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Managerial Values and Rationality in the UK National Health Service

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  • Alistair Hewison

Abstract

The reforms of the National Health Service arising from the White Paper Working for Patients , were predicated on a particular view of management and the implementation of the changes heralded by this act relied heavily on the actions of the managers charged with carrying them through. This article reports on work undertaken to discover how middle managers responded to this challenge. The views of middle managers concerning the values that guide their work are explored in the context of managing in the reformed NHS. Data were collected by means of a focused ethnography and analysed thematically. This process was informed, in part, by recourse to Weber's conceptualization of rationality. It was found that managers are struggling to reconcile the demands inherent in their role that arise from contrasting and often competing rationalities, which is a reflection of conflict over priorities in the wider health policy environment.

Suggested Citation

  • Alistair Hewison, 2002. "Managerial Values and Rationality in the UK National Health Service," Public Management Review, Taylor & Francis Journals, vol. 4(4), pages 549-579, January.
    • Handle: RePEc:taf:pubmgr:v:4:y:2002:i:4:p:549-579
    DOI: 10.1080/14616670210164762
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    1. David Farnham & Sylvia Horton, 1993. "The Political Economy of Public Sector Change," Palgrave Macmillan Books, in: David Farnham & Sylvia Horton (ed.), Managing the New Public Services, chapter 1, pages 3-26, Palgrave Macmillan.
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    Cited by:

    1. Julia Segar & Kath Checkland & Anna Coleman & Imelda McDermott & Stephen Harrison & Stephen Peckham, 2014. "Changing the Ties That Bind? The Emerging Roles and Identities of General Practitioners and Managers in the New Clinical Commissioning Groups in the English NHS," SAGE Open, , vol. 4(4), pages 21582440145, October.

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