The Introduction of General Management in the NHS: An Example of Managed Social Change

As has been discussed, until 1984 the NHS had two unusual organizational characteristics: the national uniformity of its senior management structures, and the practice of ‘consensus management’. Just as the dust of the NHS’s second major reorganization was beginning to settle, what was seen by the government as the inability of the NHS management to achieve significant improvements in cost containment or unit management was cited by Minister Norman Fowler as evidence of the need for further change. Four leading businessmen were to conduct an independent management inquiry into the: … effective use and management of manpower and related resources in the NHS from professional managers with experience in other large organizations. (DHSS 1983 NHS Management Inquiry; Press Release No. 83/30 3 February) This chapter considers the details of this inquiry, known as the Griffiths Report. It examines the critique of the NHS as developed in this Report, the Griffiths recommendations for the NHS and the reactions to the Report from the various groups who work in the NHS. As an example of managed social change, the Griffiths Report offers an opportunity to explore the relevance of Eliasian or process sociology to understanding such processes of managed social change.