaos and complexity in organisations has particular importance for health which is bedevilled by the complexity of organisations and the sometimes chaotic nature of its core activities. This article seeks to explore these issues in the context of one of the key functions which is expected to hold together this diversity: Human Resource Management (HRM). An exploration of the nature of HRM in health care as it has evolved indicates that in order for it to have a pivotal role for the future it will need to rethink this role in the changing paradigm which is now emerging; in so doing it could develop as the organisational intelligence for health care in the future facilitating organisational learning and creativity.

Using current research into the management training of doctors in the UK, looks at some of the personal rather than just the organizational issues which arise from the development of doctors as managers. The variety of interpretations of the role raises a number of questions, some of which are highlighted: for example, the status of the management activity for doctors; the option of professional retreat from, or isolation in, difficult managerial roles; parttime management; disempowerment of other professionals; re‐entry needs to full‐time professional clinical work; women doctors as managers and the double‐ or even triple‐glazed ceilings which they face. Some positive trends are evident, e.g. the impact of successful female chief executives as role models, the impact of training, but no one solution has emerged and this trend itself is seen as encouraging, given the context of a complex and ever changing environment.