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A critical account of the rise and spread of ‘leadership’: The case of UK healthcare

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  • Martin, Graham P.
  • Learmonth, Mark

Abstract

This paper considers the rise of ‘leadership’ in discourses relating to the British health service, and the application of the term to increasingly heterogeneous actors. Analysing interviews with NHS chief executives from the late 1990s, and key policy documents published since, we highlight how leadership has become a term of choice among policymakers, with positive cultural valences which previously predominant terms such as ‘management’ now lack. We note in particular how leadership is increasingly conferred not only on those in positions of formal power but on frontline clinicians, patients and even the public, and how not just the implementation but the design of policy is now constructed as being led by these groups. Such constructions of the distribution of power in the health service, however, contradict the picture drawn by academic work. We suggest, therefore, that part of the purpose of leadership discourse is to align the subjectivities of health-service stakeholders with policy intentions, making their implementation not just everyone’s responsibility, but part of everyone’s sense of self. Given the realities of organizational life for many of the subjects of leadership discourse, however, the extent to which leadership retains its current positive associations and ubiquity remains to be seen.

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  • Martin, Graham P. & Learmonth, Mark, 2012. "A critical account of the rise and spread of ‘leadership’: The case of UK healthcare," Social Science & Medicine, Elsevier, vol. 74(3), pages 281-288.
  • Handle: RePEc:eee:socmed:v:74:y:2012:i:3:p:281-288
    DOI: 10.1016/j.socscimed.2010.12.002
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    References listed on IDEAS

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    1. Hunter, David J., 1996. "The changing roles of health care personnel in health and health care management," Social Science & Medicine, Elsevier, vol. 43(5), pages 799-808, September.
    2. Jackie Ford & Nancy Harding & Mark Learmonth, 2008. "Leadership as Identity," Palgrave Macmillan Books, Palgrave Macmillan, number 978-0-230-58418-1, March.
    3. Jean Hartley & Maria Allison, 2000. "The Modernization and Improvement of Government and Public Services: The Role of Leadership in the Modernization and Improvement of Public Services," Public Money & Management, Taylor & Francis Journals, vol. 20(2), pages 35-40, April.
    4. Finn, Rachael & Learmonth, Mark & Reedy, Patrick, 2010. "Some unintended effects of teamwork in healthcare," Social Science & Medicine, Elsevier, vol. 70(8), pages 1148-1154, April.
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    Cited by:

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    2. Martin, Graham P. & Leslie, Myles & Minion, Joel & Willars, Janet & Dixon-Woods, Mary, 2013. "Between surveillance and subjectification: Professionals and the governance of quality and patient safety in English hospitals," Social Science & Medicine, Elsevier, vol. 99(C), pages 80-88.
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    4. Berghout, Mathilde A. & Oldenhof, Lieke & Fabbricotti, Isabelle N. & Hilders, Carina G.J.M., 2018. "Discursively framing physicians as leaders: Institutional work to reconfigure medical professionalism," Social Science & Medicine, Elsevier, vol. 212(C), pages 68-75.
    5. Jones, Lorelei & Exworthy, Mark, 2015. "Framing in policy processes: A case study from hospital planning in the National Health Service in England," Social Science & Medicine, Elsevier, vol. 124(C), pages 196-204.
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    7. McCabe Thomas Joseph & Sambrook Sally Anne, 2019. "A discourse analysis of managerialism and trust amongst nursing professionals," The Irish Journal of Management, Sciendo, vol. 38(1), pages 38-53, December.
    8. Cascón-Pereira, Rosalía & Chillas, Shiona & Hallier, Jerry, 2016. "Role-meanings as a critical factor in understanding doctor managers' identity work and different role identities," Social Science & Medicine, Elsevier, vol. 170(C), pages 18-25.

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