Analysing changes in the nature of health service management in England

Health service management maintains a balance between collective values concerned with service provision and individual values concerned with health practice. It is also balanced between the application of co-ordinative and directive approaches to management. Over the last quarter century economic and ideological factors have caused health service management to experience more directive. Today, the role of health service management becoming more directive. Today, the role of health service management appears further threatened by staffing cuts and changes in traditional patterns of organising work. This, while it may lead to bifurcation between specialist and general management roles, is unlikely to restore the dominance of practitioner values or notably soften the form of management.