9 NHS managers at a crossroads: part of the problem or the solution?
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Ian Kirkpatrick
Abstract
A view shared by many politicians and parts of the media is that the NHS employs too many managers and back room administrators, soaking up resources, stifling creativity and interfering with the work of frontline clinicians. Essentially, managers have become part of the problem. In this chapter, I critically assess these claims, drawing on the latest evidence. Following a discussion of terminology, I provide a brief overview of historical attempts to develop specialised management functions in the NHS and the origins of recent critiques. Drawing on organisational theory and the available research, I then raise questions about three primary assumptions: a) that the NHS is over-managed; b) that managers are a rent seeking and self-serving elite; and c) that managers and administrators are an unproductive overhead. A key conclusion is that, in light of the mounting evidence, it is necessary to take more seriously the need to develop managers as an occupation in the NHS and to recognise their potential to help improve the service in future.
Abstract
A view shared by many politicians and parts of the media is that the NHS employs too many managers and back room administrators, soaking up resources, stifling creativity and interfering with the work of frontline clinicians. Essentially, managers have become part of the problem. In this chapter, I critically assess these claims, drawing on the latest evidence. Following a discussion of terminology, I provide a brief overview of historical attempts to develop specialised management functions in the NHS and the origins of recent critiques. Drawing on organisational theory and the available research, I then raise questions about three primary assumptions: a) that the NHS is over-managed; b) that managers are a rent seeking and self-serving elite; and c) that managers and administrators are an unproductive overhead. A key conclusion is that, in light of the mounting evidence, it is necessary to take more seriously the need to develop managers as an occupation in the NHS and to recognise their potential to help improve the service in future.
Chapters in this book
- Front Matter i
- Contents v
- List of figures and tables vii
- Notes on contributors viii
- Foreword x
- The NHS at 75: an unfolding story 1
- NHS governance: the centre claims authority 21
- Health and care funding at 75 40
- The devolved nations 71
- NHS at 75: general practice through the lens of access 90
- NHS hospitals and the bedpan doctrine: the first 75 years 112
- Quality and the NHS: fair-weather friends or a longstanding relationship? 136
- Improving health and tackling health inequalities: what role for the NHS? 157
- NHS managers at a crossroads: part of the problem or the solution? 177
- Forgotten, neglected and a poor relation? Reflecting on the 75th anniversary of adult social care 197
- The NHS at 75 in comparative perspective 216
- Our NHS? The changing involvement of patients and the public in England’s health and care system 232
- After 75 years, whither the NHS? Some conclusions 253
- Index 270
Chapters in this book
- Front Matter i
- Contents v
- List of figures and tables vii
- Notes on contributors viii
- Foreword x
- The NHS at 75: an unfolding story 1
- NHS governance: the centre claims authority 21
- Health and care funding at 75 40
- The devolved nations 71
- NHS at 75: general practice through the lens of access 90
- NHS hospitals and the bedpan doctrine: the first 75 years 112
- Quality and the NHS: fair-weather friends or a longstanding relationship? 136
- Improving health and tackling health inequalities: what role for the NHS? 157
- NHS managers at a crossroads: part of the problem or the solution? 177
- Forgotten, neglected and a poor relation? Reflecting on the 75th anniversary of adult social care 197
- The NHS at 75 in comparative perspective 216
- Our NHS? The changing involvement of patients and the public in England’s health and care system 232
- After 75 years, whither the NHS? Some conclusions 253
- Index 270
