The purpose of this paper is to explore a possible discursive history of National Health Service (NHS) “management” (with management, for reasons that will become evident, very…
Abstract
Purpose
The purpose of this paper is to explore a possible discursive history of National Health Service (NHS) “management” (with management, for reasons that will become evident, very much in scare quotes). Such a history is offered as a complement, as well as a counterpoint, to the more traditional approaches that have already been taken to the history of the issue.
Design/methodology/approach
Document analysis and interviews with UK NHS trust chief executives.
Findings
After explicating the assumptions of the method it suggests, through a range of empirical sources that the NHS has undergone an era of administration, an era of management and an era of leadership.
Research limitations/implications
The paper enables a recasting of the history of the NHS; in particular, the potential for such a discursive history to highlight the interests supported and denied by different representational practices.
Practical implications
Today’s so-called leaders are leaders because of conventional representational practices – not because of some essence about what they really are.
Social implications
New ideas about the nature of management.
Originality/value
The value of thinking in terms of what language does – rather than what it might represent.
Details
Keywords
The paper invites us to reconsider the processes at work in the conduct of qualitative interviews, especially in the context of management studies; it emphasises, in particular…
Abstract
Purpose
The paper invites us to reconsider the processes at work in the conduct of qualitative interviews, especially in the context of management studies; it emphasises, in particular, the paradoxes that arise from the inescapable interdependency between interviewer and interviewee.
Design/methodology/approach
The author reflects upon his own experiences of conducting interviews with managers whilst studying for a PhD, and suggests alternative ways of thinking about what goes on during such exchanges.
Findings
Interview techniques are not necessarily the neutral tools they might seem to be.
Originality/value
The deconstructive insights about interview processes provide a way of thinking about qualitative interview research that might be more consistent with the insights of certain “critical” management studies.
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Ryan MacNeil and Britanie Wentzell
Although a great deal has been written about the challenges and opportunities for collaboration between librarians and professors in higher education, most recommendations for…
Abstract
Although a great deal has been written about the challenges and opportunities for collaboration between librarians and professors in higher education, most recommendations for faculty–library collaboration are written by librarians, published in librarian-oriented venues, and rely on second-hand accounts of professorial perceptions and experiences. Dialogue between librarians and professors is missing. In this chapter, the authors present a duoethnographic inquiry into a librarian–professor collaboration: the authors collaboratively examine their four years working together on the senior seminar course “Small Business Management” at Acadia University, Canada. In considering the evolution of their course and their collaboration, the authors reflect on six dimensions of their experiences: the way their collaboration has shaped the course learning outcomes, the value the authors have derived from collaboratively reflexive teaching, the workload tensions the authors have navigated, the challenge of “fitting in,” and the role of library champion. The authors then conclude with four insights from their professorial–librarian collaboration that might be transferable to other contexts of higher education: the importance of openness, collegiality, time for collaboration, and attention to the cultural gaps between professorship and librarianship.
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Received wisdom about management and leadership in health care takes it for granted that better management is, by definition, a good thing. Aims to raise some doubts about this…
Abstract
Purpose
Received wisdom about management and leadership in health care takes it for granted that better management is, by definition, a good thing. Aims to raise some doubts about this received wisdom and suggest that perhaps better management may be unconditionally “better” for only a few people.
Design/methodology/approach
These doubts are raised mainly via accounts of the author's personal experiences of being a manager in the UK National Health Service.
Findings
Author's attraction to some parts of a body of literature called critical management studies is discussed that was subsequently used to make sense of these experiences.
Originality/value
The accounts are offered in the belief that they will be of interest to other people who are wrestling with their own ways of making sense of personal experiences in and around better management in health care.
Details
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Presents the results of a qualitative analysis of copies of The Hospital, a journal for UK hospital administrators, from 1946‐1948: immediately prior to the establishment of the…
Abstract
Presents the results of a qualitative analysis of copies of The Hospital, a journal for UK hospital administrators, from 1946‐1948: immediately prior to the establishment of the NHS. Characterises administrators in that period as kindly technicians. Analyses administrators’ ways of thinking; spheres of influence and level of education. Also notes their concern for the running of support services; their implicit and unexamined deference to medical staff and an explicit belief in the need to carry out their role with kindliness. Concludes by highlighting the changes in managerial thinking between the 1940s and today and speculates that these changes may be best understood, following Foucault, as phenomena of rupture and discontinuity rather than as linear progression.
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It is commonplace to talk of the UK's National Health Service (NHS) as having its inception in 1948 in an Act of Parliament which brought together many hundreds of widely…
Abstract
Purpose
It is commonplace to talk of the UK's National Health Service (NHS) as having its inception in 1948 in an Act of Parliament which brought together many hundreds of widely dispersed organisations into one, new organisation, “the” NHS. This paper aims to challenge the concept of “a” National Health Service and to argue that the (seeming) accomplishment of this “organisation” is the daily task of health managers.
Design/methodology/approach
The paper develops a theoretically‐based analysis of how an “organisation” is accomplished through ongoing processes of construction. First, critiques of the ontological status of this thing called “organisation” are considered. Then Laclau and Mouffe's discourse theory of political action, inspired by Derrida and Gramsci is used, to try to understand this apparent “thing” and the work of those charged with its management.
Findings
There has been little application of this theoretical perspective to understanding management in general and health management in particular but, given the highly politicised nature of health management, their theoretical perspective seems more than apposite. Application of Laclau and Mouffe's theory to the NHS leads to the conclusion that there is no such “thing” as the NHS. There is, rather, a presumption of the thingness of the NHS and one of the major tasks of managers working “within” this organisation is to achieve this sense of thingness.
Research limitations/implications
This is “work in progress” – these ideas continue to evolve, but feedback from readers is necessary.
Originality/value
This is the first time that Laclau and Mouffe's work has been used to analyse health organizations. The value of the paper is mostly for people working to develop critically‐informed understandings of how organizations work.